جستجوی مقالات مرتبط با کلیدواژه "پرستاری 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.

Evidence-based nursing (EBN) is a useful approach for clinical care and improving the quality of treatment. One of the factors that plays an important role in improving the EBN of nurses is self-efficacy. This study aims to investigate the mediating role of knowledge and attitude in the relationship between self-efficacy and EBN practice.

This is a descriptive and cross-sectional study. Participants were 250 nurses employed in hospitals affiliated to Mashhad University of Medical Sciences, Iran in 2023. They were selected by multi-stage cluster sampling method. The data collection tool was a five-part questionnaire, including a sociodemographic part, general self-efficacy scale, and knowledge, attitude and practice scales. Data analysis was done using descriptive statistics, Pearson correlation test and path analysis in SPSS software, version 27 and AMOS software, version 24. 

Self-efficacy had a direct effect on the EBN practice (β=0.308). It also had an indirect effect on the EBN practice through knowledge of EBN and attitude toward EBN (β=0.013). The designed model had a good fit to the data (χ2/df=1.131, GFI=0.988, CFI=0.993, IFI=0.994, TLI=0.988, RMSEA=0.023).

Considering the important role of self-efficacy in EBN, it is recommended that medical universities and medical centers pay special attention to the nurses’ self-efficacy. Improving their self-efficacy, EBN knowledge, and attitude towards EBN by holding workshops or training courses should be a priority in medical centers. Adopting strategies to motivate and encourage nurses to use EBN can also be useful.

Fatigue is one of the most annoying complaints reported in people undergoing hemodialysis. However, the lack of awareness of health care providers about evidence-based interventions in one hand   and unavailability of information in a coherent manner on the other hand is an important barrier to taking more effective measures. Therefore, it was decided to investigate evidence-based nursing interventions on the fatigue of hemodialysis patients in Iran.

Data collection in this systematic review study was conducted without any time limit in both Persian and English articles by searching on different databases of Iran medical articles bank such as IranDoc databases, elmnet, SID, Google scholar, Magiran, PubMed, Library Cochrane CINAHL, and Scopus. Finally, the findings of each study were entered into the data entry form as a data collection tool.

Out of 119 available articles, 25 related articles were reviewed. These studies were conducted between 2012 to 2019.Various interventions such as massage therapy, aromatherapy, care patterns, nutrition therapy, exercise and laugh therapy have been investigated to reduce the fatigue of hemodialysis patients. The results of studies on fatigue reduction have shown that all the proposed interventions can be effective in reducing the fatigue of hemodialysis patients.

A look at the evidence-based interventions of various studies shows an increased tendency to control health using complementary medicine and it expresses the importance of combining complementary and clinical medicine, however, its use in hospitals has been neglected

This study aimed at investigating the obstacles to the implementation of evidence-based care from the perspective of the staff nurses in Rajaie Cardiovascular Medical and Research Center, Tehran, Iran

Evidence-based care plays a crucial role in enhancing the nursing care quality due to the up-to-date care measures and procedures, and the cost-effectiveness for patients. However, there are some obstacle to implement it that should be addressed.

  This is a descriptive cross-sectional study conducted on 215 nurses from different departments of Rajaie Cardiovascular Medical and Research Center, Tehran, Iran. They were selected using simple random sampling method. The data collection tool was a questionnaire measuring the obstacles to the implementation of evidence-based care. The collected data were analyzed using descriptive and inferential statistics in SPSS version 20.

According to the nursing staff, the obstacles to the implementation of evidence-based care in the management dimension were the insufficient number of staff (80 percent), the large number of patients (71 percent), and the lack of motivation in the staff (68 percent) and in the individual-care dimension the obstacles were the lack of enough time for nurses to study the conducted research (72 percent).

  The obstacles to the implementation of evidence-based care are in both individual and managerial areas, so it is suggested to correct arrangement of human resources, holding training workshops and meetings, creating interaction with the centers implementing evidence-based care, and using their life experiences considering the available facilities.

Proper management and control of pain requires evaluation and treatment based on observation of the patient's condition. The aim of this study was to examining of the effect of patient evidence-based ambulation on pain after inguinal hernia surgery in Imam Hossein (AS) Hospital in Shahroud.Materials and MethodsThis is a single-blind clinical trial. In witch the study population was with hernia surgery in 2017.60 patients were divided into experimental and control groups by random allocation. Data collecting was done by the help of demographic forms and visual simulation scale of pain. Data were analyzed using SPSS16 software and Kolmogorov, Fisher, Friedman’s chi-2 and Wilkason tests.Findings The pain intensity among the experimental group's participants was less than control group's at the first step ,before the first ambulation (6.30 versus6.50) At the second step,befor the second ambulation,the experimental group s participants suffered from less pain intensity in comparison with the control group (5.40 versus6.83) and also the pain intensity at the third step was less in experimental group than the control group (5.27 versus7.00) At the fourth stepbefore the fourth ambulation,the experimental group's participants felt a less pain intensity than the control group's patients (5.37versus6.57) At the fifth step,befor dismissal,the adnauseam intensity in the experimental group was also less than control group (3.57 versus 5.77) Conclusion The research results shows that evidence based ambulation, after surgery is accompanied with decreasing the patient's pain intensity.

Implementing evidence-based nursing care guidelines, which is a new way to improve the quality of nursing care, increases patient satisfaction, including patients who are candidates for coronary artery surgery.

This study aimed to design evidence-based nursing care guidelines for patients undergoing coronary artery surgery.

Nursing care guidelines were designed based on the Stettler model and with an evidence-based approach. Studies have been searched using relevant keywords in reputable databases including Magiran، Science Direct، Scopus, PubMed, and SID during the last 10 years. For the validity of the instructions, the method of face and content validity was used with the opinion of 10 experts (including faculty members of Baqiyatallah School of Nursing, AJA, and experienced nurses of the Intensive Care Unit and Open Heart Surgery).

In this study, six evidence-based nursing care guidelines were designed for patients undergoing coronary artery surgery, which can be used as a clinical guide for the care of these patients based on the most authoritative scientific texts and with an evidence-based approach.

Designing and compiling nursing care guidelines with an evidence-based approach in patients undergoing coronary artery surgery leads to more specialized nursing care and thus increases the satisfaction of those receiving this care. The designed guidelines will also be an up-to-date source of information available to cardiologists.

Nausea is a common symptom of general anesthesia and its control with non-pharmacological methods is one of the most important goals of nursing. one of the ways to increase the quality of nursing care is evidence-based method. The purpose of this study was to determine the effect of ambulation according to the evidence-based method on nausea in patients after inguinal hernia surgery.
This single-blind clinical trial was conducted on 60 patients who underwent inguinal hernia surgery in Shahrood imam-Hossein-Hospital in 1395. Patients were randomly divided into two groups: test and control.intensity of nausea was measured at 3,6,9 and 12 hours after surgery and before discharge time.The data were analyzed in SPSS16 using Fisher test, likelihood ratio, Kolmogorov Smironov,K2Pearson,K2Friedman,and Wilcoxon.
Findings: In first stage(before first ambulation), nausea intensity in experimental group was less than patients of control group(3.30VS3.57). In second stage (before second ambulation), nausea intensity in experimental group was less control group(3.03VS3.53). In third stage (before third ambulation), nausea intensity in experimental group was less than control group(2.73VS3.6).In fourth stage(before fourth ambulation), nausea intensity in experimental group was less than of control group patients(2.96VS3.63). In fifth stage (before discharge) nausea intensity in experimental group was less than patients of control group(2.03VS3.13).
according to results,an evidence based procedure is effective in reducing the intensity of nausea following inguinal hernia surgery.Considering the cost and fewer complications and ease of implementation of this method, it can be recommended as a care strategy in reducing nausea.

Nursing process is the important pivot of nursing, and it is an icon of the art and science application in the prevention of disease and promotion and maintaining of health. The aim of this study was to examine the impact of evidence-based nursing education in executive skill of nursing process among Khoy faculty of nursing students.
Methods & This quasi-experimental study was conducted on 40 students in Khoy faculty of nursing with convenience sampling and then randomly divided into two groups: control (20), and intervention (20). We provided a workshop as two sessions in two hours associated with team work and critical thinking practices for experiment group. We do not provide any intervention in control group. They were evaluated how to write a nursing process, before the intervention, by providing the scenario and after the intervention on patient care at the bedside, by using a check list. To determine the validity of the checklist, the formal and content validity and reliability of the Cronbach's alpha (α= 0.75) and test-retest (r=0.70) were used. The data were analyzed by using independent T test and paired T test of SPSS software.
The mean age of students was 22.16 ± 1.23. The results of independent T test showed that there was no significant relationship between two group before intervention (p Regarding to the impact of training in executive skills of nursing process, it is recommended that patients care in educational centers provided by using nursing process and evidence - based nursing. It can cause to improve the quality of nursing care and effectiveness in gaining professional autonomy and enhancement of nurse's capabilities.

Evidence-based care is using evidence obtained from research into clinical practice based on the patient's condition and type of illness. This study aimed to investigate the barriers to implementation of evidence-based nursing care based on instructors and educators’ opinion.
This was a cross-sectional study that was performed with the participation of 70 faculty members and non-faculty members of School of Nursing of Rafsanjan and Kerman, Iran, with different educational levels. Inclusion criteria were having at least bachelor's degree and two-years work experience. Data was analyzed using SPSS and descriptive statistics (frequency and percentage).
Women and men instructors comprised 68.6% and 31.4% of respondents, respectively. Most of them (44.3%) were 35 to 44 years of age. In their opinion, the major obstacles to implementation of evidence-based nursing in the education domain was "lack trained staff to use the findings from research in evidence-based care" with 94.3%. In the management domain "lack of knowledge of nursing managers regarding the importance of evidence-based nursing care" with 85.7% and in the individual domain "lack of adequate skills for the implementation of evidence-based practice" and "lack of nurse's knowledge of evidence-based practice" with 85.7% were also mentioned by participants as obstacles.
The main barriers in the application of evidence-based nursing can be noted in the domains of education and management. Therefore, a big step forward in this regard will be providing access to the resources and facilities, library, and continuing education for nursing staff, and updating their information in the field of evidence-based care, which requires cooperation of the managers at different levels of planning.

Clinical practice guidelines (CPGs) are brief principles in health care providing and Implementation of CPGs which can improve patient safety and patient outcomes. According to effective role of nurses in caring patients, this study aims to design and validate the evidence based on the nursing care guideline among the patients with diabetic foot ulcer (DFU) based on Stetler model in 2015.
This study was a methodological study based on Stetler Evidence based Model. Studies for 5years with related keywords in Pub Med, Scopus, Web of Science and Google Scholar, SID, Magiran were selected. According to nursing diagnosis and evidence levels were designed as a guideline, related evidences about nursing care in DFU were extracted as well. Quality appraisal of guideline was done by AGREEII instrument in 6 domains of Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability and Editorial Independence by an expert panel. Furthermore, applicability of the guideline in clinical state was assessed with a checklist by nursing group.
From 114 studies in this field, 19 studies were chosen. In the AGREEII domains, Scope and Purpose (92%) and Applicability (76%) were the highest and the lowest scores respectively. 92.9% of nurses reported that implementation of guideline recommended on caring of DFU were effective and lack of needed equipment for its implementation was a barrier.
According to nurse’s opinion, implementation of recommended guideline has effective role in prevention and reduction of complication in DFU.

In recent years, evidence-based care has been recognized as one of the essential competencies of nursing graduates. Since senior nursing students are on the verge of graduating, studying factors affective on the use of evidence-based care in their professional future and emphasis on educational programming to strengthen this competency are necessary. This study aimed to evaluate the knowledge and performance of senior nursing students regarding evidence-based care.
The present descriptive-analytical study was conducted on 43 senior nursing students of Kerman University of Medical Sciences, Iran, in 2015. Data were collected using the Persian version of the Nursing Student's Knowledge and Performance about Evidence-Based Practice Questionnaire. Data were analyzed using descriptive statistics (percentage, mean, and standard deviation) and analytical statistics (Pearson correlation coefficient, ANOVA) in SPSS software.
The results indicated that the majority of students (53.5%) had sufficient knowledge of evidence-based care. The total mean score of knowledge of the students was 12.25 ± 3.34, while the majority of students (51.2%) showed poor performance. The total mean score of performance of the students was 17.28 ± 7.85. There was a direct correlation between knowledge and performance of the students (r There is gap between the knowledge and performance of students regarding evidence-based care; despite their sufficient knowledge on evidence-based care, their performance was poor. It is suggested that a suitable milieu for promoting evidence-based care is provided and theory and practice are linked through suitable planning, a review of the curriculum, and creating an appropriate educational environment for nursing students as future nurses.

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.

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.

Implementation of Evidence-Based practice (EBP) is a basic need for improving nursing skills. Nurses should not only be aware about last evidences، but also use it in clinical environments. Therefore identifying barriers and facilitators can be one of the important steps for implementation of EBP. This study aimed to assess Nurse’s perception about facilitators and barriers of implementation of EBP in Guilan educational and remedial Centers، 2012. In this cross sectional study، 247 nurses that working in Guilan educational and remedial Centers، were chosen by random sampling. Data collection scale was Funk Barriers Scale and facilitators of implementation of EBP were filled with self-report method. Data were analyzed with SPSS and using independent t-test and ANOVA. The first three important barriers were “The nurse does not have time to read research” (3. 22 ± 0. 9) “The facilities are inadequate for implementation” (3. 11 ± 0. 9) and “There is insufficient time on the job to implement new ideas” (3. 05 ± 1) and most important facilitator was “collaboration between university centers and hospitals” (3. 25 ± 0. 8). Also there was a statistical significant difference between nurse’s position and facilitator score (P= 0. 002). Implementation of EBP will succeed when the nurses work in clinical settings that EBP consider، as an important value there. Organizations will have effective role in reducing barriers، through provid ing sufficient time، necessary facilities and improving nurse’s ability in researches.

Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection overall and the most common nosocomial infection among mechanically ventilated patients in the intensive care units (ICUs). It is associated with significant morbidity and mortality. Considering the importance of prevention of VAP in patients undergoing mechanical ventilation, the aim of this study was to evaluate the critical care nurses’ knowledge of evidence-based guidelines for prevention of VAP. In a descriptive cross-sectional study, a total of 120 critical care nurses who worked in the ICUs of in Amol and Sari city in 2013, were evaluated. A three part self-reported questionnaire including personal information, multiple choice questions for evaluation of the nurses’ knowledge regarding evidence-based guidelines for prevention of VAP and questions about the barriers of implementing evidence-based practices regarding prevention of VAP in their wards were used for data collection. The collected data were analyzed using descriptive statistics, Pearson correlation coefficient, independent t-test, ANOVA and multiple regression analysis (adjusted) using SPSS 20 software. The results of the present study have shown that among all of the participants, 14 (11.6%) were male and 106 (88.33%) were female, with mean±SD age of 32.45±6.11 and average work experience was 8.01±5.005 years. The lowest level of knowledge of nurses (0.5%) were about using endotracheal tubes with extra lumens for drainage of subglottic secretions and the highest level of their knowledge (92.5%) were about the appropriate position for reducing the incidence of VAP in patients undergoing mechanical ventilation. Regarding taking actions based on the evidence in the prevention of VAP, 57.5% of nurses stated that some of these actions are performed routinely in their workplace. Multivariate linear regression analysis revealed that with an increase of one year of work experience, nurse’s knowledge scores have been increased by 10%.Discussion & Considering the low level of nurses’ knowledge about evidence-based guideline in the prevention of VAP and its important role in this regard; allocation of resources and educational programs regarding evidence-based practice guideline for prevention of VAP and therefore changes of caring methods in patients undergoing mechanical ventilation, can have an important role in the prevention of VAP in these patients.

Evidence-based nursing is the process in which the nurse can use the available research evidences، his/her clinical skills and patient preferences for appropriate clinical decision making. This study aimed to identify the knowledge، attitude and practice of intensive care nurses on evidence-based nursing in the teaching hospitals of Yazd University of Medical Sciences Hospitals.

In this descriptive study، with census sampling، all of the 120 nurses working in ICU and CCU departments were selected. Tool used to evaluate the knowledge، attitude and practice of nurses was a standard questionnaire which was translated to Farsi. Collected data were analyzed using the statistical software SPSS 18، T-Test، correlation coefficient، ANOVA and frequency distributions.

The mean knowledge score was 22. 35 ± 4. 31 out of 38، the mean of attitude score was 23. 88 ± 1. 86 out of 29 and the mean of practice score was 28. 56 ± 3. 59 out of 37. The results about the knowledge، attitude and practice of nurses on evidence-based nursing indicated that the mean knowledge score had a significant relationship with gender (p=0. 001)، age (p=0. 009) and work experience (p=0. 004). The mean attitude score had a significant relationship with age (p=0. 001). The mean of practice score had a significant relationship with gender (p=0. 001)، age (p=0. 006) and with work experience (p=0. 004). Also، there was a significant relationship betwean the mean of knowledge score and mean practice scores (p=0. 001). Findings of this study showed that nurses have a positive attitude toward evidence-based nursing but most of them had moderate and low levels of knowledge and performance about it.

Based on the results of this study، the need to educate nurses about evidence-based practice in the form of practical and workshop training، provideing facilities for evidence based nursing، nurses'' participation in clinical research and establishing a view point of supporting research-based care seems necessary.

Contemporary advances in technology and sciences parallel to changeable patient's status make it essential to nurses to combine their skills and knowledge with evidences in order to identify patient's problems, care planning, implementation and evaluation through interaction with other health team members. Nurses must be able to make clinical decisions independently which is possible just by using research evidences in clinical practice. The purpose of this article is concept of evidence based nursing and teaching barriers and facilitators in nursing. This article is an integrative review. Different data bases such as ProQuest, Ovid, PubMed, Science Direct, Google Scholare magiran, sid were applied for collecting articles by using evidence based teaching, evidence based nursing and education as key words. At all 24 articles have been included in this review. Studies show many barriers in implementation of EBN and teaching it to students. For example professors do not have enough time to teach EBN or do not know how to teach it. Furthermore nurses have information and time shortages and workload that make it hard to work based on evidences. It seems that by making national policies and making EBN compulsory, universities and professors will teach EBN to nursing students.

In addition to teaching pre-designed courses, physicians are usually expected to participate directly in designing curriculum during their professional life. Today, traditional education systems are not sufficient for developing the expected competencies in physicians. One of the applications of new advancements by cognitive science in curriculum design is the development of strategies for improving the quality of the undergraduate medical education curriculum. Educational strategies are “fundamental, oriented decisions in teaching that are aimed to achieve educational goals.” This article was a narrative review that introduced and explained the most important educational strategies in undergraduate medical curriculum, through surveying valid electronic and library resources. Now, the most important educational strategies in undergraduate medical curriculum are a series of student-centered, problem-based learning, integrated or inter-professional teaching, community-based, elective-driven and systematic strategies (SPICES), and also a set of strategies that are product-focused, relevant, inter-professional, short courses, multisite locations and symbiotic (PRISMS); and a group of realistic, integrated, feedback, learning and evaluation strategies (RIFLE), as well. Each strategy is represented as a spectrum. In each spectrum, the educational planner must define the position of every component of the curriculum. In order to apply these strategies, the curriculum must be intervened according to the selected strategy; so that the results of the evaluations and the evidence of interventions ensure the planners that the quality of the curriculum is improved.