Use of Pain Management Champions to Enhance Guideline Implementation by Care Workers in Nursing Homes.
Background: Underutilization of evidence‐based pain management in nursing homes (NHs) is common. Evidence toward effective approaches to improve adoption of evidence‐based practices in NHs is limited. Application of theory in evaluation approaches can increase understanding of implementation challen...
| Publicado en: | Worldviews on Evidence-Based Nursing (John Wiley & Sons, Inc.) Vol. 18; no. 2; pp. 138 - 147 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
John Wiley & Sons, Inc.
Apr2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149844305&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149844305 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17416787 NRNX jtl: Worldviews on Evidence-Based Nursing (John Wiley & Sons, Inc.) issn: 17416787 maglogo: N pubinfo: dt: Apr2021 vid: 18 iid: 2 pid: 52269 pub: John Wiley & Sons, Inc. artinfo: ui: 149844305 149844305 149844305 10.1111/wvn.12499 149844305 ppf: 138 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Use of Pain Management Champions to Enhance Guideline Implementation by Care Workers in Nursing Homes. aug: au: Brunkert, Thekla Simon, Michael Zúñiga, Franziska affil: Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland sug: subj: Pain Management Nursing Home Personnel Nursing Practice, Evidence-Based Practice Guidelines Implementation Science Self-Efficacy Evaluation Human Switzerland Multicenter Studies Multimethod Studies Conceptual Framework Psychological Theory Questionnaires Prospective Studies Self Report Logistic Regression Focus Groups Behavioral Changes Models, Theoretical Scales Descriptive Statistics Confidence Intervals Data Analysis Software Interview Guides Audiorecording Nurse Attitudes Outcomes of Education Seminars and Workshops ab: Background: Underutilization of evidence‐based pain management in nursing homes (NHs) is common. Evidence toward effective approaches to improve adoption of evidence‐based practices in NHs is limited. Application of theory in evaluation approaches can increase understanding of implementation challenges. Aim: To get a better understanding of the impact of implementation strategies by exploring the underlying mechanisms using behavioral theory. Methods: This mixed‐methods study is embedded in an implementation‐effectiveness study of a pain management guideline in four Swiss NHs. To evaluate our implementation strategies, training workshops were held, and trained pain champions were introduced. We also developed a conceptual framework. Based on Bandura's self‐efficacy theory, we hypothesized how our implementation strategies might affect changes in care workers' behavior. Care workers' questionnaire surveys were conducted at baseline (n = 136), after 3 months (n = 99), and after 6 months (n = 83) to assess self‐efficacy in pain management and self‐reported guideline adoption. We computed linear mixed‐effect models to assess changes over time in self‐efficacy and logistic regressions to assess associations between self‐efficacy and guideline adoption. Concurrently, we conducted focus groups with care workers (n = 8) to explore their response to the implementation strategies. Results: Overall, there was a significant increase in self‐efficacy at both time points (p <.001). We found significant associations between self‐efficacy and adoption of two guideline components, that is, performing a comprehensive pain assessment and using observational pain assessment tools in cognitively impaired residents. Qualitative findings showed that implementation strategies were received positively by care workers. Focus group participants reported more attentiveness to residents' pain experience. The participants also reported increases in assessment and documentation of pain with more detail than before. Linking Evidence to Action: Our findings highlighted that the training and use of pain champions increased self‐efficacy and thereby induced behavior change leading to guideline adoption. Regarding persistent implementation challenges, a theory‐based conceptual model contributes to the overall understanding. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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