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Objective: It is necessary to facilitate the implementation of evidence-based practice in clinical practice to improve patients' health results. Sumamos Excelencia ® is an implementation project led by nurses that aims to improve the evidence-based practice uptake. Building on the first edition, we have improved the project design and proposed new intervention topics. The objective is to evaluate the effects of the implementation of evidence-based recommendations through a multifaceted implementation strategy., Methods: This study is an implementation research with a quasi-experimental, multicentre, before-and-after design and audits for data collection at baseline, 3, 6, and 12 months. It will be developed in hospital units, primary care centres, and nursing homes. Units choose to implement recommendations of one of these topics: assessment and management of pain, conservative management of urinary incontinence, prevention of childhood obesity, or breastfeeding promotion. All units will implement recommendations about hand hygiene. Audits will assess changes in process and patient outcomes, barriers and strategies, and evidence-based practice competencies through specific questionnaires and clinical records data. Analysis will be descriptive and inferential., Conclusions: Sumamos Excelencia ® will aim to improve the use of evidence-based practice in the Spanish National Health System and to advance implementation science. This study will also provide important insight into the barriers that nurses face to implementing evidence-based practice in clinical practice and the strategies that they can use to overcome them. This generated knowledge can be used in other evidence-based practice implementation projects in a similar context to enhance adherence to evidence-based recommendations.

Competing Interests: Competing interests: None declared.

The raison d'être of nursing is caring for human beings. Mainly due to its close link to the nursing discipline's raison d'être, "caring," translational science is recently getting more attention from nursing scientists across the globe. This paper is to discuss the current status of translational science in nursing across four countries (the USA, Taiwan, South Korea, and Japan). The data used in this discussion paper included: (a) written notes on issues related translational research/science in individual countries; (b) written memos on exemplars/cases from their own experiences; and (c) summaries of literature reviews. The data analysis was conducted using a simple content analysis. Four themes reflecting the current status of translational science across the countries were identified: (a) "contextualized in unique culture and history of nursing"; (b) "connecting basic science to clinical practice"; (c) "an extension of evidence-based practice"; and (d) "highly promoted, but still minimal translation of nursing knowledge.", (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

By applying the PDCA model to the care of children with Henoch-Schonlein purpura, the nursing process can be divided into four stages: planning, execution, inspection, and treatment. According to the age characteristics and disease progression of pediatric patients, a complete nursing plan is formulated to efficiently implement the nursing content and improve the nursing effect. This paper studies the application of the PDCA nursing model in the nursing of children with Henoch-Schonlein purpura and statistically analyzes the disappearance of skin rash, joint pain relief, disappearance of urine protein, disappearance of gastrointestinal symptoms, etc. Finally, this paper combines the experiment to evaluate the intervention effect of this nursing model and provides reference for the follow-up care of children with Henoch-Schonlein purpura. From the results of experimental research, it can be known that PDCA nursing can improve the comfort of children with Henoch-Schonlein purpura, shorten the time for symptom disappearance, and speed up the recovery process., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Shuai Qin et al.)

Editor's note: This is the seventh article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the authors. To see all the articles in the series, go to http://links.lww.com/AJN/A204., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Nurse scientist (NS) roles in clinical practice settings are key components of The Future of Nursing and ANCC Magnet® recognition. Despite increased opportunities for NS roles, leveraging these roles to advance nursing science remains at an early stage. We describe opportunities and challenges for NSs in clinical practice settings, highlighting the value of a strong partnership with chief nurse officers as critical for the success of NSs and outcomes associated with these roles., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The COVID-19 pandemic requires an urgent action to transform health-care delivery and to promote research and capacity-building nursing programs. Specifically, many countries at the global level have described nursing informatics as an essential competence for nurse professionals. In Peru, nursing personnel represents the largest health workforce group and nursing informatics is still emerging, but the field appear to hold much promise. In this sense, the Peruvian Ministry of Health (MoH) defined in 2020 the core nursing competences, which included a technology and innovation domain. The competence established to apply scientifically based technology and innovation to improve the processes or health service resources. The minimum competencies established by the MoH were as follows: to carry out innovations in processes or resources in their different professional performance areas, to creatively adapt technology in different areas of professional performance, to make rational and ethical use of health technologies with focus on new developments that will be evaluated and applied critically, and to manage information and communication technologies, and health information systems, with emphasis on telehealth (i.e. telemedicine, telecare management, tele-education, and tele-training). Besides the nursing competences defined by the MoH is a good starting point, this special contribution discusses the urgent need to strengthen nursing informatics competencies in Peru.

Background: The Advancing Research and Clinical practice through close Collaboration (ARCC © ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC © Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay., Aims: The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC © Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay., Methods: Structural equation modeling was used to test relationships among the variables in the ARCC © Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States., Results: The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses., Linking Evidence to Action: As described in the ARCC © Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC © Model is a key strategy in assisting systems to reach health care's Quadruple Aim., (© 2021 Sigma Theta Tau International.)

Editor's note: This is the fourth article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the authors. To see all the articles in the series, go to http://links.lww.com/AJN/A204., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital's nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Proning intubated intensive care unit patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the intensive care unit., Local Problem: Nursing units previously designated for medical/surgical populations had to adjust quickly to provide evidence-based care for COVID-19 patients attempting self-proning., Methods: Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale., Interventions: A new self-proning nursing protocol was implemented outside the intensive care unit., Results: Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol., Conclusions: Implementation of a new nursing protocol is possible with strong unit-based support, even during a pandemic., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: To support evidence-based nursing practice, the authors provide guidelines for nonresearch evidence, which includes clinical practice guidelines, consensus or position statements, literature review, expert opinion, organizational experience, case reports, community standards, clinician experience, and consumer preferences. This is the third in a three-part series., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To explore how to integrate the "best" practice into nursing of venous thromboembolism (VTE) based on the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework., Methods: A mixed-methods design was used. A steering group for clinical evidence implementation (EI) was established to conduct pre-implementation baseline surveys, a thorough analysis of the evidence, and an analysis of the survey results. The hindering and enabling factors associated with the clinical implementation of the evidence were analysed based on the three core elements of i-PARIHS, to formulate the clinical implementation plan for VTE nursing evidence. On-site expert reviews and focus group interviews were used to evaluate the feasibility of the draft plan, make adjustments, and finalize the evidence-based practice plan, which was then put into practice and evaluated., Results: A new nursing process, a health education manual and a nursing quality checklist on VTE has been established and proved to be appropriate through the implementation. Compliance with evidence related to VTE nursing increased significantly in the two units, with better compliance in unit B than unit A. The knowledge, attitude and behaviour scores for VTE nursing increased substantially in both nurses and patients., Conclusion: The EI programme of incorporating the "best" evidence on VTE nursing into clinical practice using the i-PARIHS framework demonstrated feasibility, appropriateness and effectiveness and could serve as a reference., Competing Interests: The authors have declared that no competing interests exist.

Background: The importance of the role of clinical nursing leaders as Evidence-based Practice (EBP) mentors has increased; however, information regarding their experiences is limited. Aims: This study aimed to explore EBP mentors' lived experiences. Design: This qualitative study used a phenomenological framework suggested by Colaizzi. Methods: The participants were seven EBP mentors working as unit managers in Korea. Data were collected via in-depth, semi-structured interviews. Findings: The experiences of EBP mentors were identified to three categories: 'challenges in taking on the new role of EBP mentor', 'forming intimate EBP mentor-staff nurse relations' and 'becoming independent as a facilitator'. The EBP mentors experienced role ambiguity, stress, and burden during the initial phase of EBP mentorship; however, they adjusted and reported positive experiences during the adjustment process. Conclusion: Before implementation an EBP initiative, systematic and educational programs that target the EBP mentors should be offered. A systematic approach to creating an institutional culture of EBP are also needed.

Background : Little is known about the personal, professional and workplace factors that influence evidence-based practice for forensic mental health nurses. Aim : This study describes the sources of practice knowledge for forensic mental health nurses, and the factors that influence the implementation of evidence-based practice. Design : This research study utilised a cross sectional survey design. Methods : All nurses ( n  = 244) working in one forensic mental health in-patient facility were sent an electronic invitation to complete the Developing Evidence Based Practice Questionnaire. Data was analysed to calculate descriptive statistics. Findings : Fifty-three respondents completed the survey. Respondents reported using experiential knowledge and locally derived sources of information more frequently than research-based evidence to inform their practice. Respondents reported being least skilled at finding, reviewing and using research evidence to change practice. The most frequently rated barriers to evidence-based practice were having insufficient time and resources to both finding and reviewing information and to implement changes in practice. Conclusions : Forensic mental health nurses tend to express a bias towards valuing social or qualitative sources of information to inform practice. Exploring the relationships between individual and organisational factors in the context of forensic mental health is recommended in order to gain further insights into the translation of evidence into practice for forensic mental health nurses. Impact statement : Unique contextual aspects of the forensic mental health environment may influence the implementation of evidence-based practice. Our study highlights that further support, resources and training is required to promote the use of research-based evidence in forensic mental health nursing.

An internal peer-reviewed journal was created to promote high-quality nursing practice, improve patient outcomes, and inspire nurses at an academic medical center. The goal of the journal was to increase nurses' utilization of evidence-based practice (EBP). The publication provides a platform that facilitates the dissemination of nursing research and supports the implementation of EBP across the organization.

Purpose: To define research utilization (RU) and identify barriers and facilitators to RU in nursing practice., Methods: An international integrative review of 42 studies was conducted related to barriers and facilitators of RU., Results: Following a review of the research that met the inclusion criteria, the author identifies common themes related to the implementation of research into clinical practice and the challenges surrounding RU., Conclusion: Despite consistently perceived barriers to research among nurses from different geographic, cultural, and clinical backgrounds, practice changes are typically out of their hands. Further research is necessary to gauge perception among the nursing associations, regulatory bodies, healthcare organizations, policy makers, and managers responsible for implementing these changes.

Standardized nursing practice based on the foundations of evidence-based practice leads to high-quality patient care and optimal outcomes. Despite knowing the benefits of evidence-based practice, health care organizations do not consistently make it the standard of care; thus, implementation of evidence-based practice at the system level continues to be challenging. This article describes the process adopted by a facility in the Southwest that took on the challenge of changing the organizational culture to incorporate evidence-based practice. The organization met the challenges by identifying perceived and actual barriers to successful implementation of evidence-based practice. The lack of standardized practice was addressed by developing a group of stakeholders including organizational leaders, clinical experts, and bedside providers. Changing the culture required a comprehensive process of document selection and development, education, and outcome evaluation. The ultimate aim was to implement an integrated system to develop practices and documents based on the best evidence to support patient outcomes., (©2020 American Association of Critical-Care Nurses.)

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

The integration (routinizing and sustaining) of evidence-based practice (EBP) into hospital management is a key element for improving patient safety and ensuring better patient outcomes. Hospital managers and clinical leaders play crucial roles in this integration. Interactions between leaders and integration context influence the improvement's quality, but leader-based actions that are effective for improving nursing practice remain unclear. The relationship between leaders could also either hinder or enable this implementation process. The aim of this study was to generate a theory about patterns of leader behavior that leaders are engaged in when attempting to integrate EBP in a clinical setting. We used a classic grounded theory methodology to generate a substantive EBP theory. In this study, through participant observation, we observed 63 nurses (15 specialist, 39 registered, and 9 assistant nurses). From these, five ward leaders (two head nurses, one assistant head nurse, and two teaching nurses) participated in individual interviews, and 18 clinical nurses participated in four focus groups. "Creating room for EBP" emerged as a theory for explaining the way in which the leaders attempted to resolve their main concern: How to achieve EBP treatment and care with tight resources and without overextending the nurses. Creating room for EBP encompasses a process of interactions, including positioning for, executing, and interpreting responses to EBP., (© 2019 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.)

The aging demographic shift occurring world-wide is creating an opportunity for innovative care models to address the burgeoning care needs of the expanding population of older adults. Nursing and advanced practice nursing as well as interprofessional models past and present hold insights into how to meet the needs of older adults across the continuum of care. A review of past and present models of care is provided. These models across settings emphasize maximizing the role of nurses and advanced practice nurses. The models reviewed include: On LOK and Programs of All-inclusive Care for the Elderly (PACE); Community Aging in Place, Advancing Better Living for Elders (CAPABLE); Teaching Nursing Homes; Interventions to Reduce Acute Care Transfers (INTERACT); Missouri Quality Initiative (MOQI); Evercare/Optum; Nurses Improving Care for Health System Elders (NICHE); Acute Care for the Elderly Unit (ACE Unit); Hospital Elder Life Program (HELP); Age-Friendly Health Systems; and the Transitional Care Model. Each model emphasizes education on the special needs of older adults, providing easy access to evidence-based tools and interventions, as well as strong interprofessional collaboration. Sustainable evidence-based nursing and interprofessional innovations are present across health care settings from the community, long-term care and the acute care setting to address the complex needs of older adults., (Copyright © 2020. Published by Elsevier Inc.)

Purpose: The purpose of this article is to describe how the Nurse-Family Partnership (NFP) has been scaled up and supported in Colorado. As an intermediary, Invest in Kids (IIK) provides implementation support for the NFP in Colorado using a generalizable implementation framework, the Active Implementation Frameworks (AIF)., Organizing Construct: An overlay of the AIF and the clinical nursing-informed implementation support that IIK offers to NFP providers across Colorado is explored, and relevant examples are highlighted., Conclusions: Without the use of the AIF in combination with clinical nursing expertise to support high fidelity use of the NFP throughout Colorado, promised NFP program outcomes may likely not be realized and sustained., Clinical Relevance: Further understanding of how to utilize implementation frameworks to support evidence-based clinical nursing programs and interventions may allow for results found in research studies to be more widely attained and maintained across practice settings., (© 2019 Sigma Theta Tau International.)

Aim and Objectives: To examine the influence of staff nurses' individual factors on knowledge, attitudes and implementation of evidence-based practice in Saudi Arabia and to identify facilitators and barriers to evidence-based practice implementation., Background: Evidence-based practice has been considered as a key for healthcare quality measure. The literature, however, shows that nurses worldwide are not implementing evidence-based practice as expected and recommended by governing agencies. In Saudi Arabia, evidence-based practice implementation has not been addressed sufficiently., Design: A cross-sectional, correlational design was used. We have complied with the guidelines of STROBE Checklist in presenting this research. A convenience sample of staff nurses (n = 227) was selected from four hospitals in Riyadh, Saudi Arabia. The survey questions included the Evidence-based Practice Questionnaire and individual factors. Data were analysed using multiple linear regression models., Results: Attitudes towards evidence-based practice had the highest mean followed by evidence-based practice knowledge and implementation means. Evidence-based practice training and research involvement were associated with knowledge in the bivariate and multivariate analyses. None of the individual factors were associated with attitudes. However, knowledge was associated with attitudes. Knowledge and attitudes influenced evidence-based practice implementation positively. Unexpectedly, receiving evidence-based practice training made it more difficult for nurses to participate in evidence-based practice implementation process. We found that attitudes partially mediated the relationship between knowledge and evidence-based practice implementation., Conclusion: Nurses in Saudi Arabia are willing to be involved in the evidence-based practice process. However, nurses identified that they need to improve their knowledge and skills in order to be active participants in the process., Relevance to Clinical Practice: Organisations and nursing leadership may benefit from developing a comprehensive strategy to promote staff nurses' involvement in the evidence-based practice process through providing continuing education and mentoring programmes about evidence-based practice., (© 2019 John Wiley & Sons Ltd.)

Purpose: The purpose of this article is to describe the differences between quality improvement and implementation science, the urgency for nurses and nurse scientists to engage in implementation science, and international educational opportunities and resources for implementation science., Organizing Construct: There is a push for providing safe, effective, patient-centered, timely, efficient, and equitable health care. Implementation science plays a key role in adoption and integration of evidence-based practices to improve quality of care., Methods: We reviewed implementation science programs, organizations, and literature to analyze the roles of nurses and nurse scientists in translating evidence into routine practice., Findings: Implementation-trained nurses and nurse scientists are needed as part of multidisciplinary teams to advance implementation science because of their unique understanding of contextual barriers within nursing practice. Likewise, nurses are uniquely qualified for recognizing what implementation strategies are needed to improve nursing care across practice settings., Conclusions: Many international clinical and training resources exist and are supplied to aid interested readers in learning more about implementation science., Clinical Relevance: Half of research evidence never reaches the clinical setting, and the other half takes 20 years to translate into clinical practice. Implementation science-trained nurses are in a position to be excellent improvers for meaningful change in practice., (© 2019 Sigma Theta Tau International.)

Background: This study aimed to identify clinical nurses' evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt's Advancing Research & Clinical Practice through Close Collaboration model as the first step., Methods: A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP., Results: Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation., Conclusions: Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization., Competing Interests: The authors have declared that no competing interests exist.

In healthcare, timely communication of critical information is imperative among workforce members. Nurse leaders struggle with how to reach clinical staff effectively when informing them of program updates, practice changes, or available resources. This article provides a review of the marketing and communication literature sharing best practices for improving visibility and program uptake for infrastructure supporting the conduct of inquiry projects among hospital employees using an evidence-based practice approach.

Evidence-based nursing is a process that requires nurses to have the knowledge, skills, and confidence to critically reflect on their practice, articulate structured questions, and then reliably search for research evidence to address the questions posed. Many types of research evidence are used to inform decisions in health care and findings from qualita- tive health research studies are useful to provide new insights about individuals' experi- ences, values, beliefs, needs, or perceptions. Before qualitative evidence can be utilized in a decision, it must be critically appraised to determine if the findings are trustworthy and if they have relevance to the identified issue or decision. In this article, we provide practical guidance on how to select a checklist or tool to guide the critical appraisal of qualitative studies and then provide an example demonstrating how to apply the critical appraisal process to a clinical scenario.

Leveraging an established evidence-based practice (EBP) workshop at the Mayo Clinic campus in Arizona, the manager of Nursing Research asked local library staff to discuss the research process and to demonstrate to the attendees how to use literature databases to support their research projects and EBP practices on their units. The EBP workshop was presented via video conference from the originating location to two remote locations within the organization. Each remote site had a librarian in attendance to support the librarian at the originating campus. This method allowed the librarians at each site to guide and assist patrons and establish a face-to-face connection with attendees.

Objective: To evaluate the implementation and outcomes of evidence-based fall-risk-reduction processes when those processes are implemented using a multiteam system (MTS) structure., Data Sources/study Setting: Fall-risk-reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall-event reporting system to drive improvement., Study Design: A one-group pretest-posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall-event reporting system., Data Collection: Hospitals used gap analyses to assess the presence of fall-risk-reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall-event data throughout the study., Principal Findings: The extent to which hospitals implemented 21 processes to coordinate the fall-risk-reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end-of-study period (January 2014-July 2014). Bedside fall-risk-reduction processes were not significant predictors of these outcomes., Conclusions: Multiteam systems that effectively coordinate fall-risk-reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls., (© Health Research and Educational Trust.)

The substantial physical health disadvantage experienced by people diagnosed with mental illness is now identified in a growing body of research evidence. The recent promulgation of improved physical health care as a goal of contemporary Australian Mental Health Policy should provide impetus for initiatives and strategies to address this inequity. To date increased knowledge of the problem has not resulted in obvious and sustained changes. The aim of this article is to introduce the role of the Physical Health Nurse Consultant as a potential strategy. The potential contribution and value of this role is considered by reviewing the evidence from the perspective of multiple stakeholders and considering the suitability of nursing to meet the complex needs involved in improving physical health. The requirement for a multi-faceted and comprehensive evaluation is also articulated. A robust, prospective and long-term evaluation plan includes physical health measures, changes in health behaviours, cost-benefit analysis and consumer acceptability to ensure the intervention is effective in the long term. This thorough approach is essential to provide the level of evidence required to facilitate changes at the practice and policy levels. The specialist nursing role presented in this article, subject to the comprehensive evaluation proposed, could become an integral component of a comprehensive approach to addressing physical health inequities in people with mental illness.

EBN Perspectives brings together key issues from the commentaries in one of our nursing topic themes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Leadership style and organizational culture have often been studied independently in nursing research despite abundant evidence that the two factors both influence employee outcomes. Moreover, diverse theoretical typology and measuring instruments challenges generalizability of findings. Employees from different cultural, geographical, occupational settings were also reported to have varying interpretation on organizational culture and leadership style underlying constructs. This study aims to validate the Nursing Leadership and Organizational Culture (N-LOC) questionnaire, based on the two commonly used theoretical frameworks: Multifactor Leadership Theory and Competing Values Framework, on its applicability in an Asian hospital setting., Methods: All full-time nurses from two distinctive Asian hospitals (H1: n = 295 and H2: n = 1146) were invited to participate in this questionnaire study. Exploratory factor analysis (EFA) was carried out when confirmatory factor analysis (CFA) fit indices were not satisfactory after model refinement to explore the actual underlying construct in sampled population. Part-time and outsourced nurses were excluded. 93 nurses from H1 were randomly selected for test-retest reliability 4 weeks post initial survey. Scale internal consistency, convergent and discriminant validity were also assessed., Results: CFA results indicated that the proposed CVF organizational culture 4-factor structure was applicable to our sample but not the MLQ leadership 3-factor/9-factor structure. EFA revealed a 2-factor leadership style construct for our sample, named Confucius transformational and Laissez-Faire passive leadership. Transformational leadership traits already embedded in Confucius cultural values (self-sacrifice, stresses collective mission, instills pride) did not apply, the new Confucius transformational construct which resembles LMX theory paternalistic leadership style is deemed more suitable in an Asian context. A final 14-item 2-factor leadership and 13-item 4-factor organizational culture construct was yielded with satisfactory fit indices (CFI, TLI > 0.95, RMSEA < 0.08), internal consistency (Cronbach's alpha > 0.7), test-retest reliability (ICC > 0.4) and convergent and discriminant validity., Conclusion: A reliable N-LOC organizational culture and leadership questionnaire (N-LOC) has been validated in an Asian nurse context. Study results demonstrated the importance of scale validation in cross-cultural adaptation, as underlying scale constructs may change with specific cultural and contextual factors. Future studies are encouraged to test the adaptation of this scale in other cultural and occupational settings.

Aim: Evidence-based practices (EBPs) seek to promote the implementation of interventions that are effective, appropriate, feasible and meaningful for patients. The current demand for updated EBPs in Finland is shaped by national legislation. This study's aim was to describe nurses', nurse directors' and clinical nurse specialists' (CNSs') perceptions of how well EBPs are being implemented in nursing in Finland., Methods: In this quantitative descriptive study, the data were collected with an e-questionnaire distributed in Finland in 2017 and analysed using descriptive statistical methods., Results: A total of 1063 nurses and 340 nurse directors and CNSs participated. The majority of nurses (64%, n = 669) reported that evidence is not clearly used to develop clinical practices. Most nurses (67%, n = 702) and over half of nurse directors and CNSs (57%, n = 184) also observed that knowledge of evidence-based protocols is not widespread within their organizations. However, 39% of nurses (n = 407) and 53% of nurse directors and CNSs (n = 171) stated that they are developing EBPs., Conclusion: The results indicate that nurses need more support to implement EBPs.

Partnerships between academia and practice can lead to improved patient care and health system innovations. Nurse educators in both academia and practice are positioned to facilitate opportunities for students and practicing nurses to be involved in evidence-based practice (EBP) care initiatives involving academic-health care partners in clinical and/or community-based systems. Best practices in collaborative partnerships have demonstrated the significance of their far-reaching impact on patients, students, direct care nurses, and health systems. Translation of EBP knowledge to practice transforms patient outcomes and empowers nurses to address the complexity of health care systems. This article describes the process and outcomes of an academic-practice partnership facilitated by nurse educators in both academic and practice settings. The impact of the adoption of EBP projects on clinical practice, students, and practicing nurses is described. National and international implications for academic- practice partnerships are discussed. [J Contin Educ Nurs. 2019;50(6):282-288.]., (Copyright 2019, SLACK Incorporated.)

Purpose: This article describes the work of the National Association of Clinical Nurse Specialists (NACNS) Opioid/Pain Management Task Force and provides guidance for the clinical nurse specialist (CNS) in evidence-based pain management interventions and organizational program development., Description: In September 2016, the NACNS commissioned a group of pain management experts to identify the resources that CNSs need to address appropriate opioid use and pain management in various practice settings. Challenges faced by CNSs related to opioids and pain management were identified through NACNS Conference forums and a pain management survey of NACNS members., Outcome: On the basis of member input, the task force highlighted key components, or pain pillars, necessary for optimal pain management. Use of these pillars can guide the CNS and healthcare organizations to develop comprehensive pain management practices that provide the foundation for safe, effective, and individualized patient care., Conclusions: As an expert in clinical, professional, and systems leadership, the CNS is ideally suited to convene interprofessional groups focused on pain management including development of organizational philosophies, policies, and evidence-based care.

Aims and Objectives: To produce changes in the therapeutic relationship between clinical practice nurses and patients in psychiatric units by implementing evidence-based practices through participatory action research., Background: The therapeutic relationship is the cornerstone of nursing care in psychiatric units. The literature suggests that theoretical knowledge alone is insufficient to establish the therapeutic relationship in practice. Therefore, strategies are needed to adequately establish the therapeutic relationship in psychiatric units., Design: Participatory action research., Methods: Participants consisted of nurses from two psychiatric units of a university hospital. Data were collected through focus groups and reflective diaries, which were analysed using the content analysis method. The COREQ guidelines were followed to ensure rigour., Results: Nurses conceptualised the therapeutic relationship in their practice, identifying facilitating elements and limitations. They were able to compare their clinical practice with the recommendations of scientific evidence and constructed three evidence-based proposals to improve the therapeutic relationship: (a) a customised nurse intervention space, (b) knowledge updating and (c) reflective groups, which they subsequently implemented and evaluated., Conclusions: This study shows that nurses in psychiatric units can generate changes and improvements in the therapeutic relationship. The process of implementing evidence-based practice enhanced participants' awareness of their clinical practice and allowed them to make changes and improvements., Relevance to Clinical Practice: The process confirmed that the implementation of evidence-based practice through participatory methods, such as participatory action research, is valid and produces lasting changes. This study also reveals the need to rethink nurses' functions and competencies in current psychiatric units., (© 2018 John Wiley & Sons Ltd.)

Integration of evidence-based practice (EBP) into the culture of a healthcare organization is essential to provide safe patient care and promote a thriving culture for the nurses within the healthcare organization. Collaboration and utilization of both clinical and academic experts facilitate the removal of barriers to EBP. This article describes the successful partnership between a healthcare system and school of nursing in executing a 3-phased multimodal approach to an EBP training program.

Background: In Italy, there are still many barriers to the development of a culture of evidence-based practice (EBP) and nurses' knowledge of EBP is lacking. Additionally, in Italy there are still very few advanced practice registered nurses to significantly contribute to the development of EBP., Aim: This aims to identify the implications of a wide-scale nursing education intervention to engage clinical nurses in EBP through the Italian RN4CAST study., Methods: A qualitative study based on a thematic analysis. A total of 800 clinical nurses actively participated in nine training sessions across Italy. At the end of each training session written feedback data were collected and then underwent thematic analysis., Results: All participants were strongly motivated to engage in EBP thanks to their involvement in the RN4CAST project. With regard to the implications of EBP, the thematic analysis produced the following themes: Professional identity; Quality of care; Perceptions of patients and nurses; Research impact; and Organization., Conclusions: The involvement of a large number of clinical nurses in a research project raised their awareness about the advantages of engaging in EBP, and how evidence can be used to raise motivation to change current practice policies., (© 2019 Wiley Periodicals, Inc.)

Changes are underway at the Oncology Nursing Society to align resources so that scientists have the support needed to generate new knowledge and clinicians have access to tools needed to use evidence-based interventions that can speed the translation of research to transform cancer care.