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

Professional Stress Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04199065
• Other study ID #: CEIm-PSMAR 2018/8087/I
• Status: Completed
• Phase: N/A
• Start date: March 1, 2018
• Est. completion date: April 21, 2022

Study information

• Verified date: April 2022
• Source: Parc de Salut Mar
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1200
• Est. completion date: April 21, 2022
• Est. primary completion date: November 30, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 21 Years to 65 Years

Eligibility

Inclusion Criteria:

Nurses Work in the institutions participating in the study Acceptance to participate in the study

Exclusion Criteria:

Not be active

Related Conditions & MeSH terms

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

Intervention

Other:
• Good Practice Guidelines implementation
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.

Locations

Country	Name	City	State
Spain	Xerencia de Xestión Integrada de A Coruña	A Coruña
Spain	Hospital General Universitario de Alicante	Alicante
Spain	Hospital Universitri Germans Tries i Pujol	Badalona	Barcelona
Spain	Hospital Clínic	Barcelona
Spain	Hospital de la Santa Creu i Sant Pau	Barcelona
Spain	Hospital Universitario de Fuenlabrada	Fuenlabrada	Madrid
Spain	Hospital de Granollers	Granollers	Barcelona
Spain	Hospital de Guadarrama	Guadarrama	Madrid
Spain	Consorci Sanitari Anoia-Hospital Igualada	Igualada	Barcelona
Spain	Hospital Lucus Augusti	Lugo
Spain	Hospital Regional Universitario de Málaga	Málaga
Spain	Hospital General Universitario Santa Lucía	Murcia
Spain	Hospital Son Llàtzer	Palma De Mallorca
Spain	Hospital Universitari Son Espases	Palma De Mallorca
Spain	Hospital de Puigcerdà	Puigcerdà	Girona
Spain	Hospital Comarcal de Vinaròs	Vinaròs	Castelló
Spain	Organización Sanitaria Integrada (OSI) Araba	Vitoria Gasteiz	Araba

Sponsors (4)

Lead Sponsor	Collaborator
Parc de Salut Mar	COIB, Col·legi d'Infermers i infermeres de Barcelona, Department of Health, Generalitat de Catalunya (PERIS), Hospital del Mar Research Institute (IMIM)

Country where clinical trial is conducted

Spain, 

References & Publications (6)

Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT, Tishelman C, Scott A, Brzostek T, Kinnunen J, Schwendimann R, Heinen M, Zikos D, Sjetne IS, Smith HL, Kutney-Lee A. Patient safety, — View Citation

Aiken LH, Sloane DM, Clarke S, Poghosyan L, Cho E, You L, Finlayson M, Kanai-Pak M, Aungsuroch Y. Importance of work environments on hospital outcomes in nine countries. Int J Qual Health Care. 2011 Aug;23(4):357-64. doi: 10.1093/intqhc/mzr022. Epub 2011 — View Citation

Cho E, Chin DL, Kim S, Hong O. The Relationships of Nurse Staffing Level and Work Environment With Patient Adverse Events. J Nurs Scholarsh. 2016 Jan;48(1):74-82. doi: 10.1111/jnu.12183. Epub 2015 Dec 7. — View Citation

Fernández-Domínguez JC, de Pedro-Gómez JE, Morales-Asencio JM, Bennasar-Veny M, Sastre-Fullana P, Sesé-Abad A. Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development an — View Citation

Fuentelsaz-Gallego C, Moreno-Casbas MT, González-María E. Validation of the Spanish version of the questionnaire Practice Environment Scale of the Nursing Work Index. Int J Nurs Stud. 2013 Feb;50(2):274-80. doi: 10.1016/j.ijnurstu.2012.08.001. Epub 2012 S — View Citation

Heater BS, Becker AM, Olson RK. Nursing interventions and patient outcomes: a meta-analysis of studies. Nurs Res. 1988 Sep-Oct;37(5):303-7. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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
Primary	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	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
Secondary	change in Institutional attitude perceived by nurses in relation to nursing research	self-reported 4 question rating: yes, not, unknown.	baseline and 1 year