Impact of Good Practice Guidelines on Evidence-based Practice and Nurses' Work Environment

Study Overview
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Brief Summary
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Evidence-based practice (EBP) has improved patient health outcomes. The work environment of nurses is a key element to improving the quality of care and to facilitate EBP, while also improving health outcomes. The CCEC® / BPSO® program consists of the implementation of Good Practice Guides in health organizations in the Spanish territory, and is carried out through a training and participatory methodology, actively involving nurses in the process. The present study tries to know if in the health organizations where the CCEC® / BPSO® program has been implemented, the perception of the nurses' working environment has improved, as well as their attitude towards evidence-based practice, with respect to organizations where this program has not been implemented.

Detailed Description
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Quasi-experimental pre-post multicentre study with a non-equivalent control group, within the framework of the third cohort of the RNAO Good Practice Guidelines Implementation Program in Centers Committed to Care Excellence (CCEC® / BPSO®). PARTICIPATING INSTITUTIONS: Intervention group(IG): (institutions included in the third cohort of CCEC®): Estructura de Gestión Integrada de Lugo, Cervo y Monforte de Lemos (Galicia), Hospital General Universitario Santa Lucía (Murcia), Xerencia de Xestión Integrada de A Coruña (Galicia), Hospital Guadarrama (Madrid), Hospital Universitari Germans Trias i Pujol (Cataluña), Hospital Regional Universitario de Málaga (Andalucía), Organización Sanitaria Integrada OSI Araba (Araba). Control group(CG): Hospital Son Espases (Mallorca), Hospital Son Llàtzer (Mallorca), Hospital de Granollers (Barcelona), Hospital de Puigcerdà (Girona), Hospital d'Igualada (Barcelona), Hospital General Universitario de Alicante (Alicante), Hospital Comarcal de Vinaròs de Castellón de la Plana (Castellón), Hospital Clínic de Barcelona (Barcelona), Hospital Universitario de Fuenlabrada (Madrid), Hospital de la Santa Creu i Sant Pau (Barcelona). To collect data, two validated questionnaires will be passed to all nurses in 7 health institutions where the RNAO Good Practice Guidelines Implementation Program begins (experimental group) and in 10 where it is not implemented (control group), both groups distributed throughout the Spanish territory. Basal data will be recorded before the beginning of the program and post intervention data will be recorded after one year. Then the results will be compared to determine whether there are differences between nurses who work in the group of hospitals that have started the program with respect to those who work in other centers. The total duration of the project will be three years.

Official Title
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Impact of the Implementation of Good Practice Guidelines on Beliefs-attitudes and Behavior in the Face of Evidence-based Practice and on the Perception of the Nurses' Work Environment

Conditions
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Nurses' Work Environment, Committed Centers With Excellence in Care (CCEC®) Program, Nurses' Evidence-based-practice Attitudes, Nurse Physician Relations, Practice Nurse's Scope, Professional Stress

Intervention / Treatment
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* Other: Good Practice Guidelines implementation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nurses Work in the institutions participating in the study Acceptance to participate in the study Exclusion Criteria: Not be active

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Good Practice Guidelines group<br>Implementation of Good Practice Guidelines | Other: Good Practice Guidelines implementation<br>* Implementation of Good Practice Guidelines on the framework of the Best Practice Spotlight Organization in Spain (CCEC® / BPSO®), that allows a standardized methodology for providing care and registering indicators.<br>|
| No Intervention: usual practices group<br>Not Implementation of Good Practice Guidelines, so working as the usual way | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in Nurses' work environment | self reported perceived current work environment through the Practice Environment Scale-Nursing Work Index (PES-NWI) questionaire, with 31 Likert type questions (1: Strongly Disagree -> 4 Strongly Agree), including 5 sub-scales: Nurse participation in hospital affairs (8 questions); nursing foundations for quality of care (10 questions); nurse manager ability, leadership and support of nurses (5 questions); staffing and resource adequacy (4 questions); and collegial nurse-physician relationships (3 questions) | baseline and 1 year | 
| change in Beliefs- attitudes and behavior in front of EBP | self-reported Beliefs- attitudes and behavior in front of EBP, through the 60 Likert type questions (from 1: minimum agreement to 10: maximum agreement) of the Health Sciences-Evidence Based Practice questionnaire (HS-EBP), that are classified in 5 dimensions: Beliefs and attitudes, (12 items); Results from scientific research (14 items); Development of professional practice (10 items); Evaluation of results (12 items) and Barriers / Facilitators (12 items). | baseline and 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in Job satisfaction: Likert type question rating | self-reported job satisfaction through a unique Likert type question rating 1: very unsatisfied; 5: very satisfied. | baseline and 1 year | 
| change in Institutional attitude perceived by nurses in relation to nursing research | self-reported 4 question rating: yes, not, unknown. | baseline and 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Evidence-Based Practice, nurses' Workplace, Good Practices Guides, Hospital