Clinical trial NCT03269331: Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC)
Official title: Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model for Military Treatment Facility (MTF) Implementation of Nursing Evidence-Based Practice (EBP)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Evidence-Based Practice
Nurse's Role
Keywords: nursing practice
evidence-based practice models
military nursing
clinical inquiry
Lead sponsor: David Grant U.S. Air Force Medical Center
Sponsor class: FED
Collaborators: name: Ohio State University
First posted: 2017-08-31
Enrollment: 131
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: David Grant Medical Center active duty nurses and technicians

Brief summary: The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. While magnet facilities require a commitment to evidence-based nursing practice, military facilities currently lack such a requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful path toward developing high-reliability organizations. Currently, little is known regarding the effectiveness of specific EBP models and frameworks within the military culture. The purpose of this investigation is to determine the effectiveness of the Advancing Research and Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment Facility (MTF) beginning with nursing services.

Research questions:

1. What is the current state of organizational culture and readiness for EBP within the MTF's nursing services?
2. Will utilization of the ARCC model significantly improve EBP beliefs, knowledge, and practice in MTF nurses over a two-year period?
3. Is the ARCC model feasible for implementation in Air Force MTF's?

This study includes an intervention group (n=70) of active duty nurses and technicians who attend an intensive 5-day EBP Immersion Workshop and a control group (n=70) who do not. The intervention group will have access to specialized resources such as: a) Center for Transdisciplinary Evidence-Based Practice (CTEP) expert EBP mentors, b) EBP toolkit and resources, c) one year of free access to the Ohio State University (OSU) virtual library. Control group participants will have standard MTF education opportunities. Established valid and reliable survey measures (EBP attitudes, knowledge, beliefs) will be hosted electronically by CTEP at baseline, three, and twelve months. Online measures include institutional and nursing process measures (EBP implementation, policy changes, and publications) over the two-year study period. De-identified data from the anonymous survey measures will be shared by CTEP with this study team. Data analysis will include Student's t-tests to explore differences between groups. Repeated measures ANOVA or the nonparametric equivalent (Friedman's test or Skillings-Mack test) will be used to compare three time points within groups. Feasibility metrics and demographics will be reported with descriptive statistics.

Detailed description: Further study details as provided by David Grant Medical Center, Travis Air Force Base, California

Eligibility criteria: Inclusion Criteria:

* Nurse (active duty) assigned to DGMC
* Medical/Surgical technician (active duty) assigned to DGMC
* 15 month retain-ability from time of enrollment

Exclusion Criteria:

* Disciplines outside of Nursing (PA, MD, Occupational Therapy (OT), Physical Therapy (PT), etc.)
* Nurse/technician General Schedule (GS),VA, Contractor employed at David Grant Medical Center (DGMC)
* Anticipated/Scheduled Permanent Change of Station (PCS) in next 15 months

Primary outcomes:
measure: Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time
timeFrame: baseline, month 3, month 12
measure: Evidence-Based Practice Beliefs (EBPB) Scale changes over time
timeFrame: baseline, month 3, month 12
measure: Evidence-Based Practice Implementation (EBPI) Scale changes over time
timeFrame: baseline, month 3, month 12
measure: EBP Knowledge Assessment Questionnaire (EBP-KAQ) changes over time
timeFrame: baseline, month 3, month 12
Secondary outcomes:
measure: Nursing process outcomes changes over time
timeFrame: baseline, month 3, month 12
Other outcomes:
measure: Feasibility metrics changes over time
timeFrame: baseline, month 3, month 12
Locations:
city: Fairfield
country: United States
facility: David Grant Medical Center
state: California
Study officials:
affiliation: Staff
name: Laurie A Migliore, PhD
role: PRINCIPAL_INVESTIGATOR
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