Effect Of Evidence-Based Nursing Practices Training Programme on the Competency of Nurses Caring for Mechanically Ventilated Patients
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Abstract
Evidence-Based Practice (EBP) is globally recognized as a standard approach to improving healthcare quality and patient outcomes. Nurses, particularly those in Intensive Care Units (ICUs), play a crucial role in implementing EBP. Therefore, this study aims to assess the impact of an adapted evidence-based nursing practices training program on the competency of nurses caring for mechanically ventilated patients.
Methods: A prospective open-label parallel 1:1 controlled trial was conducted involving 80 nurses from the National Hepatology and Tropical Medicine Research Institute, , caring for ICU patients. The trial, registered under NCT05721664, took place between November 2022 and February 2023. Nurses were randomly assigned to either the intervention group, receiving the evidence-based nursing practice training program (EBNPTP) based on the Johns Hopkins EBP conceptual model, or the control group, receiving traditional in-service education. Four assessments (one pre- and three post-assessments) were conducted using the adapted evidence-based nursing competency assessment checklist to measure competency levels over time. The primary outcome was an increase in competency levels among nurses caring for mechanically ventilated patients.
Results: Statistically significant differences were observed between the intervention and control groups in terms of competency levels across the three post-assessments (p <.001). However, competency levels declined significantly over time (p <.001). A significant correlation was found between nurses' pre-assessment scores, educational level, and the third endpoint assessment (p <.01), as determined by multiple linear regression.
Conclusion: The EBP training program led to a significant increase in nurses' competency compared to traditional education. This emphasizes the importance of training nurses in EBP skills to enhance competency and improve patient care. However, sustaining EBP adoption in the long term requires further investigation into influencing factors.
References
1. Saunders, H., & Vehviläinen-Julkunen, K. Key considerations for selecting instruments when evaluating healthcare professionals’ evidence‐based practice competencies: a discussion paper. Journal of Advanced Nursing, 74, 2301–11.
2. American Nurses Association (ANA). What is evidence-based practice in nursing? Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/
3. Davies, C., Lyons, C., & Whyte, R. Optimizing nursing time in a day care unit: quality improvement using lean six sigma methodology. International Journal of Quality Health Care, 31(Supplement1), 22–8.
4. Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. Johns Hopkins evidence-based practice for nurses and healthcare professionals: model and guidelines. Sigma Theta Tau, 2021.
5. Nightingale, F. Notes on matters affecting the health, efficiency and hospital administration of the British Army… by Florence Nightingale… Harrison and Sons, 1858.
6. D’Souza, P., George, A., Noronha, J., & Renjith, V. Integration of evidence-based practice in nursing education: a novel approach, 2015.
7. Bassford, C. Decisions regarding admission to the ICU and international initiatives to improve the decision-making process. Critical Care, 21, 1–3.
8. Jung, Y. T., Kim, M. J., Lee, J. G., & Lee, S. H. Predictors of early weaning failure from mechanical ventilation in critically ill patients after emergency gastrointestinal surgery: a retrospective study. Medicine, 97.
9. Kobayashi, H., Uchino, S., Takinami, M., & Uezono, S. The impact of ventilator-associated events in critically ill subjects with prolonged mechanical ventilation. Respiratory Care, 62, 1379–86.
10. Fathy, A., Abdelhafeez, R., Abdel-Hady, E-G., & Abd Elhafez, S. A. Analysis of ventilator associated pneumonia (VAP) studies in Egyptian University hospitals. Egypt Journal of Chest Diseases and Tuberculosis, 62, 17–25.
11. Elkolaly, R. M., Bahr, H. M., El-Shafey, B. I., Basuoni, A. S., & Elber, E. H. Incidence of ventilator-associated pneumonia: Egyptian study. Egypt Journal of Bronchology, 13, 258–66.
12. Kollef, M. H., Chastre, J., Fagon, J. Y., François, B., Niederman, M. S., Rello, J., et al. Global prospective epidemiologic and surveillance study of ventilator-associated pneumonia due to pseudomonas aeruginosa. Critical Care Medicine, 42, 2178–87.
13. Xie, J., Yang, Y., Huang, Y., Kang, Y., Xu, Y., Ma, X., et al. The current epidemiological landscape of ventilator-associated pneumonia in the intensive care unit: a multicenter prospective observational study in China. Clinical Infectious Diseases, 67 suppl2, S153–61.
14. Galal, Y. S., Youssef, M. R. L., & Ibrahiem, S. K. Ventilator-associated pneumonia: incidence, risk factors and outcome in paediatric intensive care units at Cairo University Hospital. Journal of Clinical and Diagnostic Research, 10, SC06.
15. Karakuzu, Z., Iscimen, R., Akalin, H., Girgin, N. K., Kahveci, F., & Sinirtas, M. Prognostic risk factors in ventilator-associated pneumonia. Medical Science Monitor, 24, 1321.
16. Liu, M., Lin, Y., Dai, Y., Deng, Y., Chun, X., Lv, Y., et al. A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: development, implementation, and preliminary outcomes. Nurse Education in Practice, 52, 102964.
17. Meligy, B. S., Kamal, S., & El Sherbini, S. A. Mechanical ventilation practice in Egyptian pediatric intensive care units. Electronic Physician, 9, 4370.
18. Abdelhafez, A. I., & Tolba, A. A. Nurses’ practices and obstacles to oral care quality in intensive care units in Upper Egypt. Nursing in Critical Care.
19. Gunawan, N. P. I. N., Hariyati, R. T. S., & Gayatri, D. Motivation as a factor affecting nurse performance in regional general hospitals: a factors analysis. Enfermería Clínica, 29, 515–20.
20. TEAL Center Fact Sheet No. 11: Adult Learning Theories| Adult Education and Literacy| U.S. Department of Education. Retrieved from https://lincs.ed.gov/state-resources/federal-initiatives/teal/guide/adultlearning.
21. Chan, A. W., Tetzlaff, J. M., Altman, D. G., Laupacis, A., Gøtzsche, P. C., Krleža-Jerić, K., et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Annals of Internal Medicine, 158, 200–7.
22. Schulz, K. F., Altman, D. G., & Moher, D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials.
23. Behzadi, F., Khanjari, S., & Haghani, H. Impact of an education program on the performance of nurses in providing oral care for mechanically ventilated children. Australian Critical Care, 32, 307–13.
24. AACN Levels of Evidence - AACN. Retrieved from https://www.aacn.org/clinical-resources/practice-alerts/aacn-levels-of-evidence.
25. Mussa, C. C., Gomaa, D., Rowley, D. D., Schmidt, U., Ginier, E., & Strickland, S. L. AARC clinical practice guideline: management of adult patients with tracheostomy in the acute care setting. Respiratory Care, 66, 156–69.
26. Boltey, E., Yakusheva, O., Kelly Costa, D., & Michigan, A. A. 5 nursing strategies to prevent ventilator-associated pneumonia. American Nurse Today, 12.
27. Smith, V., Devane, D., Nichol, A., & Roche, D. Care bundles for improving outcomes in patients with COVID-19 or related conditions in intensive care– a rapid scoping review.
28. Lawshe, C. H. A quantitative approach to content validity. Personnel Psychology, 28, 563–75.
29. Gallagher-Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. The effects of an intensive evidence‐based practice educational and skills building program on EBP competency and attributes. Worldviews on Evidence-Based Nursing, 17, 71–81.
30. Kim, J. S., Gu, M. O., & Chang, H. Effects of an evidence-based practice education program using multifaceted interventions: a quasi-experimental study with undergraduate nursing students. BMC Medical Education, 19, 1–10.
31. Melnyk, B. M., & Fineout-Overholt, E. Evidence-based practice in nursing & healthcare: a guide to best practice.
32. van der Goot, W. E., Keers, J. C., Kuipers, R., Nieweg, R. M. B., & de Groot, M. The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: a cohort study. Nurse Education Today, 63, 6–11.
33. Lee, C. Y., Wang, W. F., & Chang, Y. J. The effects of evidence-based nursing training program on nurses’ knowledge, attitude, and behavior. New Taipei Journal of Nursing, 13, 19–31.
34. Chu, T-L., Wang, J., Monrouxe, L., Sung, Y-C., Kuo, C., & Ho, L-H., et al. The effects of the flipped classroom in teaching evidence based nursing: a quasi-experimental study. PLoS ONE, 14, e0210606.
35. Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M., & Denis, J. Nursing unit leaders’ influence on the long-term sustainability of evidence‐based practice improvements. Journal of Nursing Management, 24, 309–18.
36. Gorsuch, C. (ret) P. F., Gallagher Ford, L., Koshy Thomas, B., Melnyk, B. M., & Connor, L. Impact of a formal educational skill-building program based on the ARCC model to enhance evidence‐based practice competency in nurse teams. Worldviews on Evidence-Based Nursing, 17, 258–68.
37. Ramos-Morcillo, A. J., Fernández‐Salazar, S., Ruzafa‐Martínez, M., & Del‐Pino‐Casado, R. Effectiveness of a brief, basic evidence‐based practice course for clinical nurses. Worldviews on Evidence-Based Nursing, 12, 199–207.
38. Hashish, A., Aly, E., & Alsayed, S. Evidence-based practice and its relationship to quality improvement: a cross-sectional study among Egyptian nurses. Open Nursing Journal.
39. Bellizzi, S., & Padrini, S. Report of the satisfaction survey amongst public health services nurses in Port Said. BMC Nursing, 20, 1–5.
40. Al-Busaidi, I. S., Al Suleimani, S. Z., Dupo, J. U., Al Sulaimi, N. K., & Nair, V. G. Nurses’ knowledge, attitudes, and implementation of evidence-based practice in Oman: a multi-institutional, cross-sectional study. Oman Medical Journal, 34, 521.
41. Stokke, K., Olsen, N. R., Espehaug, B., & Nortvedt, M. W. Evidence based practice beliefs and implementation among nurses: a cross-sectional study. BMC Nursing, 13, 1–10.
42. Mlambo, M., Silén, C., & McGrath, C. Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nursing, 20, 1–13.
2. American Nurses Association (ANA). What is evidence-based practice in nursing? Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/evidence-based-practice-in-nursing/
3. Davies, C., Lyons, C., & Whyte, R. Optimizing nursing time in a day care unit: quality improvement using lean six sigma methodology. International Journal of Quality Health Care, 31(Supplement1), 22–8.
4. Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. Johns Hopkins evidence-based practice for nurses and healthcare professionals: model and guidelines. Sigma Theta Tau, 2021.
5. Nightingale, F. Notes on matters affecting the health, efficiency and hospital administration of the British Army… by Florence Nightingale… Harrison and Sons, 1858.
6. D’Souza, P., George, A., Noronha, J., & Renjith, V. Integration of evidence-based practice in nursing education: a novel approach, 2015.
7. Bassford, C. Decisions regarding admission to the ICU and international initiatives to improve the decision-making process. Critical Care, 21, 1–3.
8. Jung, Y. T., Kim, M. J., Lee, J. G., & Lee, S. H. Predictors of early weaning failure from mechanical ventilation in critically ill patients after emergency gastrointestinal surgery: a retrospective study. Medicine, 97.
9. Kobayashi, H., Uchino, S., Takinami, M., & Uezono, S. The impact of ventilator-associated events in critically ill subjects with prolonged mechanical ventilation. Respiratory Care, 62, 1379–86.
10. Fathy, A., Abdelhafeez, R., Abdel-Hady, E-G., & Abd Elhafez, S. A. Analysis of ventilator associated pneumonia (VAP) studies in Egyptian University hospitals. Egypt Journal of Chest Diseases and Tuberculosis, 62, 17–25.
11. Elkolaly, R. M., Bahr, H. M., El-Shafey, B. I., Basuoni, A. S., & Elber, E. H. Incidence of ventilator-associated pneumonia: Egyptian study. Egypt Journal of Bronchology, 13, 258–66.
12. Kollef, M. H., Chastre, J., Fagon, J. Y., François, B., Niederman, M. S., Rello, J., et al. Global prospective epidemiologic and surveillance study of ventilator-associated pneumonia due to pseudomonas aeruginosa. Critical Care Medicine, 42, 2178–87.
13. Xie, J., Yang, Y., Huang, Y., Kang, Y., Xu, Y., Ma, X., et al. The current epidemiological landscape of ventilator-associated pneumonia in the intensive care unit: a multicenter prospective observational study in China. Clinical Infectious Diseases, 67 suppl2, S153–61.
14. Galal, Y. S., Youssef, M. R. L., & Ibrahiem, S. K. Ventilator-associated pneumonia: incidence, risk factors and outcome in paediatric intensive care units at Cairo University Hospital. Journal of Clinical and Diagnostic Research, 10, SC06.
15. Karakuzu, Z., Iscimen, R., Akalin, H., Girgin, N. K., Kahveci, F., & Sinirtas, M. Prognostic risk factors in ventilator-associated pneumonia. Medical Science Monitor, 24, 1321.
16. Liu, M., Lin, Y., Dai, Y., Deng, Y., Chun, X., Lv, Y., et al. A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: development, implementation, and preliminary outcomes. Nurse Education in Practice, 52, 102964.
17. Meligy, B. S., Kamal, S., & El Sherbini, S. A. Mechanical ventilation practice in Egyptian pediatric intensive care units. Electronic Physician, 9, 4370.
18. Abdelhafez, A. I., & Tolba, A. A. Nurses’ practices and obstacles to oral care quality in intensive care units in Upper Egypt. Nursing in Critical Care.
19. Gunawan, N. P. I. N., Hariyati, R. T. S., & Gayatri, D. Motivation as a factor affecting nurse performance in regional general hospitals: a factors analysis. Enfermería Clínica, 29, 515–20.
20. TEAL Center Fact Sheet No. 11: Adult Learning Theories| Adult Education and Literacy| U.S. Department of Education. Retrieved from https://lincs.ed.gov/state-resources/federal-initiatives/teal/guide/adultlearning.
21. Chan, A. W., Tetzlaff, J. M., Altman, D. G., Laupacis, A., Gøtzsche, P. C., Krleža-Jerić, K., et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Annals of Internal Medicine, 158, 200–7.
22. Schulz, K. F., Altman, D. G., & Moher, D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials.
23. Behzadi, F., Khanjari, S., & Haghani, H. Impact of an education program on the performance of nurses in providing oral care for mechanically ventilated children. Australian Critical Care, 32, 307–13.
24. AACN Levels of Evidence - AACN. Retrieved from https://www.aacn.org/clinical-resources/practice-alerts/aacn-levels-of-evidence.
25. Mussa, C. C., Gomaa, D., Rowley, D. D., Schmidt, U., Ginier, E., & Strickland, S. L. AARC clinical practice guideline: management of adult patients with tracheostomy in the acute care setting. Respiratory Care, 66, 156–69.
26. Boltey, E., Yakusheva, O., Kelly Costa, D., & Michigan, A. A. 5 nursing strategies to prevent ventilator-associated pneumonia. American Nurse Today, 12.
27. Smith, V., Devane, D., Nichol, A., & Roche, D. Care bundles for improving outcomes in patients with COVID-19 or related conditions in intensive care– a rapid scoping review.
28. Lawshe, C. H. A quantitative approach to content validity. Personnel Psychology, 28, 563–75.
29. Gallagher-Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. The effects of an intensive evidence‐based practice educational and skills building program on EBP competency and attributes. Worldviews on Evidence-Based Nursing, 17, 71–81.
30. Kim, J. S., Gu, M. O., & Chang, H. Effects of an evidence-based practice education program using multifaceted interventions: a quasi-experimental study with undergraduate nursing students. BMC Medical Education, 19, 1–10.
31. Melnyk, B. M., & Fineout-Overholt, E. Evidence-based practice in nursing & healthcare: a guide to best practice.
32. van der Goot, W. E., Keers, J. C., Kuipers, R., Nieweg, R. M. B., & de Groot, M. The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: a cohort study. Nurse Education Today, 63, 6–11.
33. Lee, C. Y., Wang, W. F., & Chang, Y. J. The effects of evidence-based nursing training program on nurses’ knowledge, attitude, and behavior. New Taipei Journal of Nursing, 13, 19–31.
34. Chu, T-L., Wang, J., Monrouxe, L., Sung, Y-C., Kuo, C., & Ho, L-H., et al. The effects of the flipped classroom in teaching evidence based nursing: a quasi-experimental study. PLoS ONE, 14, e0210606.
35. Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M., & Denis, J. Nursing unit leaders’ influence on the long-term sustainability of evidence‐based practice improvements. Journal of Nursing Management, 24, 309–18.
36. Gorsuch, C. (ret) P. F., Gallagher Ford, L., Koshy Thomas, B., Melnyk, B. M., & Connor, L. Impact of a formal educational skill-building program based on the ARCC model to enhance evidence‐based practice competency in nurse teams. Worldviews on Evidence-Based Nursing, 17, 258–68.
37. Ramos-Morcillo, A. J., Fernández‐Salazar, S., Ruzafa‐Martínez, M., & Del‐Pino‐Casado, R. Effectiveness of a brief, basic evidence‐based practice course for clinical nurses. Worldviews on Evidence-Based Nursing, 12, 199–207.
38. Hashish, A., Aly, E., & Alsayed, S. Evidence-based practice and its relationship to quality improvement: a cross-sectional study among Egyptian nurses. Open Nursing Journal.
39. Bellizzi, S., & Padrini, S. Report of the satisfaction survey amongst public health services nurses in Port Said. BMC Nursing, 20, 1–5.
40. Al-Busaidi, I. S., Al Suleimani, S. Z., Dupo, J. U., Al Sulaimi, N. K., & Nair, V. G. Nurses’ knowledge, attitudes, and implementation of evidence-based practice in Oman: a multi-institutional, cross-sectional study. Oman Medical Journal, 34, 521.
41. Stokke, K., Olsen, N. R., Espehaug, B., & Nortvedt, M. W. Evidence based practice beliefs and implementation among nurses: a cross-sectional study. BMC Nursing, 13, 1–10.
42. Mlambo, M., Silén, C., & McGrath, C. Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nursing, 20, 1–13.
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Dec 19, 2022
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Yousif Ghafel Latif Aldhafeeri, Jarallah Sawadi Rheel Aldhafeeri, Mohammad Fahhat Solabi Alenazi, Khaled Abdullah Soliman Alzabni, Ahmad Fahad Latif Aldhafeeri, Abdullah Haif Onaiber Aldhafeeri, Abdullaziz Hajjaj Onaiber Aldhafeeri. (2022). Effect Of Evidence-Based Nursing Practices Training Programme on the Competency of Nurses Caring for Mechanically Ventilated Patients. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1029-1037. https://doi.org/10.53555/jptcp.v29i04.5649
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Yousif Ghafel Latif Aldhafeeri, Jarallah Sawadi Rheel Aldhafeeri, Mohammad Fahhat Solabi Alenazi, Khaled Abdullah Soliman Alzabni, Ahmad Fahad Latif Aldhafeeri, Abdullah Haif Onaiber Aldhafeeri, Abdullaziz Hajjaj Onaiber Aldhafeeri. (2022). Effect Of Evidence-Based Nursing Practices Training Programme on the Competency of Nurses Caring for Mechanically Ventilated Patients. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1029-1037. https://doi.org/10.53555/jptcp.v29i04.5649