جستجوی مقالات مرتبط با کلیدواژه "عملکرد مبتنی بر شواهد" در نشریات گروه "پزشکی"

Evidence-based practice is the use of the best scientific findings in clinical decisions and plays an important role in improving the quality of nursing care. But it faces challenges. This study was conducted with the aim of identifying the challenges of evidence-based practice.

The current review study was conducted using the Broome 2000 method. Key words “evidence-based practice, evidence-based practice barriers and challenges, and evidence-based nursing” were searched in Persian databases (SID, Magiran, IranMedex, and Irandoc) and English databases (Web of Science, PubMed, and Google Scholar). After obtaining 173 articles, 164 articles were excluded due to lack of inclusion criteria, and finally 9 articles were included in the study.

The findings confirmed that it is impossible to hope for the use of evidence at the desired level and showed several challenges that were classified in 6 areas: mismatch of organizational strategies, human, educational, research, cultural factors, and resources and equipment.

It seems that these obstacles cannot be prioritized because their impact can be different in different regions of the country. But they can be identified by looking carefully in each area. Therefore, being aware of these challenges, the officials will be able to find their roots and take action to solve them so that they can take steps towards improving the health of the society.

Postmodernism is an intellectual, social, cultural, artistic, and moral evolutionist movement in the contemporary era. Nursing theorists consider postmodernism essential for formulating and presenting a care program because rethinking, critical thinking, and evidence-based training and practice are the main concepts of this philosophical thinking. The present study reviewed the available literature and evidence about postmodernism as an evidence-based approach to nursing.

In this study, a non-systematic narrative review method was used. Articles were searched using the keywords Postmodern, Postmodernism, Evidence-Based Practice, and Nursing. The search for Persian and English articles was done in the internal databases of SID and Magiran and external databases of PubMed, ProQuest, and Science Direct without time and methodological limitations. A total of 207 articles were found, and after reviewing the articles, 18 studies were evaluated and analyzed based on the inclusion and exclusion criteria for data extraction.

The results showed that the five features of postmodernism in evidence-based nursing science include "decentralization in care practice," "attention to patient values," "strengthening decision-making and clinical reasoning," "reflection and critical thinking in evidence," and "interaction and communication therapy."

Since the postmodernist theory shares many concepts with the evidence-based approach, this point of view can be used to increase the standards of education and care in nursing. Therefore, it is suggested that respected nurses consider using this approach. Also, professors, clinical nursing trainers, and nursing managers should pay more attention to applying this important approach.

Considering the importance of women's health researches (WHR) in achieving the millennium goals development and lack of a unified and organized direction in the development and support of women's health research, planning and policy making, creating an infrastructure for watching researches and observatory in this field will be an effective step. The aim of this study was designing a model for WHR networking and collaboration, and establishment of WHRwatching and observing system in Iran.

This applied field qualitative study includes reviewing scientific literatures and documents, exploring expert’s views and opinions by conducting expert meetings, questionnaires and interviews, developing and finalizing the model. Data analysis was performed using content analysis method and MAX_ QDA software version 2018

The model and the conceptual framework for WHR network and observatory were designed with 3 main axes including identifying and classifying WHR, establishing collaboration between research centers and transition of knowledge and application of WH researches. In designing the model; Mission, objectives, structure, resources and deployment requirements were identified.

Comprehensive cooperation of stakeholders is necessary to identify the challenges and problems of WH in the country. Due to limited resources and the need to create an appropriate organizational culture to develop all components and expected infrastructure of the designed model; advocacy and support for establishment of WH research network, watching and observing system is necessary.

Pregnancy is a critical period. A healthy lifestyle during pregnancy has profound direct and indirect effects on the long-term health of the mother, the fetus and the newborn. According to studies, healthy lifestyle education for pregnant mothers in Iran, including at the level of primary health care, is not in a favorable condition. Lack of training program updates for midwives and lack of documented comprehensive educational content are among the reasons. The present policy brief aimed at dealing with this health problem by implementing the best evidence in practice. We propose "delivering healthy lifestyle education to pregnant women by midwives according to the best evidence-based criteria" to the health policymakers in Iran Ministry of Health and medical sciences universities. In this regard, it is recommended to systematically train midwives in healthcare settings, integration of healthy lifestyle education to mothers and primary health care programs, including that in the electronic health records of pregnant women, and continuous monitoring of these activities could be of great benefit.

Health care systems need reforms in the process of education to performance. Reforms with a targeted educational and medical perspective that will permeate all effective health care systems and evidence-based medicine is considered a practical method in the development of health care and treatment in the world. This approach will be effective during its lifetime in the education of medical sciences, on the quality of education, on the quality of education, from the beginning of the education of health and medical sciences until the lifetime of the educators.
The present study is a systematic review by searching in Iranian databases such as: SID, Iranmedex, Magiran, foreign databases such as: Uptodate, Pubmed, Scopous during the years 2019 to 2022 with keywords; Evidence-based medicine, evidence-based education, evidence-based practice, evidence-based learning, evidence-based care, educational quality, medical science education are searched.
Evidence-based medicine in line with its longevity in medical sciences still needs a fundamental review in healthcare and treatment, many studies have stated the lack of use of evidence-based medicine and obstacles to its implementation in their results. However, the growing trend of using evidence-based medicine is not significant and requires inductive impulses to implement, apply and use and evaluate its effects.
Evidence-based medical education and its effects have been clearly studied, but micro and macro policies in its implementation and application require a fundamental review so that the process of education, learning, performance and care is the most favorable process of growth and development in the body. Go through the educational and research system of medical sciences.

Evidence-based performance evaluation is the main issue in all organizational analyzes in healthcare, especially hospitals. The aim of this study is to evaluate evidence-based performance of Tehran University of Medical Sciences hospitals

The current research is applied, qualitative with a mixed approach. To identify and extract the components, an open interview was conducted with 14 experts familiar with evidencebased performance evaluation of teaching hospitals of Tehran University of Medical Sciences. The experts were selected using the snowball method, and the selection of experts continued until theoretical saturation was reached. Thematic analysis method was used to analyze the data from the interviews.

Evidence-based performance evaluation was presented in the form of thirteen main components. The approved components in this research were: clinical effectiveness, staff requirements, strategic planning, organizational mission statement, patientcentered, human resources empowerment, satisfaction, accountability governance, support services, service quality and safety, hospital management, accountability, Central employee.

Considering that it was found that the impact factor of all evidence-based performance evaluation components is acceptable, therefore, the managers of teaching hospitals of Tehran University of Medical Sciences should pay attention to the use of this research in order to create appropriate infrastructures for evidence-based performance evaluation.

Evidence-based practice, as a new paradigm for healthcare practice and medical education, has become a core competence for the new century healthcare professionals and thereby, it is now possible for healthcare professionals to easily retrieve, critically appraise, and apply evidence from primary and secondary quantitative research. However, despite the increasing growth of qualitative research in the field of healthcare and the importance of the use of evidence from qualitative research in clinical decision-making and practice, the retrieval, appraisal, and application of qualitative evidence have been neglected in the principles of evidence-based practice. This editorial briefly introduces the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework as an alternative to the PICO (Population/Problem, Intervention/Exposure, Comparison/Control, Outcome) framework for systematic retrieval of qualitative evidence.

The employment of faculty members who have sufficient knowledge and positive attitude toward evidence-based care in clinical setting is necessary. The aim of this study was to determine the level of knowledge, attitude and adoption of faculty members of nursing schools of north west Iran in field of evidence-based practice. Hence,in the present descriptive-analytical study conducted by census method, a questionnaire was sent to 120 faculty members via email, which received 84 questionnaires upon completion (response rate 70%). Then, the data collection tool consisted of four sections. The first section included demographic information and the second, third, and fourth sections included a questionnaire on knowledge, attitudes, and acceptance of Rubin and Parrish. Data were analyzed using SPSS software version 22. Accordingly, data analysis showed that mean and standard deviation of knowledge scores werecounted in 65.87±6.31 (out of 75), attitude 76.77±7.12 (out of 95) and acceptance 46.13±5.10 (out of 55). There was a positive significant relationship between all three dimensions of knowledge, attitude and adoption (P <0.05). In relation to demographic variables, there was a significant relationship between knowledge level with gender (P = 0.01) and English language proficiency (P = 0.005).  According to result, the level of knowledge, attitude and adoption of faculty members of nursing schools was at a good level that indicated an effective move towards integration of Evidence Based Practice (EBP) at educational and academic level. Therefore, it is necessary to pay special attention to the role of teachers in designing EBP training programs. 

Many nurses face challenges of implementing evidence-based practice as a problem-solving approach in the field of health care. Therefore, the purpose of this study was to summarize and report structurally the results of various studies conducted in this field to identify challenges and strategies for implementing evidence-based practice in nursing to develop effective and efficient guidelines.

In this systematic review study, using the internal database: Magiran, SID, Iranmedex and foreign: CINAHL, ProQuest, Ovid, PubMed, Scopus, Science Direct, Google Scholar all articles published in Iran in 2010 to 2020 in the field of Evidence-based practice were explored. The result of this research was the achievement of 39 articles and a research project related to the subject, which eventually 19 completely related studies are included in the research.

Among the studies reviewed, 3 articles (16%) were published in foreign journals and 16 articles (84%) in domestic journals. The results represent four main concepts include: "Evidence-Based Practice Features", "Evidence-Based Practice Barriers", "Evidence-Based Practice Strategies" and "Evidence-Based Practice Instructions".

According to the results, most nurses are not familiar with the concept of evidence-based practice and there are several barriers in the way of nurses in implementing evidence-based practice. To address the clinical challenges of nursing, health care managers and policymakers should plan to use nursing professors and graduate students with the support of nursing managers to guide nurses in the implementation of evidence-based practice and the development of protocols.

The current study was conducted to determine the relationship between learning style and EBP. In a cross sectional- correlational study, 65 individuals of clinical assistance were recruited to the study as stratified random and proportional assignment. The tools were learning style of Vark scale and evaluation of knowledge and attitude towards evidence-based performance. Data were collected by referring of the researcher to the hospitals and offering the questioners to subjects and completing by them, thereafter data were analyzed by SPSS software. The dominant learning style was one-mode (75%) of auditory style with frequency percent of (49.2%). The attitudes (67.7%) of the clinical assistance regarding EBP were positive and 43.1% of them had an appropriate level of EBP. The chi square test showed a significant relationship between awareness and EBP (P=0.01), as well as between attitude and EBP (P<0.001). There was no relationship among EBP and learning style (P=0.639). With increasing the awareness level, and positive attitude, EBP level was raised in clinical assistances, so, it is essential to provide some systematic and disciplined educational programs about EBP.

Evidence-based performance requires that Clinical staff in different areas of teaching, clinical and management learn the skills of using the evidence from the research and apply these. The purpose of this study was to determine the relationship between learning style and evidence-based performance in nurses working in Kermanshah hospitals. This study was performed on 319 nurses working in hospitals affiliated to Kermanshah University of Medical Sciences in 2015 by stratified random sampling and proportional assignment. The data gathering tool in this research was questionnaires include: the learning style of VARK, Evidence-based performance and demographic data form. Validity and reliability of the VARK learning style questionnaire have been confirmed in the country and abroad.
Validity of evidence-based performance questionnaire was confirmed through content validity and the test-retest method was used to determine the reliability of this questionnaire. Data analysis was performed using the VARK learning style analytical tool in Excel, Spearman correlation and Chi-square tests. The learning style of single-mode template (84.1%) and hearing-type with relative frequency (46.3%). Knowledge about evidence-based performance (53.2%) was moderate in nurses Attitude (52.6%) of people was positive about evidence-based performance. The evidence-based practice nurses (57/8 %) were nearly desirable level. There was no significant relationship between nursing learning styles and evidence-based performance (p = 0.926). Nurses have different learning styles. The development of Effective educational methods adapted to the learning style will help increasing their evidence-based performance by increase nursing awareness. Principled and systematic training to raise awareness and improve attitudes toward evidence-based performance and Nursing education also seems to be essential in terms of the concepts of evidence-based practice, scientific and workshop training, and the creation of facilities.

Ventilator-associated pneumonia (VAP) is a subset of hospital infections occurring 24 hours after intubation or mechanical ventilation. Considering the outcome of VAP, prevention is of a high importance in the care of patients who are being treated by mechanical ventilation. Thus, evidence-based guidelines have been published by researchers to prevent ventilator-associated pneumonia and can effectively reduce its incidence.
The purpose of this study was to review the knowledge on these evidence-based guidelines in prevention of ventilator-associated pneumonia.
This is a descriptive -analytical, cross-sectional study which used census sampling method. 171 nurses with bachelor and master degree participated in the study. To determine their knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia, a two-part questionnaire was used. The first part included demographic information including age, sex, nursing position title, university degree, working experience and years in the intensive care unit as well as ICU specifications such as type and number of beds and internet access. The second part had Labeau et al. questionnaire that consisted of 9 multiple-choice questions. Questionnaires were given to the participants during morning, afternoon and night shifts by a researcher in each ward. The response time was 15 minutes. After collecting the questionnaires, correct responses were calculated in percentage and the mean of total score was determined. In this study, evaluations and judgments were based on the mean of score. In order to analyze the data, descriptive statistics were used to estimate the frequency. Chi-square, t-test and ANOVA were used to examine the relationship between level of knowledge, demographic variables and characteristics of intensive care unit.
171 of 219 ICU nurses participated in this study and 48 patients were excluded due to vaccation at the time of sampling or unwillingness. Most of the study population was women (93.6%) with a Bachelor's Degree (94.7%) and nurse position title (89.5%).In this study, 59.9% of the nurses had not passed any ICU-specific training course. 42.7% of them were in ICU with more than 8 beds. The majority of them (40.4%) had between 1-5 years of working experience. Furthermore, the mean score of nine one-score questions equaled 4.63±1.708. The most wrong answers belonged to the questions about "ventilator set's replacement frequency" and "the moisturizer's replacement period". The most correct answers were about "choosing a semi-sitting position for reducing VAP". Mean of scores obtained by women was higher than men. The independent t-test showed no significant difference between the two groups (P=0.721). The mean score was higher in nurses with master degree and the ones who had passed specific ICU nursing courses than the ones who did not. Independent t-test manifested no significant difference (P=0.189, P=0.204) in this regard. Among the participants who had replacement nurse position, nurses working in ICUs with more than 8 beds and nurses with more than 10 years of experience had a higher mean score. Yet, ANOVA showed no significant difference among these groups (P =0.168, P=0.882, P=0.327).
This results in more attention to training purposes in some parts of the guidelines. Lack of nurse's knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia is one of the potential barriers and increasing the awareness level will be the first step in a successful training program.
The findings seem to highlight the importance of specific parts of the guidelines that should be considered in trainings. Lack of nurse's knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia is one of the potential barriers. Increasing their awareness will be the first step for a successful training program on VAP prevention.

evidence-based care in the use of the best scientific evidence in clinical decisions and do the best care. It is one of the major challenges in the nursing interventions. This study aimed to determine of facilities and barriers to evidence-based nursing.
This study was a cross-sectional. The study population included clinical nurses, nurses, managers and nurse educators. The sample was calculated of 300 persons by simple random sampling method. Based on Rostas tool, then carried out good validity and reliability in order (r=0.83, r=0.79) was used. To achieve the objectives of the research using software SPSS 16 and data was analyzed by parametric (t-test and ANOVA) and Pearson correlation coefficient.
Most nurses in order to viewpoint were the facilitates of training courses and development of methods to analyze evidence (27.7%) and most of the barriers to implementation barriers (42.6 ± 2.2) the lack of easy access to information and research to date and effective (38.12%). There were between barriers and facilitate relationship meaningful and negative significant P= 0.0 2 , r = - 0.15 Between barriers and facilities based on demographic variables other than age and work experience P By removing barriers and providing facilities, However support and encourage the use of EBP, nursing Approaches will change. To achieve this, nurses need ongoing training and practice in this field.

Evidence-based practice (EBP) education is essential in nursing education. Therefore, identifying factors influencing nurse's adoption of EBP is very important to perform optimum quality nursing interventions. The aim of present study was to determine the factors affecting the adoption of EBP based on Roger's diffusion of innovations models in nurses.
Methods & Materials: This was a descriptive–analytical study. The research subjects were 130 nurses who worked in the hospitals affiliated to Tehran University of Medical Sciences in 2014. The research instruments were four questionnaires including demographic data; knowledge, attitude and the adoption of EBP; individual innovation and perceived attributes of EBP. Data were analyzed by descriptive and inferential statistics (Pearson correlation coefficient and path analysis) on SPSS v.19 and EQS.
The study findings showed that age and the working experiences of nurses had significant inverse relationships with knowledge of EBP (r=-0.809, r=-0.805). There was a direct relationship between individual innovation and knowledge (r=0.776). In addition, knowledge not only had a significant direct relationship with the adoption of EBP but also had the greatest impact on the adoption of EBP compared to other variables of model (r=0.937). Perceived attributes of EBP had significant direct relationships with attitude and the adoption of EBP (r=0.898, r=0.888 respectively). Attitude toward EBP also had a direct and significant relationship with the adoption of EBP (r=0.869). The results of the path analysis indicated the model variables to have an optimal fit (P The results of this study identify the factors affecting the adoption of EBP. Determining these factors can be an effective step to more adopt it in clinical environments.

Evidence Based Practice is a one of the competency in nursing that led to the scientific decision for health care. Recognition of barriers from the perspective of students can play a significant role in its development. The aim of this study was to evaluate the student's understanding of the barriers to evidence-based practice. This study was a qualitative- descriptive study. Participants were 28 nursing students in final year who were chosen purposeful. Sampling continued until data saturation. Collection data was conducted by 14 individual interviews and 2 focus groups. All interviews were tape recorded, handwritten, and were analyzed line by line. Conventional content analysis was conducted for data analysis and Max Q data software was used to record interviews and edit data. Most patients were female (72%) and 21-26 years old. Three themes and nine categories were achieved from data analysis. They include cognitive factors (Nursing education programs, quality education and empowerment of teachers), emotional factors (Student motivation and teacher motivation) and implementation factors (Organizational factors, community perspective, time, facilities). Planning for Effective Teaching Evidence-based practice with remove barriers is recommended. In this respect, empower and motivate teachers and students have important roles. Creation of background in clinical practice based on institutional support and facilities can be help to smooth of the path.

Nurses’ main tasks include the provision of healthcare services at the highest levels of quality and quantity standards, and based on the findings of scientific research. The aim of the present study is to identify and determine the barriers of evidence-based practice among nurses of Qazvin hospitals, in Iran, at 2013.
The present cross-sectional research was a descriptive- analytic study conducted among 260 nurses practicing in six hospitals of Qazvin in 2013. The barriers scale questionnaire developed by Funk, et al. was used to examine the four dimensions of evidence-based practice (EBP) barriers including adopter, organization, innovation and communication characteristics. To analyze the data, descriptive and analytic statistics were used.
The mean score of EBP barriers among subjects was 3.07 out of 4. Among the barriers, "organization" and "adopter" dimensions had the highest and lowest mean scores, respectively. There was no significant statistical relationship between gender and EBP performance, But a significant relationship was observed between organizational dimension with age, employment type and work experience.
Since “organization” was found to be the main barrier to the use of research in nursing performance, policy-makers and administrators should pay attention to the use of research in performance, the establishment of a research culture in organization, the creation of appropriate infrastructures, and the allocation of sufficient time to the nursing personnel to have access to evidences.

In regard to the importance of nursing student's attitudes toward EBP and using it in their professional future as well as the emphasis on educational planning for students, this study aimed to evaluate the attitude of senior nursing students toward evidence-based practice.
The present study was a descriptive- analytical cross-sectional study conducted in Kerman School of Nursing and Midwifery in 2014. Data were collected through the Persian version of a standard questionnaire of knowledge, attitude and practice of undergraduate nursing students about evidence-based practice. Sampling was conducted through the census method and 43 senior nursing students participated in the study. Data analysis was done through SPSS20 software.
According to the obtained scores, students showed a moderate attitude (2.80 ±1.11) toward evidence-based practice. The highest mean score was related to the item saying that EBP should be a part of the nursing curriculum (3.10±1.13). Student's attitudes toward EBP had significant relationship with the rate of course satisfaction, participation in research activities such as diagnosing issues for research, cooperation in research projects, evaluation of research reports and the method and rate of access to evidences (PAlthough student's attitude toward evidence-based practice was moderate, but appropriate educational planning and modifying nursing curriculum, are efficient steps for promotion of evidence- based practice.

Although the majority of research has shown a positive attitude towards evidence-based care, but in practice this care is not used. Nurses who act based on the scientific evidence have been able to make better decisions. this study aims to review the barriers to implementing evidence-based care from the perspective of nurses in the literatures. In this study, a review was carried out by searching the Iranian data bases of Magiran, SID, and English language; Google scholar, Scopus, Ovid, Science Direct, ProQuest, Ovid, PubMed with the key words of "evidence-based nursing" and "nursing". 38 articles that had the inclusion criteria were evaluated. The review of literature showed that the barriers for applying evidence based practice included in five categories including: personal obstacles, management and educational issues, related to the evidence, and environmental factors. The issue of evidence-based nursing is facing a lot of problems in implementation. effective searching databases, access to libraries in hospitals improving the professional knowledge of nursing managers, organizing the shifts, the provision of efficient human resources and encourage the employees to provide evidence-based care are recommended to promote the use of Scientific and updated evidences among nurses.

Traditional teaching of research methodology is associated with low learning and satisfaction but effective teaching increase professional abilities and positive attitude toward science. In this study the effect of research methodology teaching based on evidence based care, applications and research designing, on knowledge, attitude and teaching satisfaction was studied. In this quasi experimental study fifth semester nursing students at Birjand University of medical sciences were selected through census method in 2012 and for research methodology teaching from text books, at random were divided into two groups of 39 experimental and control students. Intervention included promoting skills to providing “evidence based care”, education of research methodology applications in different courses and cares and group designing of 11 research plans. In the control group, teaching was conducted using group discussion. Two researcher-developed questionnaires at the beginning and end of the study were used. Intervention outcomes included; scores of research knowledge, attitude toward benefits, necessity and research methodology applications and teaching satisfaction that were measured by 20 multiple choice questions, 12 and 21 likert scale items (score1-5) respectively. Data were analyzed by Chi-square, independent and paired t-tests, using SPSS 16 software. After intervention, the total research knowledge score of the experimental group (6.05±8.59) was higher than control (2.74±5.51) group (P<0.041). The attitude score of experimental group toward research after intervention to compare control group (P<0.028) and to with before intervention was higher (P<0.015). The teaching satisfaction score of experimental group (78.61±8.67) was higher than the control (71.23±9.24) group (P<0.001). Research methodology teaching combined with ongoing support for students, based on evidence based care, applications and group designing of research, can establish a relationship between the principles, designing, implementation and applications of research, increase knowledge and facilitate attitude and satisfaction.