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Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and effects of the programme based on information‐motivation‐behavioural skills (IMB) model (IMB programme) on adherence to inhalation therapy and other health outcomes in chronic obstructive pulmonary disease (COPD) patients. Background: Poor adherence to inhalation therapy is common among COPD patients. The IMB model is supported by previous studies as useful in promoting adherence to health behaviours. Methods: This pilot randomized controlled trial randomized 35 COPD patients to receive either the IMB‐based programme or usual care. The 4‐week IMB programme consisted of a face‐to‐face and two telephone sessions to empower patients with skills and knowledge on using inhalation therapy and support their goal attainment for treatment compliance. Outcome evaluation including adherence to inhalation therapy, inhalation techniques, disease impact, and quality of life was conducted at baseline and at 6 weeks after randomization. Feasibility of the IMB programme was evaluated by a satisfaction survey and implementation experience. Results: Thirty patients completed the study, with an attrition rate of 14.3%. The intervention group (n = 15) had significant improvements in inhalation adherence, inhalation techniques, and quality of life than the control group over the evaluation period. Patient satisfaction survey results and observations on programme implementation suggested the feasibility of the IMB programme. Conclusion: A IMB model is a feasible and potentially effective intervention for improving COPD patients' adherence to inhalation therapy. SUMMARY STATEMENT: What is already known about this topic? Information‐motivation‐behavioural skills (IMB) models have produced positive effects on adherence behaviour in patients with acquired immune deficiency syndrome, coronary heart disease, and diabetes. What this paper adds? No study has evaluated the effects of the IMB model on an intervention for adherence behaviour in patients with chronic obstructive pulmonary disease (COPD).The pilot randomized controlled trial (RCT) showed that the IMB model used in the intervention was effective in improving COPD patients' adherence to inhalation regimen and techniques.The pilot study found that the IMB intervention programme was feasible for implementation in outpatient settings and was highly accepted by COPD patients. The implications of this paper: This programme may be effective in improving COPD patients' adherence to inhalation regimen and inhalation techniques.The programme is feasible and acceptable.There is need to conduct an adequately powered multisite RCT to provide stringent outcome evaluation of the IMB intervention programme. [Correction added on 28 January 2020: 'The implications of this paper' section has been amended.] [ABSTRACT FROM AUTHOR]

This paper describes an online facilitation for operationalizing the knowledge-to-action (KTA) model. The KTA model incorporates implementation planning that is optimally suited to the information needs of clinicians. The can-implement© is an evidence implementation process informed by the KTA model. An online counterpart, the can-implement.pro©, was developed to enable greater dissemination and utilization of the can-implement© process. The driver for this work was health professionals' need for facilitation that is iterative, informed by context and localized to the specific needs of users. The literature supporting this paper includes evaluation studies and theoretical concepts relevant to KTA model, evidence implementation and facilitation. Nursing and other health disciplines require a skill set and resources to successfully navigate the complexity of organizational requirements, inter-professional leadership and day-to-day practical management to implement evidence into clinical practice. The can-implement.pro© provides an accessible, inclusive system for evidence implementation projects. There is empirical support for evidence implementation informed by the KTA model, which in this phase of work has been developed for online uptake. Nurses and other clinicians seeking to implement evidence could benefit from the directed actions, planning advice and information embedded in the phases and steps of can-implement.pro©. [ABSTRACT FROM AUTHOR]

Diarrhoea has been identified as the second leading cause of mortality among under-5s and also claims more life than HIV, measles and malaria combined together in the same category of population. This article is a combination of literature review and personal experience of lessons learnt from past diarrhoea outbreaks in Botswana that caused significant rate of mortality among under-5s. The paper used literature review to identify contributory factors to diarrhoea burden among under-5s in Botswana and applied a community health nursing framework ( PRECEDE-PROCEED) to tackle the problems identified. The study revealed that Botswana mothers are lacking in knowledge related to exclusive breastfeeding, prevention and treatment of diarrhoea disease. The paper recommends that health-care workers in Botswana be sensitized on current diarrhoea management to tailor their health education methods appropriately. [ABSTRACT FROM AUTHOR]

This paper presents a discussion of knowledge and awareness regarding prevention of functional decline in older hospitalized patients. Functional decline is experienced by 30-60% of the older hospitalized patients, resulting in decreased independence and other adverse health outcomes. One literature study and four cohort studies (total n = 1628) were conducted to develop and validate an instrument to identify older hospitalized patients at risk for functional decline. An evidence-based best practice was developed to improve the quality of care for older patients. This paper shows the relevance and the complexity of this problem and shows that patients at risk can be recognized by four simple questions. Due to their ability to observe and guide patients and their 24-h patient supervision, nurses should play a key role in strategies to prevent functional decline. Nurses should assess the geriatric needs in patients at risk and based on these initiate and coordinate multi-professional interventions. Given the growing number of older people in western society and the growing need for care, action to prevent functional decline cannot be withheld. Knowledge of the ageing process, implementation of an evidence-based programme and a multidisciplinary approach is a basic ingredient to prevent functional decline. [ABSTRACT FROM AUTHOR]

Genomics is an ever increasing aspect of nursing practice, with focus being directed towards improving health. The authors present an implementation strategy for the incorporation of genomics into nursing practice within the UK, based on three behaviour change theories and the identification of individuals who are likely to provide support for change. Individuals identified as Opinion Leaders and Adopters of genomics illustrate how changes in behaviour might occur among the nursing profession. The core philosophy of the strategy is that genomic nurse Adopters and Opinion Leaders who have direct interaction with their peers in practice will be best placed to highlight the importance of genomics within the nursing role. The strategy discussed in this paper provides scope for continued nursing education and development of genomics within nursing practice on a larger scale. The recommendations might be of particular relevance for senior staff and management. [ABSTRACT FROM AUTHOR]

Background: Nurse staffing models have been developed across different countries to address nursing shortages and improve quality of nursing care. However, there is no published study that describes nurse staffing models in Ethiopian hospitals. Aims: To describe the existing staffing models for nursing practice in acute care units of two hospitals (one public and one private) in Ethiopia. Methods: A cross‐sectional study was conducted from July to December 2018. A self‐administered questionnaire was used to collect data such as shift patterns, hours worked, and number of patients cared for per shift. Unit‐level data on nurse staffing were collected using a checklist developed specifically for this study. Results: Fifty‐nine percent (59.9%) of participants reported that they worked six or seven days per week. On average, they worked 50 hours per week and 12% working over 60 hours per week. The number of patients they provided care for during their last shift ranged from four to 45 with an average of 13 patients. Conclusion: This study demonstrates that nurses working in acute care settings in Ethiopia are typically working more than 40 hours per week and caring for many patients per shift, which has the potential to impact patient safety. SUMMARY STATEMENT: What is already known about this topic? Nurse staffing is a critical factor affecting patient safety and nurse workforce outcomes.There are different staffing models in which staff are assigned to give care for patients in different healthcare settings but much of the research is from high‐income countries. What this paper adds? This paper describes nurse staffing in acute care settings in Ethiopia, a low‐income country. The number of patients for whom nurses provide care per shift, and the number of hours nurses provide care per week, is very high compared with other settings.Nurses work very long hours, often more than 50 hours per week.Many nurses routinely work six or seven days per week and on average nurses care for 13 patients per shift The implication of this paper: Hospital managers should ensure that working more than 40 hours or more than five days per week should not be routine.Hospital policy that addresses the maximum number of patients who receive care by one nurse is necessary.The findings of this study support the consideration of mandated nurse‐to‐patient ratios in Ethiopia. [ABSTRACT FROM AUTHOR]

An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices. [ABSTRACT FROM AUTHOR]

This paper aims to explicate the essence of spiritual engagement from the perspective of palliative care clients and their caregivers. Van Manen's hermeneutic phenomenological approach guided this study. In-depth interviews of 14 rural Australian participants with experience of a life-limiting condition provided rich discourse of the lived experience of spiritual engagement. This research highlights spiritual engagement represented in a relational model developed from a creative synthesis of the emerging themes. Spiritual engagement is associated with 'personal transformation', 'human values of love, compassion and altruism', 'maintaining relationships', 'participating in religious practices' and 'culture'. The findings of this research are supported by Mayes' observations on spirituality, that is, the 'pursuit of a trans-personal and trans-temporal reality that serves as the ontological ground for an ethic of compassion and service'. [ABSTRACT FROM AUTHOR]

Aims: To examine the presence of symptom clusters and synergistic effects of symptom clusters on quality of life in rheumatoid arthritis patients. Background: Rheumatoid arthritis patients frequently experience multiple concurrent symptoms of pain, fatigue, and depression. Design A nonexperimental, cross‐sectional correlation design. Methods: The study participants were 179 rheumatoid arthritis patients. Data were collected between August and December 2016. A hypothetical model was developed based on the Theory of Unpleasant Symptoms Model: physiological antecedents included disease activity and obesity; symptoms of pain, fatigue, and depression were hypothesized as being clustered, and quality of life was taken as the outcome variable. Results: Disease activity had significant direct effects on pain, fatigue, and depression and indirect effects on fatigue and depression, whereas obesity had a significant direct effect on fatigue alone. Three symptom clusters, namely, pain fatigue, fatigue depression, and pain‐fatigue depression were identified and found to have significant synergistic effects on quality of life. Conclusions: Our findings support the importance of managing clusters of symptoms simultaneously, that is, collective symptom management. Inter‐cluster dynamics between symptoms should be considered when nurses develop symptom management strategies or self‐management programs to improve the quality of life of rheumatoid arthritis patients. SUMMARY STATEMENTS: What is known about this topic? A symptom cluster is a stable group of different symptoms that co‐occur in association with a specific disease.Rheumatoid arthritis patients frequently experience multiple concurrent symptoms of pain, fatigue, and depression. What this paper adds? The most common and distressing rheumatoid arthritis symptoms of pain, fatigue, and depression were found to co‐occur and to be interrelated, which are the two major criteria of symptom clusters.Three symptom clusters, namely, pain fatigue, fatigue depression, and pain‐fatigue depression, were identified and found to have significant synergistic effects on quality of life. The implications of this paper: Our findings support the importance of managing clusters of symptoms simultaneously, that is, collective symptom management.The complicated intercluster dynamics demonstrated between symptoms in the present study should be considered when nurses develop effective symptom management strategies or self‐management intervention programs to improve the quality of life of rheumatoid arthritis patients. [ABSTRACT FROM AUTHOR]

Aim: This study examines the amount of sleep and daytime sleepiness, and how these change in a follow‐up cohort study of school‐aged children. Methods: A total of 1351 schoolchildren (aged 10) and their parents were invited to participate in the study and were studied again at ages 12 and 15 years. A survey put forth by the Health Behaviour of Schoolchildren research network was used. Results: The amount of sleep during weekdays dropped significantly from age 10 to 15. At weekends, the amount of sleep increased significantly. During weekdays, the proportion of children reporting having slept enough dropped from 71% at age 10 to 19% at age 15. Frequent daytime sleepiness occurred in 13% of children at age 10 and increased to 24% at the age of 15. Conclusions: It is essential to promote adequate amount of sleep and prevent daytime sleepiness in children growing from age 10 to 15 years. Nurses and other health care professionals should systematically assess and promote healthy sleeping habits while caring for children between these ages. SUMMARY STATEMENT: What is already known about this topic? Sufficient sleep is essential for the healthy development of school‐aged childrenThe amount of sleep drops between ages 10 and 15 years What this paper adds? Daytime sleepiness increases significantly between ages 10 and 15 years, and girls reported more frequent daytime sleepiness compared with boys.The amount of sleep drops more in girls compared with boys between the ages 10 and 15 yearsParents reported their children to sleep more compared with the children themselves The implications of this paper: Daytime sleepiness and amount of sleep should be systematically assessed by nurses and other health care professionals.Gender and age specific differences should be considered when promoting healthy sleep.Future research should focus on developing effective, youth‐driven interventions to promote healthy sleep and prevent daytime sleepiness. [ABSTRACT FROM AUTHOR]

Among women, cardiovascular disease is the leading cause of mortality worldwide. After experiencing an acute cardiovascular event, a woman's physical health, the prevalence of morbidities, likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favourable than men. The social support resources of marginality and religiousness are associated with physical and mental health outcomes following cardiovascular crises. This study aimed to evaluate the reliability and validity of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the Koci Marginality Index and the Duke University Religion Index among 282 women (aged 35-92 years) representing seven cultures. Results showed that reliability and validity were strong (coefficient alpha of 0.79 and 0.84). Understanding a woman's social isolation and whether she has a connection to religious groups assists health-care professionals to identify a woman's social support resources during recovery following acute cardiovascular episodes. [ABSTRACT FROM AUTHOR]

Yoo H, Kim CJ, Jang Y, You M-A. International Journal of Nursing Practice 2011; 17: 599-606 Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases Although prior research in Western societies has revealed an association between self-efficacy and both self-management behaviours and better health status, little is known about the applicability of this association in Korean populations. We examined the differences in self-management behaviours and health status among three groups according to the level of self-efficacy (high, moderate and low). We used a descriptive and correlational design, and administrated a questionnaire to 322 Korean patients with diabetes mellitus, hypertension or arthritis at three ambulatory clinics in a university medical centre. We performed the Pearson chi-square test to test for differences in proportions, and the Kruskall-Wallis and Mann-Whitney U-tests for non-parametric measures. The level of self-efficacy was associated with self-management behaviours ( P < 0.05) and with better health status indices ( P < 0.001) except fatigue ( P < 0.277). The mean age (Mean ± standard deviation, 53.71 ± 12.60), the percentage of high level of education (62.4%) and the level of employment (51.4%) were significantly higher in high self-efficacy group than in low self-efficacy group or moderate self-efficacy group. Further study of the potential factors affecting any relationship between self-efficacy and fatigue is recommended. Self-efficacy-enhancing interventions can be beneficial for Korean chronic patients to improve their self-management behaviours and health status. [ABSTRACT FROM AUTHOR]

Jefford E, Fahy K, Sundin D. International Journal of Nursing Practice 2011; : 246-253 What are the strengths and limitations of existing Decision-Making Theories as a basis for guiding best practice clinical decision-making within a framework of midwifery philosophy? Each theory is compared in relation with how well they provide a teachable framework for midwifery clinical reasoning that is consistent with midwifery philosophy. Hypothetico-Deductive Theory, from which medical clinical reasoning is based; intuitive decision-making; Dual Processing Theory; The International Confederation of Midwives Clinical Decision-Making Framework; Australian Nursing and Midwifery Council Midwifery Practice Decisions Flowchart and Midwifery Practice. Best practice midwifery clinical Decision-Making Theory needs to give guidance about: (i) effective use of cognitive reasoning processes; (ii) how to include contextual and emotional factors; (iii) how to include the interests of the baby as an integral part of the woman; (iv) decision-making in partnership with woman; and (v) how to recognize/respond to clinical situations outside the midwife's legal/personal scope of practice. No existing Decision-Making Theory meets the needs of midwifery. Medical clinical reasoning has a good contribution to make in terms of cognitive reasoning processes. Two limitations of medical clinical reasoning are its reductionistic focus and privileging of reason to the exclusion of emotional and contextual factors. Hypothetico-deductive clinical reasoning is a necessary but insufficient condition for best practice clinical decision-making in midwifery. [ABSTRACT FROM AUTHOR]

Ben Natan M, Hanukayev A, Fares S. International Journal of Nursing Practice 2011; : 141-150 Violence against nurses in the workplace is universal. Violence has negative implications for nurses, their patients and the medical facility. Nonetheless, violent incidents are only infrequently reported (20-25%). A correlational design was used to examine whether the guiding conceptual model, constructed of the variables: assailant traits, victim traits and type of violence, succeeds in predicting a nurse's decision to report violence perpetrated against them in the workplace. Data were gathered with a structured questionnaire, constructed specifically for the current research and based on the literature review and research model. The research population was sampled by convenience sampling and consisted of nurses from general hospitals in northern and central Israel of 220 nurses, of whom nearly 72% ( n = 158) had experienced violent incidents over the past year, mainly verbal abuse by patients' relatives. Only 26.6% ( n = 42) reported violent incidents in written form. Most reports were submitted to the nurse in charge of the department. Correlations were found between assailant traits (identity and mental state) and victim traits (sociodemographic characteristics and attitudes on and perceptions of reporting) and intention and actual report. Nurses' normative beliefs regarding reporting violence had the greatest effect on intention to report. [ABSTRACT FROM AUTHOR]

Data from the Patients and Families Psychological Response to the Home Automated External Defibrillator Trial were used to examine the relationship between biopsychosocial variables and patients' coping strategies postmyocardial infarction. This study is the secondary data analysis of longitudinal observational study. A total of 460 patient-spouse pairs were recruited in January 2003 to October 2005. Hierarchical linear regression analysis examined biological/demographic, psychological and social variables regarding patients' coping scores using the Family Crisis Oriented Personal Evaluation Scale. Lower social support and social support satisfaction predicted lower total coping scores. Being younger, male gender and time since the myocardial infarction predicted lower positive coping strategy use. Higher anxiety and lower social support were related to fewer positive coping methods. Lower educational levels were related to increased use of negative coping strategies. Reduced social support predicted lower total coping scores and positive coping strategy use and greater passive coping style use. Social support from a broad network assisted with better coping; those living alone may need additional support. Social support and coping strategies should be taken into consideration for patients who have experienced a cardiac event. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore the individual, social and environmental factors influencing regular exercise on the basis of the theoretical framework of social ecological model among adults with type 2 diabetes and peripheral neuropathy. A total of 122 participants were chosen from Tianjin Metabolic Disease Hospital from November 2013 to May 2014. Information on exercise status and influencing factors was collected. Most participants took walking as the mode of exercise and exercised alone. Only 59.8% of participants were reported to carry out regular exercise. Logistic regression analysis suggested that being male, longer duration with diabetic peripheral neuropathy, higher self-efficacy for exercise and higher objective support were associated with regular exercise. Exercise status was clearly not ideal among adults with type 2 diabetes and peripheral neuropathy. The study highlighted the need to take measures to improve self-efficacy for exercise and social support in order to promote exercise participation among adults with type 2 diabetes and peripheral neuropathy. [ABSTRACT FROM AUTHOR]

The objective of this study was to test nine variables which derived from the model of self-care in chronic illness and previous studies on elderly patients with hypertension. A descriptive research design was employed in this study. Totally, 306 elderly patients diagnosed with hypertension were selected from three public health centres for the study. The stepwise regression analysis was conducted by analysing predictors of self-care in elderly patients with hypertension. Statistical analyses, including correlation analysis, t-test and analysis of variance tests were conducted for seven variables. The results indicated that only four variables were significant, and the model explained 57% of the variance in self-care. Among these predictors, empowerment was the strongest predictor, followed by social support, depression and perceived severity. These findings demonstrate the significance of assessing predictors of self-care behaviour when examining patients' health behaviours and planning intervention strategies. [ABSTRACT FROM AUTHOR]

Thirty-three participants in a human immunodeficiency virus ( HIV) medication adherence feedback ( MAF) intervention were compared with 58 HIV-positive non-participants in laboratory-tested CD4 and viral load. The intervention provided adherence feedback and counselling based on a visual display from an electronic pill bottle ( MEMSTM). Multiple regression controlling for baseline CD4 and showed that postintervention CD4 was higher for MAF participants than for non- MAF participants. Non- MAF participants' CD4 significantly declined over time. MAF participants were also less likely than non- MAF participants to have a detectable postintervention viral load. [ABSTRACT FROM AUTHOR]

Adverse events are common in acute clinical settings but little is known about these events occurring after Intensive Care discharge. This study aimed to develop a reliable and valid tool for exploring clinicians' opinions of factors associated with post-Intensive Care adverse events. A convenience sample of Australian Intensive Care Liaison Nurses was invited to complete and appraise a questionnaire using structured guidelines. Content validity and internal consistency were assessed. Twelve Intensive Care Liaison Nurses completed the questionnaire. Cronbach?s alpha coefficient showed high internal consistency for the questionnaire; all 24 items on the questionnaire had coefficients greater than 0.852. The content validity index of the questionnaire overall was 0.76. The post-Intensive Care adverse events questionnaire demonstrated reliability and validity. It is a tool that can be used to explore clinicians? opinions of factors associated with these events. The tool is important as it facilitates further insight into the causes of post-Intensive Care adverse events. [ABSTRACT FROM AUTHOR]

Ma AX, Quinn Griffin MT, Capitulo KL, Fitzpatrick JJ. International Journal of Nursing Practice 2010; 16: 443-453 Demands of immigration among Chinese immigrant nurses The purpose of this study was to identify the demands of immigration among Chinese nurses that have immigrated to the USA. The relationship between the demands of immigration and length of stay in the USA was investigated also. A descriptive correlational study design was used. A convenience sample of 128 nurses was recruited. A self-administered survey was conducted using the demands of immigration scale developed by Aroian, along with a demographic questionnaire. The results showed Chinese immigrant nurses have high demands of immigration. There were significant negative relationships between the demands of immigration and length of stay in the USA. Immigration demands decreased as length of stay increased but remained high even for those who had been in the USA for > 5 years. This information is vital to health-care agencies designing and implementing adaptation programmes targeting these demands to facilitate Chinese nurses' adaptation process. [ABSTRACT FROM AUTHOR]

The author reflects on knowledge translation (KT) and evidence-based healthcare (EHBC) in the nursing profession. A description of KT is provided. Topics discussed include the five steps to EBHC, the Joanna Briggs Institute (JBI) conceptual model, key ingredients that enhance EHBC, and application of the JBI model to EHBC.