DOI QR코드

DOI QR Code

Evidence Based Practice in Long Term Care Settings

  • Specht, Janet K. (The University of Iowa, John A. Hartford Center for Geriatric Nursing Excellence)
  • Received : 2013.03.19
  • Accepted : 2013.03.19
  • Published : 2013.04.30

Abstract

Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

Keywords

References

  1. Abbott, S., & Hotchkiss, J. (2001). It takes more than clinical effectiveness to change nursing practice: An unsuccessful project in the nurse promotion of urinary continence. Clinical Effectiveness in Nursing, 5(2), 81-87. https://doi.org/10.1054/cein.2001.0186
  2. Agency for Healthcare Research and Quality. (2001, March). Translating research into practice (TRIP)-II. Retrieved August 18, 2005, from http:// www.ahrq.gov/research/findings/factsheets/translating/tripfac/index. html
  3. Armellino, D., Quinn Griffin, M. T., & Fitzpatrick, J. J. (2010). Structural empowerment and patient safety culture among registered nurses working in adult critical care units. Journal of Nursing Management, 18(7), 796-803. http://dx.doi.org/10.1111/j.1365-2834.2010.01130.x
  4. Berman, A., Mezey, M., Kobayashi, M., Fulmer, T., Stanley, J., Thornlow, D., et al. (2005). Gerontological nursing content in baccalaureate nursing programs: Comparison of findings from 1997 and 2003. Journal of Professional Nursing, 21(5), 268-275. http://dx.doi.org/10.1016/j.profnurs. 20 05.07.005
  5. Bland, D. R., Dugan, E., Cohen, S. J., Preisser, J., Davis, C. C., McGann, P. E., et al. (2003). The effects of implementation of the Agency for Health Care Policy and Research urinary incontinence guidelines in primary care practices. Journal of the American Geriatrics Society, 51(7), 979-984. https://doi.org/10.1046/j.1365-2389.2003.51311.x
  6. Brazil, K., Royle, J. A., Montemuro, M., Blythe, J., & Church, A. (2004). Moving to evidence-based practice in long-term care: The role of a Best Practise Resource Centre in two long-term care settings. Journal of Gerontological Nursing, 30(3), 14-19.
  7. Campbell, S. L. (2003). Empowering nursing staff and residents in longterm care. Geriatric Nursing (New York, NY), 24(3), 170-175. https://doi.org/10.1067/mgn.2003.40
  8. Castle, N. G. (2001). Innovation in nursing homes: Which facilities are the early adopters? Gerontologist, 41(2), 161-172. https://doi.org/10.1093/geront/41.2.161
  9. Conger, J. A., & Kanungo, R. N. (1988). The empowerment process: Integrating theory and practice. The Academy of Management Review, 13(3), 471-482.
  10. Deci, E. L., Connell, J. P., & Ryan, R. M. (1989). Self-determination in a work organization. Journal of Applied Psychology, 74(4), 580-590. https://doi.org/10.1037/0021-9010.74.4.580
  11. Estabrooks, C. A., Floyd, J. A., Scott-Findlay, S., O Leary, K. A., & Gushta, M. (2003). Individual determinants of research utilization: A systematic review. Journal of Advanced Nursing, 43(5), 506-520. https://doi.org/10.1046/j.1365-2648.2003.02748.x
  12. Feldman, P. H., & Kane, R. L. (2003). Strengthening research to improve the practice and management of long-term care. Milbank Quarterly, 81(2), 179-220, 171. https://doi.org/10.1111/1468-0009.t01-1-00051
  13. Frantz, R. A., Gardner, S., Specht, J. K., & McIntire, G. (2001). Integration of pressure ulcer treatment protocol into practice: Clinical outcomes and care environment attributes. Outcomes Management for Nursing Practice, 5(3), 112-120.
  14. Gecas, V. (1989). The social psychology of self-efficacy. Annual Review of Sociology, 15, 291-316. http://dx.doi.org/10.1146/annurev.so.15.08018 9.001451
  15. Greenberger, D. B., & Strasser, S. (1986). Development and application of a model of personal control in organizations. The Academy of Management Review, 11(1), 164-177.
  16. Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82(4), 581-629. http://dx. doi.org/10.1111/j.0887-378X.2004.00325.x
  17. Gross, P. A., Greenfield, S., Cretin, S., Ferguson, J., Grimshaw, J., Grol, R., et al. (2001). Optimal methods for guideline implementation: Conclusions from Leeds Castle meeting. Medical Care, 39(8 Suppl 2), II85-II92.
  18. Gutierrez, L. M. (1994). Beyond coping: An empowerment perspective on stressful life events. Journal of Sociology and Social Welfare, 21(3), 201-220.
  19. Herr, K., Bursch, H., Ersek, M., Miller, L. L., & Swafford, K. (2010). Use of pain-behavioral assessment tools in the nursing home: Expert consensus recommendations for practice. Journal of Gerontological Nursing, 36(3), 18-29. http://dx.doi.org/10.3928/0098913 4-20100108-04
  20. Hollinger-Smith, L., Lindeman, D., Leary, M., & Ortigara, A. (2002). Building the foundation for quality improvement: LEAP for a quality longterm care workforce. Seniors Housing & Care Journal, 10(1), 31-43.
  21. Hollinger-Smith, L., & Ortigara, A. (2004). Changing culture: Creating a long-term impact for a quality long-term care workforce. Alzheimer's Care Quarterly, 5(1), 60-70.
  22. Hysong, S. J., Best, R. G., & Pugh, J. A. (2006). Audit and feedback and clinical practice guideline adherence: Making feedback actionable. Implementation Science, 1, 9. http://dx.doi.org/10.1186/1748-5908-1-9
  23. Jacobsen, S. M., Stickler, D. J., Mobley, H. L., & Shirtliff, M. E. (2008). Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis. Clinical Microbiology Reviews, 21(1), 26-59. http://dx.doi.org/10.1128/cmr.00019-07
  24. Jones, K. R., Fink, R., Vojir, C., Pepper, G., Hutt, E., Clark, L., et al. (2004). Translation research in long-term care: Improving pain management in nursing homes. Worldviews on Evidence-Based Nursing, 1(Suppl 1), S13-S20. http://dx.doi.org/10.1111/j.1524-475X.2004.04045.x
  25. Kanter, R. M. (1977). Men and women of the corporation. New York, NY: Basic Books.
  26. Laschinger, H. K. S., Finegan, J., Shamian, J., & Wilk, P. (2004). A longitudinal analysis of the impact of workplace empowerment on work satisfaction. Journal of Organizational Behavior, 25(4), 527-545. http:// dx.doi.org/10.1002/job.256
  27. Lekan-Rutledge, D. (2000). Diffusion of innovation. A model for implementation of prompted voiding in long-term care settings. Journal of Gerontological Nursing, 26(4), 25-33.
  28. Loeb, M., Brazil, K., Lohfeld, L., McGeer, A., Simor, A., Stevenson, K., et al. (2002). Optimizing antibiotics in residents of nursing homes: Protocol of a randomized trial. BMC Health Services Research, 2(1), 17. https://doi.org/10.1186/1472-6963-2-17
  29. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417. http://dx.doi.org/10.1097/NNA.0b013e3182664e0a
  30. Meyer, A. D., & Goes, J. B. (1988). Organizational assimilation of innovations: A multilevel contextual analysis. The Academy of Management Journal, 31(4), 897-923. https://doi.org/10.2307/256344
  31. Miley, K. K., O'Melia, M., & DuBois, B. (1988). Generalist social work practice: An empowering approach (2nd ed.). Boston, MA: Allyn and Bacon.
  32. National Institutes of Health. (2011, March 21-22). 4th Annual NIH Conference on the science of dissemination and implementation: Policy and practice. Bethesda, MD: Author.
  33. Offermann, L. R. (2004). Empowerment. In J. M. Burns, G. R. Goethals, & G. Sorenson (Eds.), Encyclopedia of leadership. (pp. 434-437) Berkshire Publishing Group/Sage.
  34. Parmelee, P. A. (2004). Quality improvement in nursing homes: The elephants in the room. Journal of the American Geriatrics Society, 52(12), 2138-2140. https://doi.org/10.1111/j.1532-5415.2004.52577.x
  35. Rantz, M. J., Popejoy, L., Petroski, G. F., Madsen, R. W., Mehr, D. R., Zwygart- Stauffacher, M., et al. (2001). Randomized clinical trial of a quality improvement intervention in nursing homes. Gerontologist, 41(4), 525-538. https://doi.org/10.1093/geront/41.4.525
  36. Reinhard, S., & Stone, R. (2001). Promoting quality in nursing homes: The wellspring model. New York, NY: The Commonwealth Fund.
  37. Resnick, B., Quinn, C., & Baxter, S. (2004). Testing the feasibility of implementation of clinical practice guidelines in long-term care facilities. Journal of the American Medical Directors Association, 5(1), 1-8.
  38. Richards, K., & Beck, C. (2002). Translating nursing home research into practice: How and for whom? Journal of the American Geriatrics Society, 50(9), 1595-1596. https://doi.org/10.1046/j.1532-5415.2002.50419.x
  39. Roe, B., Watson, N. M., Palmer, M. H., Mueller, C., Vinsnes, A. G., & Wells, M. (2004). Translating research on incontinence into practice. Nursing Research, 53(6 Suppl), S56-S60. https://doi.org/10.1097/00006199-200411006-00009
  40. Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press
  41. Schnelle, J. F., Alessi, C. A., Simmons, S. F., Al-Samarrai, N. R., Beck, J. C., & Ouslander, J. G. (2002). Translating clinical research into practice: A randomized controlled trial of exercise and incontinence care with nursing home residents. Journal of the American Geriatrics Society, 50(9), 1476-1483. https://doi.org/10.1046/j.1532-5415.2002.50401.x
  42. Specht, J. K. (2005). 9 myths of incontinence in older adults: Both clinicians and the over-65 set need to know more. American Journal of Nursing, 105(6), 58-68.
  43. Specht, J. K., Horras, S., & Mobily, P. R. (2006). Lessons learned from a pilot test of an intervention to increase the adoption of evidence-based practices in NHs. Iowa City, IA: John A. Hartford Center of Geriatric Nursing Excellence.
  44. Specht, J. K., Mobily, P. R., & Bossen, A. (2012). Improving continence & pain control in LTC: The multi-level translation application in nursing homes intervention (MTRAIN) (No. 1R01NR009678-01A2 Revised). Bethesda, MD: NIH Research Portfolio Online Reporting Tools (RePORT).
  45. Spreitzer, G. M. (1996). Social structural characteristics of psychological empowerment. Academy of Management Journal, 39(2), 483-504. https://doi.org/10.2307/256789
  46. Thomas, L. H., Cullum, N. A., McColl, E., Rousseau, N., Soutter, J., & Steen, N. (2000). Guidelines in professions allied to medicine. Cochrane Database of Systematic Reviews, (2), CD000349. http://dx.doi.org/10.1002/ 14651858.cd000349
  47. Titler, M. G. (2004). Methods in translation science. Worldviews on Evidence- Based Nursing, 1(1), 38-48. http://dx.doi.org/10.1111/j.1741- 6787.2004.04008.x
  48. Titler, M. G., & Everett, L. Q. (2001). Translating research into practice. Considerations for critical care investigators. Critical Care Nursing Clinics of North America, 13(4), 587-604
  49. Titler, M. G., & Kerr, P. (2002). How to teach toward evidence based practice. Excellence in Nursing Education and Research, 3(1), 1-4.
  50. VeneKlasen, L., & Miller, V. (2002). Power and empowerment. In A. Milligan (Ed.), The action guide for advocacy and citizen participation (pp. 39-58). Nottingham, UK: Russell Press.
  51. Wagner, E. H., Austin, B. T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001). Improving chronic illness care: Translating evidence into action. Health Affairs, 20(6), 64-78. https://doi.org/10.1377/hlthaff.20.6.64
  52. Watson, N. M. (2004). Advancing quality of urinary incontinence evaluation and treatment in nursing homes through translational research. Worldviews on Evidence-Based Nursing, 1(Suppl 1), S21-S25. http:// dx.doi.org/10.1111/j.1524-475X.2004.04043.x
  53. Watson, N. M., Brink, C. A., Zimmer, J. G., & Mayer, R. D. (2003). Use of the Agency for Health Care Policy and Research Urinary Incontinence Guideline in nursing homes. Journal of the American Geriatrics Society, 51(12), 1779-1786. https://doi.org/10.1046/j.1532-5415.2003.51564.x
  54. Weissman, D. E., Griffie, J., Muchka, S., & Matson, S. (2001). Improving pain management in long-term care facilities. Journal of Palliative Medicine, 4(4), 567-573. http://dx.doi.org/10.1089/109662101753381755
  55. Wipke-Tevis, D. D., Williams, D. A., Rantz, M. J., Popejoy, L. L., Madsen, R. W., Petroski, G. F., et al. (2004). Nursing home quality and pressure ulcer prevention and management practices. Journal of the American Geriatrics Society, 52(4), 583-588. http://dx.doi.org/10.1111/j.1532-5415. 2004.52166.x
  56. World Health Organization. (2012). Knowledge translation framework for ageing and health: A framework for policy development. Retrieved Nov 3, 2012, from http://www.who.int/ageing/publications/knowledge_ translation/en/index.html

Cited by

  1. Changing the Culture of Mouth Care: Mouth Care Without a Battle vol.54, pp.suppl1, 2013, https://doi.org/10.1093/geront/gnt145
  2. A Mixed-Methods Approach to Investigating the Adoption of Evidence-Based Pain Practices in Nursing Homes vol.40, pp.7, 2014, https://doi.org/10.3928/00989134-20140311-01
  3. Effect of Evidence-based Postoperative Pain Guidelines via Web for Patients undergoing Abdominal Surgery in South Korea vol.8, pp.2, 2014, https://doi.org/10.1016/j.anr.2014.05.005
  4. Living with Atrial Fibrillation: An Analysis of Patients' Perspectives vol.9, pp.4, 2013, https://doi.org/10.1016/j.anr.2015.10.001
  5. Evidence-Based Practice and Job Satisfaction of Nurses in Long-Term Care vol.6, pp.12, 2013, https://doi.org/10.4236/ojn.2016.612094
  6. Nursing care for women with pre-eclampsia and/or eclampsia: integrative review vol.50, pp.2, 2013, https://doi.org/10.1590/s0080-623420160000200020
  7. Evidence-Based Practice for Cardiac Intensive Care Unit Nurses: An Educational Intervention Study vol.51, pp.4, 2013, https://doi.org/10.3928/00220124-20200317-06
  8. Barriers and Insights in Participant Recruitment in Assisted Living Facilities vol.33, pp.2, 2013, https://doi.org/10.1177/0894318419898159
  9. Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study vol.20, pp.None, 2013, https://doi.org/10.1186/s12913-020-4998-9
  10. Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership-A Scoping Review vol.61, pp.4, 2013, https://doi.org/10.1093/geront/gnaa175
  11. Beliefs and implementation of evidence‐based practice among nurses in the nursing homes of a Swiss canton: An observational cross‐sectional study vol.30, pp.21, 2021, https://doi.org/10.1111/jocn.15826
  12. Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study vol.21, pp.1, 2021, https://doi.org/10.1186/s12877-021-02388-3
  13. Champions for improved adherence to guidelines in long-term care homes: a systematic review vol.2, pp.1, 2013, https://doi.org/10.1186/s43058-021-00185-y