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The Relationship Among Evidence‐Based Practice and Client Dyspnea, Pain, Falls, and Pressure Ulcer Outcomes in the Community Setting
Author(s) -
Doran Diane,
Lefebre Nancy,
O'BrienPallas Linda,
Estabrook Carole A.,
White Peggy,
Carryer Jennifer,
Sun Winnie,
Qian Gan,
Bai Yu Qing Chris,
Li Mingyang
Publication year - 2014
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12051
Subject(s) - psychological intervention , medicine , audit , documentation , nursing , evidence based practice , best practice , medline , consistency (knowledge bases) , evidence based nursing , family medicine , alternative medicine , management , geometry , mathematics , pathology , computer science , political science , law , economics , programming language
Background There are gaps in knowledge about the extent to which home care nurses’ practice is based on best evidence and whether evidence‐based practice impacts patient outcomes. Aim The purpose of this study was to investigate the relationship between evidence‐based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence‐based practice was defined as nursing interventions based on best practice guidelines. Methods The Nursing Role Effectiveness model was used to guide the selection of variables for investigation. Data were collected from administrative records on percent of visits made by Registered Nurses (RN), total number of nursing visits, and consistency of visits by principal nurse. Charts audits were used to collect data on nursing interventions and client outcomes. The sample consisted of 338 nurses from 13 home care offices and 939 de‐identified client charts. Hierarchical generalized linear regression approaches were constructed to explore which variables explain variation in client outcomes. Results The study found documentation of nursing interventions based on best practice guidelines was positively associated with improvement in dyspnea, pain, falls, and pressure ulcer outcomes. Percent of visits made by an RN and consistency of visits by a principal nurse were not found to be associated with improved client outcomes, but the total number of nursing visits was. Linking Evidence to Action Implementation of best practice is associated with improved client outcomes in the home care setting. Future research needs to explore ways to more effectively foster the documentation of evidence‐based practice interventions.