Journal of Korean Academy of Nursing Administration
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v.19
no.2
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pp.292-303
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2013
Purpose: The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals. Methods: Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology. Results: Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'. Conclusion: The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.
Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.
Purpose: This study was to investigate the belief in evidence-based practice, awareness of importance and performance of intravenous infusion and pressure ulcer evidence-based practice guidelines among nurses in a tertiary general hospital. Methods: The subjects of this study were 217 nurses working in a tertiary general hospital. Data collection was performed between February 11 and February 25, 2022. Data analysis was conducted descriptive statistics, t-test, hierarchical regression analysis, and Importance-Performance Analysis. Results: The mean score of belief for evidence-based practice among novice nurses was 3.34 out of 5, while preceptor nurses scored a mean of 3.41 out of 5. There was no significant difference in belief scores between novice nurses and preceptor nurses (t=-1.21, p=.227). The factors influencing the performance of evidence-based practice guidelines for intravenous infusion were belief in evidence-based practice (β=.14, p=.009) and importance of intravenous infusion (β=.51, p<.001), and the factors influencing the performance of evidence-based practice guidelines for pressure ulcer were belief in evidence-based practice (β=.15, p=.002) and importance of pressure ulcer (β=.65, p<.001). Importance-Performance Analysis of the evidence-based practice guidelines of two groups were used to identify common and different items. Conclusion: To improve the performance of evidence-based practice guidelines, it is necessary to enhance the evidence-based practice belief and importance of evidence-based practice guidelines. In particular, evidence-based practice should be provided to improve nursing quality through education on items of low-importance and low-performance and items of high-importance but low-performance guidelines identified through Importance-Performance Analysis.
Purpose: The purpose of this study was to explore how knowledge management of hospital and nurses' beliefs and competences on evidence-based practice can affect evidence-based decision making. Methods: In this descriptive study, a total of 184 nurses who were working in the five general hospitals participated. The data were collected through a self-administered questionnaire in September, 2014. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and step-wise multiple regression with SPSS/WIN Statistics 21.0 program. Results: Evidence-based decision making was correlated with EBP beliefs (r=.55, p<.001), EBP competence (r=.57, p<.001), and knowledge management (r=.50, p<.001). Hierarchical regression analysis showed that EBP beliefs (${\beta}=.18$, p=.005), EBP competence (${\beta}=.37$, p<.001), organizational knowledge management (${\beta}=.27$, p<.001) explained 48.6% of evidence based decision making (p<.001). Conclusion: The study results indicated that evidence-based practice competences, organizational knowledge management, and evidence-based practice beliefs were important factors on evidence-based decision making. In order to improve evidence-based practice among nurses through organizational knowledge management, EBP beliefs and competence at individual level need to be considered and incorporated into any systemic training of EBP.
Purpose: The purpose of this study was to identify the current status of evidence-based research, education, and practice, and to suggest a directions for the future development of evidence-based nursing. Methods: To examine the current status of evidence-based nursing research, experimental research among studies published in the Journal of Korean Academy of Nursing from 2008 to 2010 were analyzed. We suggested a direction for the future development of evidence-based research based on the analysis and literature reviews. We also suggested a direction for the future development of evidence-based education and practice based on literature reviews. Results: The results showed that designs and methods of studies were insufficient to use evidences derived from the studies in terms of evidence-based research, and experimental studies consistent with themes were found to be deficient. In the future, the methods and rationale for the design of experimental studies need to be clearer In addition, a test for intervention effects through repetitive studies and a connection between the intervention effects and a protocol for clinical practice will be required. In terms of evidence-based education, curriculum revision and development of teaching methods including contents related to evidence-based practice and research methodology in undergraduate and graduate programs will be required. Evidence-based practice in Korea was less actively done than with that of foreign countries. Some large hospitals have recently attempted systemic activities to promote evidence-based nursing practice in clinical settings. To activate evidence-based practice, the perception of nurses for evidence-based practice needs to be changed and support for education and administration of the program is required. Also, evidence-based practice guidelines, protocols, and assessment tools need to be developed. Conclusion: Evidence-based nursing in Korea is in the process of evolving. To realize evidence-based nursing, we need to develop nursing science based on evidences of closer communication and cooperation in terms of nursing research, education, and practice.
Background: As the medical knowledge base grows at an accelerating rate, evidence-based clinical performance becomes increasingly important for providing quality care. Previous studies have highlighted the need to promote job crafting to actualize evidence-based practical skills in the medical field. This study aimed to investigate the degree of evidence-based practice among dental hygienists and assess the impact of job crafting on the evidence-based practical skills of dental hygienists. Methods: Dental hygienists working at dental hospitals and clinics in Seoul and Gyeonggi Province were surveyed between February 28 and April 6, 2023. The sample was comprised of 267 participants. The hypotheses were tested independent t-tests, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression analyses using SPSS 29.0. Results: The degree of job crafting by dental hygienists demonstrated significant differences based on educational attainment, workplace size, and workplace type. Evidence-based practical skills exhibited significant variations based on educational attainment and job position. All job crafting subfactors demonstrated positive correlations with evidence-based practical skills. The job crafting subfactors affecting the evidence-based practical skills of dental hygienists were 'increasing structural job resources' and 'increasing challenging job demands,' which together explained 38.7% of the variance in evidence-based practical skills. Conclusion: This study demonstrates that job crafting was positively and significantly correlated with evidence-based practical skills. To strengthen the job crafting ability of dental hygienists, improving environmental conditions and fostering an organizational culture that motivates continued participation in education is necessary. The development and promotion of programs that enable learning of the latest evidence should be actively pursued. Additionally, regular attendance at workshops and participation in organizational evidence-based practice education programs are necessary.
EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.
The Journal of Korean Academic Society of Nursing Education
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v.22
no.3
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pp.274-282
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2016
Purpose: This study is aimed at identifying factors influencing attitudes of Evidence-Based Practice among nursing students. Methods: 202 nursing students were recruited from B city and G district. The questionnaires included critical thinking dispositions, information retrieval skills, knowledge and attitudes of Evidence-Based Practice, and characteristics. Data were analyzed by SPSS/Win 21.0 using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regressions. Results: The average score of undergraduate nursing students for Evidence-Based Practice attitudes was $32.92{\pm}4.57$. Evidence-Based Practice attitudes had positive correlation with critical thinking disposition (r=.53, p<.001), information retrieval skills (r=.45, p<.001) and Evidence-Based Practice knowledge (r=.42, p<.001). Factors influencing Evidence-Based Practice attitudes were critical thinking dispositions (${\beta}=.45$) and Evidence-Based Practice knowledge (${\beta}=.30$). Total variance was explained about 35.3% (F=55.80, p<.001). Conclusion: These results show that teaching strategies that enhance critical thinking dispositions are recommended to improve Evidence-Based Practice attitudes among nursing students. Also, nursing education should include a regular Evidence-Based Practice curriculum to improve Evidence-Based Practice knowledge as is necessary for students to improve information retrieval skill. Reading nursing articles can help nursing students comprehend the up-to-data evidence of clinical practice.
In our daily practice, we think about the diagnosis of our patient and get into a situation wherein we have to make a clinical decision. Diagnosis and treatment come from the knowledge and experiences that each dentist should have, but sometimes, we can have doubts on our decisions. "On what evidence did I make such decision? Was that really right?" Drawing our attention these days as a possible answer to this question, evidence-based dentistry seeks to apply the best available evidence gained from the scientific method to medical decision making. To make a good decision, the strength of evidence is assessed. Specifically, randomized controlled trial, systematic review, and meta-analysis are considered the highest level of evidence; cohort study, case control study, case series, animal study, bench test, and biological plausibility follow. With the approach of evidence-based dentistry, we can make objective, scientifically sound clinical decisions. It is also patient-oriented, incorporating clinical experiences and stressing good judgments; thorough and comprehensive, it uses transparent methodology. That is the reason evidence-based dentistry can be better than other assessment methods when we make a clinical decision in modern dentistry.
Journal of The Korean Association For Science Education
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v.14
no.2
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pp.123-132
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1994
The experimental evidence evaluation of the 11th grade students(N:91) was investigated. Specially, the influence of students' ideas about optical phenomena and presented evidence types on their evidence evaluation, and the influence of students' ideas on their causal inference modes were investigated. After eliciting the students' ideas about shadow phenomena and conformity of their idea, the experimental results with a binary outcome were presented as the evidence. Then the students were asked to evaluate the evidence. Again students' ideas were elicited. Most of students had causal ideas such that the shape of object(96%) and the inclination of screen(75%) were causes of shadow shape, not the shape(70%) and color(92%) of light source. In the case of the shape of object and the color of light source, most students(70%) believed strongly their ideas. Most responses(80%) in the evidence were evidence-based, and 12% of them were theory-based. There was no significant difference of reponses types between students with causal ideas(81%) and students with non-causal ideas(78%), between covariable and non-covariable evidence. But in the case of non-causal ideas, covariable evidence was more likely to yield evidence-based reponses than non-covariable evidence. If students had preconcepts inconsistent(84%) with the evidence, they were more likely to make evidence-based responses than the students with consistent ideas (75%) with the evidence. Especially in the case perceptually biased evidence, this tendency was marked. In the case of covariable evidence, many students made inclusion inferences(40%) rather than uncertainty inferences(32%). In the case of uncertainty inferences(94%), students more likely to make evidence-based reponses than inclusion inferences(83%) and exclusion infernces(88%). In the case of inclusion inferences and exclusion infernces, students tended to make idea-based responses and distort the evidences. In conclusion, when the students evaluate the experimental evidences, their ideas influence the causal inference modes. Especially, according to the conformity of the preconcepts and logical relation of evidences, the inference modes are more strongly depended upon the preconcepts rather than evidences.
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