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Resumen
Objetivo: Analizar la percepción de las enfermeras renales en España en relación con el entorno organizacional para la práctica clínica basada en la evidencia (PCBE); y determinar qué factores profesionales y del contexto influenyen esta percepción.
Material y Método: Estudio observacional transversal multiéntrico, en 15 servicios de nefrología de distitos hospitales en España y 2 centros de diálisis. Se utilizaron los instrumentos Practice Environment Scale of Nursing Work Index (PES-NWI) y Evidence Based Practice Questionnarie (EBPQ). Se realizó un análisis estadístio descriptivo, bivariado (ANOVA, Kruskall-Wallis), y regresión logística con la puntuación total del EBPQ como variable dependiente.
Resultados: Se recibieron 397 encuestas (participación84,28%), tras depuración encuestas, fueron válidas 382 (81,1% población): 82,7% mujeres, edad media 42 años, media de experiencia profesional como enfermera 18,2 años (12,2 años en nefrología), 94,8% clínicas, 81,9% de hemodiálisis. Puntuación media PES-NWI 62,35±15,10 (IC:95% 60,78-48,06). Presentaron menores puntuaciones en algunos factores del PES-NWI las enfermeras de centros >500 enfermeras, que trabajan en hemodiálisis y >11 años de experiencia profesional. Las enfermeras gestoras presentaron mayores puntuaciones en todos los factores del PES-NWI. Puntuación media EBPQ 81,05±21,92 (IC:95% 78,70-83,4). Presentaron mayores puntuaciones en varios factores del EBPQ las enfermeras con menor experiencia profesional, mejor puntuación en PES-NWI y que poseían estudios de postgrado.
Conclusiones: Los factores que más influyen en la percepción de las enfermeras renales en España son la experiencia profesional, el rol dentro de la organización, un contexto favorable y la formación de postgrado.
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Referencias
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- Glasziou P, Haynes B. The paths from research to improved health outcomes. Evid Based Nurs 2005;8(2):36–8. DOI: https://doi.org/10.1136/ebn.8.2.36
- Thompson C, McCaughan D, Cullum N, Sheldon TA, Mulhall A, Thompson DR. Research information in nurses’ clinical decision-making: what is useful? J Adv Nurs 2001;36(3):376–88. DOI: https://doi.org/10.1046/j.1365-2648.2001.01985.x
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- Peiró S, Bernal-Delgado E. What incentives foster hospital use in the National Health Service?. Gac Sanit 2006;20 Suppl 1:S110–6.
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- Pedro Gómez JE de, Morales Asencio JM. Las organizaciones ¿favorecen o dificultan una práctica enfermera basada en la evidencia? Index de Enfermería 2004;13(44–45):26–31. DOI: https://doi.org/10.4321/S1132-12962004000100006
- Dijkstra R, Wensing M, Thomas R, Akkermans R, Braspenning J, Grimshaw J, et al. The relationship between organisational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Serv Res 2006;28:6. DOI: https://doi.org/10.1186/1472-6963-6-53
- González-Torrente S, Pericas-Beltrán J, Bennasar-Veny M, Adrover-Barceló R, Morales-Asencio JM, De Pedro-Gámez J. Perception of evidence-based practice and the professional environment of Primary Health Care nurses in the Spanish context: A cross-sectional study. BMC Health Serv Res 2012;12(1):1–9. DOI: https://doi.org/10.1186/1472-6963-12-227
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- De Pedro-Gómez J, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Pericas-Beltran J, Miguélez-Chamorro A. Psychometric testing of the Spanish version of the practice environment scale of the nursing work index in a primary healthcare context. J Adv Nurs 2012;68(1):212–21. DOI: https://doi.org/10.1111/j.1365-2648.2011.05730.x
- De Pedro-Gómez J, Morales-Asencio JM, Abad AS, Veny MB, Vives GA, Campaner CP. Entorno de práctica de los profesionales de enfermería y competencia para la incorporación de la evidencia a las decisiones: Situación en las Islas Baleares. Gac Sanit 2011;25(3):191–7. DOI: https://doi.org/10.1016/j.gaceta.2010.11.007
- De Pedro Gómez JE, Morales Asencio JM, Sesé Abad A, Bennasar Veny M, Artigues Vives G, Pericàs Beltran J. Validación y adaptación al español de la escala del entorno de práctica enfermera del Nursing Work Index. Metas de enfermería 2009;12(7):65–75.
- Zhou F, Hao Y, Guo H, Liu H. Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China. Evid Based Complement Alternat Med 2016;2016. DOI: https://doi.org/10.1155/2016/5478086
- Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. Int J Nurs Stud 2016;60:54–68. DOI: https://doi.org/10.1016/j.ijnurstu.2016.03.006
- Koehn ML, Lehman K. Nurses’ perceptions of evidence-based nursing practice. J Adv Nurs 2008;62(2):209–15. DOI: https://doi.org/10.1111/j.1365-2648.2007.04589.x
- Gerrish K, Guillaume L, Kirshbaum M, Mcdonnell A, Tod A, Nolan M. Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. J Adv Nurs 2011;67(5):1079–90. DOI: https://doi.org/10.1111/j.1365-2648.2010.05560.x
- Gerrish K, Nolan M, Mcdonnell A, Tod A, Kirshbaum M, Guillaume L. Factors Influencing Advanced Practice Nurses’ Ability to Promote Evidence-Based Practice among Frontline Nurses. Worldviews Evidence-Based Nurs 2012;9(1):30–9. DOI: https://doi.org/10.1111/j.1741-6787.2011.00230.x
- Al-Busaidi IS, Al Suleimani SZ, Dupo JU, Al Sulaimi NK, Nair VG. Nurses’ Knowledge, Attitudes, and Implementation of Evidence-based Practice in Oman: A Multi-institutional, Cross-sectional Study. Oman Med J 2019;34(6):521. DOI: https://doi.org/10.5001/omj.2019.95
- Pericas-Beltran J, Gonzalez-Torrente S, De Pedro-Gomez J, Morales-Asencio JM, Bennasar-Veny. Perception of Spanish primary healthcare nurses about evidence-based clinical practice: A qualitative study. Int Nurs Rev 2014;61(1 PG-90–98):90–8. DOI: https://doi.org/10.1111/inr.12075
- Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España. Aten Primaria 2021;53(7). DOI: https://doi.org/10.1016/j.aprim.2021.102050
- Alleyne J, Jumaa MO. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services. J Nurs Manag. 2007;15(2):230–43. DOI: https://doi.org/10.1111/j.1365-2834.2007.00750.x
- Shirey MR. Authentic leaders creating healthy work environments for nursing practice. Am J Crit Care 2006;15(3):256–67. DOI: https://doi.org/10.4037/ajcc2006.15.3.256
- Strout TD, Lancaster K, Schultz AA. Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. Nurs Clin North Am 2009;44(1):93–102. DOI: https://doi.org/10.1016/j.cnur.2008.10.007
- Li S, Cao M, Zhu X, Ford C. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore).2019;98(39):e17209. DOI: https://doi.org/10.1097/MD.0000000000017209
- Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. J Adv Nurs 2009;65(2):371–81. DOI: https://doi.org/10.1111/j.1365-2648.2008.04878.x
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Referencias
Bashar FJ. Assessing Attitudes towards Knowledge and use of Evidence-Based Practice among Nurses Working in a Teaching Hospital in Kuala Lumpur. Int J Educ Lit Stud 2019;7(1):25. DOI: https://doi.org/10.7575/aiac.ijels.v.7n.1p.25
Hutchinson AM, Johnston L. Beyond the BARRIERS Scale: Commonly reported barriers to research use. J Nurs Adm 2006;36(4):189–99. DOI: https://doi.org/10.1097/00005110-200604000-00008
Zauszniewski JA, Suresky MJ, Bekhet AK, Kidd L. Moving from tradition to evidence: a review of psychiatric nursing intervention studies. Online J Issues Nurs 2007;12(2):9. DOI: https://doi.org/10.3912/OJIN.Vol12No02HirshPsy01
Stokke K, Olsen NR, Espehaug B, Nortvedt MW. Evidence based practice beliefs and implementation among nurses: A cross-sectional study. BMC Nurs 2014;13(1):8. DOI: https://doi.org/10.1186/1472-6955-13-8
Glasziou P, Haynes B. The paths from research to improved health outcomes. Evid Based Nurs 2005;8(2):36–8. DOI: https://doi.org/10.1136/ebn.8.2.36
Thompson C, McCaughan D, Cullum N, Sheldon TA, Mulhall A, Thompson DR. Research information in nurses’ clinical decision-making: what is useful? J Adv Nurs 2001;36(3):376–88. DOI: https://doi.org/10.1046/j.1365-2648.2001.01985.x
Klein R. The NHS and the new scientism: solution or delusion? QJM 1996;89(1):85–7. DOI: https://doi.org/10.1093/oxfordjournals.qjmed.a030142
Peiró S, Bernal-Delgado E. What incentives foster hospital use in the National Health Service?. Gac Sanit 2006;20 Suppl 1:S110–6.
McKenna HP, Ashton S, Keeney S. Barriers to evidence-based practice in primary care. J Adv Nurs 2004;45(2):178–89. DOI: https://doi.org/10.1046/j.1365-2648.2003.02879.x
Bryar RM, Closs SJ, Baum G, Cooke J, Griffiths J, Hostick T, et al. The Yorkshire BARRIERS project: Diagnostic analysis of barriers to research utilisation. Int J Nurs Stud 2003;40(1):73–84. DOI: https://doi.org/10.1016/S0020-7489(02)00039-1
Nolan M, Morgan L, Curran M, Clayton J, Gerrish K, Parker K. Evidence-based care: can we overcome the barriers? Br J Nurs 1998;7(20):1273–8. DOI: https://doi.org/10.12968/bjon.1998.7.20.5567
Pedro Gómez JE de, Morales Asencio JM. Las organizaciones ¿favorecen o dificultan una práctica enfermera basada en la evidencia? Index de Enfermería 2004;13(44–45):26–31. DOI: https://doi.org/10.4321/S1132-12962004000100006
Dijkstra R, Wensing M, Thomas R, Akkermans R, Braspenning J, Grimshaw J, et al. The relationship between organisational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Serv Res 2006;28:6. DOI: https://doi.org/10.1186/1472-6963-6-53
González-Torrente S, Pericas-Beltrán J, Bennasar-Veny M, Adrover-Barceló R, Morales-Asencio JM, De Pedro-Gámez J. Perception of evidence-based practice and the professional environment of Primary Health Care nurses in the Spanish context: A cross-sectional study. BMC Health Serv Res 2012;12(1):1–9. DOI: https://doi.org/10.1186/1472-6963-12-227
Ramos-Morcillo AJ, Fernández-Salazar S, Ruzafa-Martínez M, Del-Pino-Casado R. Effectiveness of a Brief, Basic Evidence-Based Practice Course for Clinical Nurses. Worldviews Evidence-Based Nurs 2015;12(4):199–207. DOI: https://doi.org/10.1111/wvn.12103
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).
Solís Muñoz M. Competencias en práctica clínica basada en la evidencia de las enfermeras en España. [Madrid]: Universidad Complutense de Madrid; 2015.
Ruzafa-Martinez M, Lopez-Iborra L, Moreno-Casbas T, Madrigal-Torres M. Development and validation of the competence in evidence based practice questionnaire (EBP-COQ) among nursing students. BMC Med Educ 2013;13(1):1–10. DOI: https://doi.org/10.1186/1472-6920-13-19
De Pedro-Gómez J, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Pericas-Beltran J, Miguélez-Chamorro A. Psychometric testing of the Spanish version of the practice environment scale of the nursing work index in a primary healthcare context. J Adv Nurs 2012;68(1):212–21. DOI: https://doi.org/10.1111/j.1365-2648.2011.05730.x
De Pedro-Gómez J, Morales-Asencio JM, Abad AS, Veny MB, Vives GA, Campaner CP. Entorno de práctica de los profesionales de enfermería y competencia para la incorporación de la evidencia a las decisiones: Situación en las Islas Baleares. Gac Sanit 2011;25(3):191–7. DOI: https://doi.org/10.1016/j.gaceta.2010.11.007
De Pedro Gómez JE, Morales Asencio JM, Sesé Abad A, Bennasar Veny M, Artigues Vives G, Pericàs Beltran J. Validación y adaptación al español de la escala del entorno de práctica enfermera del Nursing Work Index. Metas de enfermería 2009;12(7):65–75.
Zhou F, Hao Y, Guo H, Liu H. Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China. Evid Based Complement Alternat Med 2016;2016. DOI: https://doi.org/10.1155/2016/5478086
Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. Int J Nurs Stud 2016;60:54–68. DOI: https://doi.org/10.1016/j.ijnurstu.2016.03.006
Koehn ML, Lehman K. Nurses’ perceptions of evidence-based nursing practice. J Adv Nurs 2008;62(2):209–15. DOI: https://doi.org/10.1111/j.1365-2648.2007.04589.x
Gerrish K, Guillaume L, Kirshbaum M, Mcdonnell A, Tod A, Nolan M. Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. J Adv Nurs 2011;67(5):1079–90. DOI: https://doi.org/10.1111/j.1365-2648.2010.05560.x
Gerrish K, Nolan M, Mcdonnell A, Tod A, Kirshbaum M, Guillaume L. Factors Influencing Advanced Practice Nurses’ Ability to Promote Evidence-Based Practice among Frontline Nurses. Worldviews Evidence-Based Nurs 2012;9(1):30–9. DOI: https://doi.org/10.1111/j.1741-6787.2011.00230.x
Al-Busaidi IS, Al Suleimani SZ, Dupo JU, Al Sulaimi NK, Nair VG. Nurses’ Knowledge, Attitudes, and Implementation of Evidence-based Practice in Oman: A Multi-institutional, Cross-sectional Study. Oman Med J 2019;34(6):521. DOI: https://doi.org/10.5001/omj.2019.95
Pericas-Beltran J, Gonzalez-Torrente S, De Pedro-Gomez J, Morales-Asencio JM, Bennasar-Veny. Perception of Spanish primary healthcare nurses about evidence-based clinical practice: A qualitative study. Int Nurs Rev 2014;61(1 PG-90–98):90–8. DOI: https://doi.org/10.1111/inr.12075
Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España. Aten Primaria 2021;53(7). DOI: https://doi.org/10.1016/j.aprim.2021.102050
Alleyne J, Jumaa MO. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services. J Nurs Manag. 2007;15(2):230–43. DOI: https://doi.org/10.1111/j.1365-2834.2007.00750.x
Shirey MR. Authentic leaders creating healthy work environments for nursing practice. Am J Crit Care 2006;15(3):256–67. DOI: https://doi.org/10.4037/ajcc2006.15.3.256
Strout TD, Lancaster K, Schultz AA. Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. Nurs Clin North Am 2009;44(1):93–102. DOI: https://doi.org/10.1016/j.cnur.2008.10.007
Li S, Cao M, Zhu X, Ford C. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore).2019;98(39):e17209. DOI: https://doi.org/10.1097/MD.0000000000017209
Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. J Adv Nurs 2009;65(2):371–81. DOI: https://doi.org/10.1111/j.1365-2648.2008.04878.x
Hain D, Haras MS. Changing Nephrology Nurses’ Beliefs about the Value of Evidence-Based Practice and Their Ability to Implement in Clinical Practice - PubMed. Nephrol Nurs J 2015;42(6):563–6.