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Rationale, Aims, and Objectives: The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery., Methods: A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed., Results: Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit., Conclusion: To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI., (© 2018 John Wiley & Sons, Ltd.)

Aims and objectives To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent urinary incontinence, there are indications that these guidelines are not applied in hospital care. Design A qualitative study with descriptive design was conducted in two orthopaedic units. Methods Forty-six interviews and 36 observations of care were conducted from January-October 2014 and analysed with qualitative content analysis. Results Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures. Conclusions Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing urinary incontinence. Relevance to clinical practice An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team. [ABSTRACT FROM AUTHOR]

Aim. This paper reports on a study of research use among nurses two years after graduation, as well as changes over time in research use in relation to changes in working conditions. Background. The demand for evidence-based practice is widely expressed, and newly graduated nurses should possess the skills to provide high-quality care based on the best knowledge available. The way in which nurses use research during the first few years after graduating is, however, largely unknown. Method. As part of a national longitudinal survey, nurses reported their extent of instrumental, conceptual and persuasive research use in 2006 ( n = 1365) and 2007 ( n = 1256). Data were analysed cross-sectionally and prospectively, using variable- and pattern-oriented methods. Results. Instrumental research was reported most frequently, on about half of the working shifts. Seven profiles of research use were found, showing structural stability over time when compared with results from year 1. Most typically, nurses maintained the same profile over time; moreover, low users tended to become even lower users. Two years after graduation, 54·9% reported overall low use. Changes in working conditions did not explain the decrease in research use. Conclusion. The results support previous claims of a gap between research and clinical practice. The predominance of overall low users is alarming and requires further research, including investigation of individual and organizational factors, to study their impact on nurses’ research use. [ABSTRACT FROM AUTHOR]

Title. Research use in clinical practice – extent and patterns among nurses one and three years postgraduation. Aim. This paper is a report of a study of nurses’ research use in clinical practice one and three years postgraduation in Sweden. Background. Internationally, learning to critically appraise and use research is an educational objective within nursing training, with the aim of promoting research use in nursing practice. The extent to which these skills is acquired and used among relatively newly graduated nurses is largely unexplored, however. Method. A descriptive study was conducted in 2006 using a national longitudinal survey of two nursing cohorts one ( n = 1,365) and three ( n = 933) years postgraduation. The self-reported extent of instrumental, conceptual and persuasive research use was measured. Data were analysed using both variable- and pattern-oriented approaches based on cluster analysis. Results. Research use was reported to occur in about half or fewer of the working shifts. In both samples, seven clusters of nurses with different research use profiles were identified. Clusters representing overall low and very low users in all three types of research use were predominant both at one (45·6%) and three (51·6%) years postgraduation, whereas clusters of nurses reporting overall high research use were uncommon. The proportion of very low users was larger 3 years after graduation than 1 year after graduation. Conclusions. The low extent of reported research use, raises the question of whether scientific perspectives included in nursing education are translated into clinical application. The pattern-oriented approach illustrates the complexity of research use and identification of typical research use profiles in specific contexts may have potential to guide interventions aimed at supporting evidence-based practice. [ABSTRACT FROM AUTHOR]