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| Name | Class |
|---|---|
| Ohio State University | OTHER |
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The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. While magnet facilities require a commitment to evidence-based nursing practice, military facilities currently lack such a requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful path toward developing high-reliability organizations. Currently, little is known regarding the effectiveness of specific EBP models and frameworks within the military culture. The purpose of this investigation is to determine the effectiveness of the Advancing Research and Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment Facility (MTF) beginning with nursing services.
Research questions:
This study includes an intervention group (n=70) of active duty nurses and technicians who attend an intensive 5-day EBP Immersion Workshop and a control group (n=70) who do not. The intervention group will have access to specialized resources such as: a) Center for Transdisciplinary Evidence-Based Practice (CTEP) expert EBP mentors, b) EBP toolkit and resources, c) one year of free access to the Ohio State University (OSU) virtual library. Control group participants will have standard MTF education opportunities. Established valid and reliable survey measures (EBP attitudes, knowledge, beliefs) will be hosted electronically by CTEP at baseline, three, and twelve months. Online measures include institutional and nursing process measures (EBP implementation, policy changes, and publications) over the two-year study period. De-identified data from the anonymous survey measures will be shared by CTEP with this study team. Data analysis will include Student's t-tests to explore differences between groups. Repeated measures ANOVA or the nonparametric equivalent (Friedman's test or Skillings-Mack test) will be used to compare three time points within groups. Feasibility metrics and demographics will be reported with descriptive statistics.
Further study details as provided by David Grant Medical Center, Travis Air Force Base, California
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ARCC EBP Model | CTEP EBP Immersion Course |
| |
| Control Group | No CTEP EBP Immersion Course |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CTEP EBP Immersion | Behavioral | 36 continuing ed credits, virtual library access, collaboration with expert mentors |
|
| Measure | Description | Time Frame |
|---|---|---|
| Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time | 25-item assessment of organizational readiness and perceived strengths and barriers for EBP implementation. A 5-point Likert scale with, 1 (not at all) through 5 (very much) measures item response to questions focused on the extent that EBP is included in current organizational culture. For example, "To what extend do you believe that EBP is practiced in your organization?" Overall, the instrument measures the relationship between cultural factors and the organization's implementation of EBP over a 6-month time frame. Validity is reported with content and face validity and internal consistency reliabilities greater than 0.85 | baseline, month 3, month 12 |
| Evidence-Based Practice Beliefs (EBPB) Scale changes over time | 16-item assessment of an individual's beliefs regarding the value of EBP and capability for EBP implementation in clinical nursing practice. A 5-point Likert scale with, 1 (strongly disagree) through 5 (strongly agree) measures item response to statements about EBP, such as: "I believe EBP takes too much time"… "I am clear about the steps of EBP." It is anticipated, based on the results of several studies, that higher scores on the EBPB scale are associated with greater implementation of EBP and better healthcare outcomes. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85. | baseline, month 3, month 12 |
| Evidence-Based Practice Implementation (EBPI) Scale changes over time | 18-item instrument to measure the extent to which healthcare workers integrate scientific evidence in their clinical practice. A 5-point ordinal scale with frequencies listed from 0 times (0 pt.), 1-3 times (1 pt.), 4-5 times (2 pt.), 6-7 times (3 pt.) and > 8 times (4 pt.) is used to assess how often each item has applied over the past 8 weeks. For example, how often have you: "Used evidence to change my clinical practice…", "Accessed the National Guidelines Clearinghouse…" Total scores are summed where higher scores indicate greater integration of EBP in the healthcare workers practice. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85. |
| Measure | Description | Time Frame |
|---|---|---|
| Nursing process outcomes changes over time | projects, policy changes, publications | baseline, month 3, month 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility metrics changes over time | Costs, mentors, staff retention | baseline, month 3, month 12 |
Inclusion Criteria:
Exclusion Criteria:
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David Grant Medical Center active duty nurses and technicians
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| Name | Affiliation | Role |
|---|---|---|
| Laurie A Migliore, PhD | Staff | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| David Grant Medical Center | Fairfield | California | 94535 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26444511 | Background | Breckenridge-Sproat ST, Throop MD, Raju D, Murphy DA, Loan LA, Patrician PA. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice. Clin Nurse Spec. 2015 Nov-Dec;29(6):329-37. doi: 10.1097/NUR.0000000000000161. | |
| 22289132 | Background | Barrera M Jr, Castro FG, Strycker LA, Toobert DJ. Cultural adaptations of behavioral health interventions: a progress report. J Consult Clin Psychol. 2013 Apr;81(2):196-205. doi: 10.1037/a0027085. Epub 2012 Jan 30. |
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| baseline, month 3, month 12 |
| EBP Knowledge Assessment Questionnaire (EBP-KAQ) changes over time | 27-item multiple-choice objective knowledge measure of examine EBP knowledge. | baseline, month 3, month 12 |
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| 25057692 | Background | Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families; Board on the Health of Select Populations; Institute of Medicine; Denning LA, Meisnere M, Warner KE, editors. Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs. Washington (DC): National Academies Press (US); 2014 Feb 11. Available from http://www.ncbi.nlm.nih.gov/books/NBK222170/ |
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| 22407205 | Background | Melnyk BM. Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nurs Adm Q. 2012 Apr-Jun;36(2):127-35. doi: 10.1097/NAQ.0b013e318249fb6a. |
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| 8555924 | Background | Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996 Jan 13;312(7023):71-2. doi: 10.1136/bmj.312.7023.71. No abstract available. |
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