Competencias enfermeras en Práctica Basada en Evidencia,  barreras y facilitadores. Estudio mixto: comparativo y mediante  técnica Delphi

Natán Redondo Pérez; María Berdón Berdón; Isaías del Río García; Belén Martín-Gil; Noel Rivas-González; Mercedes Fernández-Castro

doi:10.58807/revtesela20246572

Natán Redondo Pérez Hospital Clínico Universitario de Valladolid. Valladolid, España https://orcid.org/0000-0002-2191-8596
María Berdón Berdón Hospital Clínico Universitario de Valladolid. Valladolid, España
Isaías del Río García Hospital Clínico Universitario de Valladolid. Valladolid, España https://orcid.org/0000-0001-9123-1485
Belén Martín-Gil Hospital Clínico Universitario de Valladolid. Valladolid, España https://orcid.org/0000-0003-0014-7208
Noel Rivas-González Hospital Clínico Universitario de Valladolid. Valladolid, España https://orcid.org/0000-0001-8363-1817
Mercedes Fernández-Castro Hospital Clínico Universitario de Valladolid. Valladolid, España https://orcid.org/0000-0003-1311-2207

DOI: https://doi.org/10.58807/revtesela20246572

Palabras clave: Práctica basada en evidencia, Barreras, Facilitadores, Gestión, Enfermeras

Key-words: Evidence based practice, Barriers, Facilitators, Management, Nurses

Resumen

Objetivo principal: Describir los cambios en competencias enfermeras en Práctica Basada en Evidencia (PBE), tras cuatro años de implantación de Guías de Buenas Prácticas (GBP), dentro del marco de Centros Comprometidos con la Excelencia en Cuidados® (CCEC®), e identificar barreras y facilitadores en PBE. Metodología: Las competencias enfermeras en PBE se recogieron mediante encuesta en 2020 y 2023. Las barreras y facilitadores se identificaron mediante técnica Delphi modificada. Resultados principales: Las dimensiones de las competencias en PBE “conocimientos, “habilidades” y “utilización” mejoraron en 2023 frente al 2020. Las principales barreras identificadas fueron: falta de incentivos/recompensas, falta de personal, de tiempo y una cultura de enfermería sometida a reglas jerárquicas. Los facilitadores identificados fueron mayor reconocimiento, trabajar en un hospital que fomenta la investigación y utilizar GBP. Conclusión principal: El programa de CCEC® ha supuesto un buen marco para implementar PBE. Identificar barreras y facilitadores permitirá diseñar estrategias efectivas.

Abstract

Objective: To describe changes in nursing Evidence-Based Practice (EBP) competences, after four years of implementation of Clinical Practice Guidelines, within the framework of Centers Committed to Excellence in Care® (CCEC®), and identify barriers and facilitators to improve EBP. Methods: Nursing competencies in EBP were collected through a survey in 2020 and 2023. Barriers and facilitators were identified using the modified Delphi technique. Results: The dimensions of the EBP competencies "knowledge, "skills" and "utilization" improved in 2023 compared to 2020. The main barriers identified were: lack of incentives/rewards, lack of staff, time and a nursing culture subject to hierarchical rules. The identified facilitators were greater recognition, working in a hospital that encourages research, and using GBP. Conclusions: The CCEC® program has provided a good framework for implementing PBE. Identifying barriers and facilitators will allow the design of effective strategies.

Bibliografía

Tucker SJ, Gallagher-Ford L. EBP 2.0: From Strategy to Implementation. Am J Nursing JN. 2019;119(4):2–4.

Caramanica L, Gallagher-Ford L, Idelman L, Mindrila D, Richter S, Thomas BK. Establishment of Nurse Manager Leadership Competencies to Support Clinicians in Evidence-Based Practice. J Nurs Adm. 2022;52(1):27–34.

Connor L, Dean J, McNett M, Tydings DM, Shrout A, Gorsuch PF, et al. Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews Evidence-Based Nurs. 2023;20(1):6–15.

Speroni KG, McLaughlin MK, Friesen MA. Use of Evidence-based Practice Models and Research Findings in Magnet-Designated Hospitals Across the United States: National Survey Results. Worldviews Evidence-Based Nurs. 2020;17(2):98–107.

Ayoubian A, Nasiripour AA, Tabibi SJ, Bahadori M. Evaluation of Facilitators and Barriers to Implementing Evidence-Based Practice in the Health Services: A Systematic Review. Galen Med J. 2020; 9:1645.

Clarke V, Lehane E, Mulcahy H, Cotter P. Nurse Practitioners’ Implementation of Evidence-Based Practice Into Routine Care: A Scoping Review. Worldviews Evidence-Based Nurs. 2021;18(3):180–9.

Li S, Cao M, Zhu X, Ford C. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Med (United States). 2019;98(39).

McNett M, Tucker S, Zadvinskis I, Tolles D, Thomas B, Gorsuch P, et al. A Qualitative Force Field Analysis of Facilitators and Barriers to Evidence-Based Practice in Healthcare Using an Implementation Framework. Glob Implement Res Appl. 2022;2(3):195–208.

Melnyk B, Tan A, Hsieh A, Gallagher-Ford L. Evidence-Based Practice Culture and Mentorship Predict EBP Implementation, Nurse Job Satisfaction, and Intent to Stay: Support for the ARCC © Model. Worldviews evidence-based Nurs. 2021;18(4):272–81.

Moreno-Casbas T, González-María E, Albornos-Muñoz L, Grinspun D. Getting guidelines into practice: lessons learned as Best Practice Spotlight Organization host. Int J Evid Based Healthc. 2019; 17:S15–7.

Grinspun D, Bajnok I, International STT. Transforming nursing through knowledge: best practices for guideline development, implementation science, and evaluation. Sigma Theta Tau International, editor. Indianapolis; 2018.

González-María E, Moreno-Casbas MT, Albornos-Muñoz L, Grinspun D, Moreno-Casbas T, Abad-Sanz C, et al. The implementation of Best practice guidelines in Spain through the Programme of the Best Practice Spotlight Organizations®. Enferm Clin. 2020;30(3):136–44.

Ruzafa-Martínez M, Fernández-Salazar S, Leal-Costa C, Ramos-Morcillo AJ. Questionnaire to Evaluate the Competency in Evidence-Based Practice of Registered Nurses (EBP-COQ Prof©): Development and Psychometric Validation. Worldviews Evidence-Based Nurs. 2020;17(5):366–75.

Fernández-Castro M, López M, Martín-Gil B, Rodríguez-Soberado P, Rivas-González N, Muñoz-Alvaredo L, et al. Nurses’ evidence-based practice competence and hospital practice environment after specific training under the Best Practice Spotlight Organization® Programme. A cross sectional study. Nurse Educ Today. 2023;126,105808.

Perego G, Cugnata F, Brombin C, Milano F, Mazzetti M, Taranto P, et al. Analysis of healthcare workers’ mental health during the COVID-19 pandemic: Evidence from a Three-Wave Longitudinal Study. 2023; Journal of health psychology, 28(14), 1279–1292.

Nordin A, Engström Å. Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic. 2023; SAGE open nursing, 9, 23779608231169218.

Sharplin G, Adelson P, Kennedy K, Williams N, Hewlett R, Wood J, et al. Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context. Healthcare. 2019; 7:142.

Naik S, Voong S, Bamford M, Smith K, Joyce A, Grinspun D. Assessment of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database using a data quality index. J Am Med Informatics Assoc. 2020;27(5):776–82.

Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain. Aten Primaria. 2021;53(7).

Ruzafa-Martinez M, Hernández-Méndez S, Garcia-Gonzalez J, Leal-Costa C, Martínez-González MÁ, Ramos-Morcillo AJ. Changes in nurse job outcomes after 4 years of a Best Practice Spotlight Organization® programme implementation in the Spanish National Health Context. J Nurs Manag. 2021;29(4):699–709.

Bach-Mortensen AM, Lange BCL, Montgomery P. Barriers and facilitators to implementing evidence-based interventions among third sector organisations: A systematic review. Implement Sci. 2018;13(1):1–19.

Competencias enfermeras en Práctica Basada en Evidencia, barreras y facilitadores. Estudio mixto: comparativo y mediante técnica Delphi

Nurses’ Evidence-Based Practice competences, barriers and facilitators. Mixed study: comparative and through Delphi technique

Resumen

Abstract

Bibliografía