Escola Anna Nery Revista de Enfermagem
https://app.periodikos.com.br/journal/ean/article/doi/10.1590/2177-9465-EAN-2017-0109
Escola Anna Nery Revista de Enfermagem
Pesquisa

Apprehensions of nurse managers on evidence-based practicea

Inquietudes de enfermeros gerentes sobre la práctica basada en evidencias

Apreensões de enfermeiros gerentes sobre a prática baseada em evidências

Fernanda Carolina Camargo; Mayla Borges Goulart; Helena Hemiko Iwamoto; Maria Rizoneide Negreiros de Araújo; Divanice Contim

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Abstract

Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro.

Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants), conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories.

Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices.

Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.

Keywords

Evidence-based Nursing; Leadership; Diffusion of Innovations; Teaching Hospitals

Resumen

Objetivo: Analizar las inquietudes de enfermeros gerentes sobre la implementación de la Práctica Basada en Evidencias en Hospitales de Enseñanza del Triángulo Minero.

Método: Investigación cualitativa orientada por la Teoría de la Difusión de Innovaciones. Se realizaron cinco talleres por grupo focal (n = 18 participantes), conducidos por interacciones hermenéutico-dialécticas, entre agosto y septiembre/2016. Los registros textuales resultantes de cada taller fueron analizados por categorías semánticas.

Resultados: Los aspectos condicionantes para implementar la Práctica Basada en Evidencias permearon desde los elementos relacionados a la fragmentación de la red asistencial hasta la necesidad de ampliar la gobernabilidad de los enfermeros gerentes para que realicen cambios en sus sectores. Mayoritariamente, el acceso oportuno a los resultados de las investigaciones realizadas en el hospital de enseñanza fue mencionado como crucial en la orientación de prácticas más calificadas.

Consideraciones finales: El abordaje permitió reconocer condiciones contextualizadas para implementar las Práctica Basada en Evidencias, en escenarios similares; y también, incrementar la producción científica nacional, aún escasa, sobre el tema.

Palabras clave

Enfermería basada en evidencias; Liderazgo; Difusión de Innovaciones; Hospitales de enseñanza

Resumo

Objetivo: Analisar apreensões de enfermeiros gerentes frente a implementação da Prática Baseada em Evidências em Hospital de Ensino do Triângulo Mineiro.

Método: Pesquisa qualitativa orientada pela Teoria da Difusão de Inovações. Foram realizadas cinco oficinas por grupo focal (n = 18 participantes), conduzidas por interações hermenêutico-dialéticas, entre agosto e setembro/2016. Registros textuais resultantes de cada oficina foram analisados por categorias semânticas.

Resultados: Aspectos condicionantes à implementação da Prática Baseada em Evidências permearem desde elementos relacionados à fragmentação da rede assistencial até a necessária ampliação da governabilidade dos enfermeiros gerentes para efetuarem mudanças nos seus setores. Majoritariamente, o acesso oportuno aos resultados das pesquisas realizadas no hospital de ensino foi mencionado como crucial para orientação de práticas mais qualificadas.

Considerações Finais: A abordagem permitiu reconhecer condições contextualizadas para a implementação da Prática Baseada em Evidências, que podem ser coincidentes a cenários similares. Como, também, incrementar a produção científica nacional sobre o tema, ainda escassa.

Palavras-chave

Enfermagem baseada em evidências; Liderança; Difusão de Inovações; Hospitais de ensino

Referências

1 Camargo FC, Iwamoto HH, Monteiro DAT, Goulart MB, Garcia LAA, Augusto ALDS, et al. Techniques undertaken to disseminate the evidence-based practice among hospital nurses. Rev Min Enferm [Internet]. 2017 Jul; [cited 2017 Jul 22]; 21:e-1003. Available from: http://www.reme.org.br/artigo/detalhes/1139

2 Bick D, Chang Y. Implementation of evidence into practice: complex, multi-faceted and multi-layered. Rev Esc Enferm USP [Internet]. 2014 Aug; [cited 2017 Mar 16]; 48(4):578-83. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000400578. DOI: 10.1590/S0080-623420140000400001

3 Melnyk BM, Gallagher-Ford L, Long LE, Fineout-Overholt E. The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews Evid Based Nurs [Internet]. 2014 Feb; [cited 2017 Mar 16]; 11(1):5-15. Available from: http://onlinelibrary.wiley.com/doi/10.1111/wvn.12021/epdf. DOI: 10.1111/wvn.12021

4 Camargo FC, Iwamoto HH, Monteiro DAT, Lorena LT, Pereira GA. Assessment of an intervention for the diffusion of evidence-based nursing in a teaching hospital. Rev Gaúch Enferm [Internet]. 2016; [cited 2017 Mar 18]; 37(esp):e68962. Available from: http://www.scielo.br/pdf/rgenf/v37nspe/0102-6933-rgenf-1983-14472016esp68962.pdf. DOI: http://dx.doi.org/10.1590/1983-1447.2016.esp.68962

5 Camargo FC, Garcia LAA, Santos AS, Iwamoto HH. Evidence-Based Practice: bibliometric review of national journals in nursing journals. REFACS [Internet]. 2017; [cited 2017 Nov 6]; 5(3):429-39. Available from: http://seer.uftm.edu.br/revistaeletronica/index.php/refacs/article/view/2137. DOI: 10.18554/refacs.v5i3.2137

6 Macedo APMC. Nursing Supervision: Studying the "Case" of the phenomenon of interorganizational articulation Nursing School and Hospital. Rev Esc Enferm USP [Internet]. 2014 Dec; [cited 2017 Mar 18]; 48(esp2):190-6. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000800190. DOI: 10.1590/S0080-623420140000800028

7 Brehmer LCF, Ramos FRS. Teaching-service integration: implications and roles in experiences of Undergraduate Courses in Nursing. Rev Esc Enferm USP [Internet]. 2014; [cited 2017 Mar 18]; 48(1):118-26. Available from: http://www.scielo.br/pdf/reeusp/v48n1/pt_0080-6234-reeusp-48-01-118.pdf. DOI: 10.1590/S0080-623420140000100015

8 Galvão MC, Sawada NO. A liderança como estratégia para a implementação da prática baseada em evidências na enfermagem. Rev Gaúcha Enferm [Internet]. 2005 Dec; [cited 2017 Mar 18]; 26(3):293-301. Available from: http://seer.ufrgs.br/index.php/RevistaGauchadeEnfermagem/article/view/4559/2486

9 Hauck S, Winsett RP, Kuric J. Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. J Adv Nurs [Internet]. 2013 Mar; [cited 2017 Nov 6]; 69(3):664-74. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22697406. DOI: 10.1111/j.1365-2648.2012.06053

10 Rogers EM. Diffusion of innovations. Nova York: Free Press; 2003. 576 p.

11 Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Implement Sci [Internet]. 2008 Jan; [cited 2017 Mar 18]; 3(1):1. Available from: https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-3-1. DOI: 10.1186/1748-5908-3-1

12 Titler MG. Nursing science and evidence-based practice. West J Nurs Res [Internet]. 2011; [cited 2017 Mar 18]; 33(3):291-5. Available from: http://journals.sagepub.com/doi/pdf/10.1177/0193945910388984. DOI: 10.1177/0193945910388984

13 Strout TD, Lancaster K, Schultz AA. Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. Nurs Clin North Am [Internet]. 2009 Mar; [cited 2017 Nov 6]; 44(1):93-102. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=Development+and+implementation+of+an+inductive+model+for+evidence-based+practice%3A+A+grassroots+approach+for+building+evidence-based+practice+capacity+in+staff+nurses

14 Andrews T. Ontological issues in qualitative research in nursing. Texto Contexto Enferm [Internet]. 2016 Oct; [cited 2017 Mar 18]; 25(3):1-2. Available from: http://www.scielo.br/pdf/tce/v25n3/0104-0707-tce-25-03-editorial.pdf. DOI: 10.1590/0104-0707201600453editorial

15 Minayo MCS. Scientificity, generalization and dissemination of qualitative studies. Ciênc Saúde Coletiva [Internet]. 2017 Jan; [cited 2017 Mar 18]; 22(1):16-7. Available from: http://www.scielo.br/pdf/csc/v22n1/en_1413-8123-csc-22-01-0016.pdf. DOI: 10.1590/1413-81232017221.30302016

16 Minayo MCS, Gualhano L. Pesquisa qualitativa para pensar e atuar no campo da saúde. Ciênc Saúde Coletiva [Internet]. 2016 Aug; [cited 2017 Mar 18]; 21(8):1. Available from: http://www.scielo.br/scielo.php?script=sci_arttext_pr&pid=S1413-81232016010900001&lng=es&nrm=iso&tlng=pt

17 Spink MJ, Menegon VM, Medrado B. Using workshops as a research strategy: theoretical and methodological articulations and ethical-political applications. Psicol Soc [Internet]. 2014; [cited 2017 Mar 18]; 26(1):32-43. Available from: http://www.scielo.br/pdf/psoc/v26n1/05.pdf. DOI: 10.1590/S0102-71822014000100005

18 Nóbrega DO, Andrade ERG, Melo ESN. Research with focal group: contributions to the study on social representation. Psicol Soc [Internet]. 2016; [cited 2017 Mar 18]; 28(3):433-41. Available from: http://www.scielo.br/pdf/psoc/v28n3/1807-0310-psoc-28-03-00433.pdf. DOI: 10.1590/1807-03102016v28n3p433

19 Lucchese R, Calixto BS, Vera I, Paula NI, Veronesi CL, Fernandes CNS. Group teaching in nursing/teaching group nursing practices guided by the Pichon-Rivière theoretical framework. Esc Anna Nery [Internet]. 2015 Apr/Jun; [cited 2017 Mar 18]; 19(2):212-9. Available from: http://www.scielo.br/pdf/ean/v19n2/1414-8145-ean-19-02-0212.pdf. DOI: 10.5935/1414-8145.20150027

20 Lapão LV, Arcêncio RA, Popolin MP, Rodrigues LBB. The role of Primary Healthcare in the coordination of Health Care Networks in Rio de Janeiro, Brazil, and Lisbon region, Portugal. Ciênc Saúde Coletiva [Internet]. 2017 Mar; [cited 2017 Mar 18]; 22(3):713-24. Available from: http://www.scielo.br/pdf/csc/v22n3/en_1413-8123-csc-22-03-0713.pdf. DOI: 10.1590/1413-81232017223.33532016

21 Vieira FS. Impact of recent decisions and discussions on the Brazilian Public Health System financing. Saúde Debate [Internet]. 2016 Jun; [cited 2017 Mar 18]; 40(109):187-99. Available from: http://www.scielo.br/pdf/sdeb/v40n109/0103-1104-sdeb-40-109-00187.pdf DOI: 10.1590/0103-1104201610915

22 Carvalho MC, Rocha FLR, Marziale MHP, Gabriel CS, Bernardes A. Work values and practices which characterize the organizational culture of a public hospital. Texto Contexto Enferm [Internet]. 2013 Jul/Sep; [cited 2017 Mar 18]; 22(3):746-53. Available from: http://www.scielo.br/pdf/tce/v22n3/en_v22n3a22.pdf. DOI: 10.1590/S0104-07072013000300022

23 Rocha FLR, Marziale MHP, Carvalho MC, Cardeal Id SF, Campos MCT. The organizational culture of a Brazilian public hospital. Rev Esc Enferm USP [Internet]. 2014 Apr; [cited 2017 Mar 18]; 48(2):303-9. Available from: http://www.scielo.br/pdf/reeusp/v48n2/0080-6234-reeusp-48-02-308.pdf. DOI: 10.1590/S0080-6234201400002000016

24 Lorenzetti J, Gelbcke FL, Vandresen L. Management technology for hospital inpatient care units. Texto Contexto Enferm [Internet]. 2016 Jul; [cited 2017 Mar 18]; 25(2):e1770015. Available from: http://www.scielo.br/pdf/tce/v25n2/0104-0707-tce-25-02-1770015.pdf. DOI: 10.1590/0104-07072016001770015

25 Lima RS, Lourenço EB, Rosado SR, Fava SMCL, Sanches RS, Dázio EMR. Representation of nurse's managerial practice in the inpatient unit: nursing staff perspective. Rev Gaúcha Enferm [Internet]. 2016 Mar; [cited 2017 Mar 18]; 37(1):e54422. Available from: http://www.scielo.br/pdf/rgenf/v37n1/0102-6933-rgenf-37-1-1983-144720160154422.pdf. DOI: 10.1590/1983-1447.2016.01.54422

26 Heydari A, Mazlom SR, Ranjbar H, Scurlock-Evans L. A study of Iranian nurses' and midwives' knowledge, attitudes, and implementation of evidence-based practice: the time for change has arrived. Worldviews Evid Based Nurs [Internet]. 2014 Oct; [cited 2017 Nov 6]; 11(5):325-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=A+study+of+Iranian+nurses'+and+midwives'+knowledge%2C+attitudes%2C+and+implementation+of+evidence-based+practice%3A+the+time+for+change+has+arrived.+Worldviews+evid.+based+nurs. DOI: 10.1111/wvn.12052

27 Lamarra NF. Universidad, sociedad y conocimiento reflexiones para el debate. Avaliação (Campinas) [Internet]. 2014 Nov; [cited 2017 Mar 18]; 19(3):663-87. Available from: http://www.scielo.br/pdf/aval/v19n3/08.pdf. DOI: 10.1590/S1414-40772014000300008

28 Fortuna CM, Mishima SM, Matumoto S, Pereira MJB, Ogata MN. The research and association between teaching and care in the consolidation of the Brazilian National Health System. Rev Esc Enferm USP. [Internet]. 2011 Dec; [cited 2017 Mar 18]; 45(spe.2):1696-700. Available from: http://www.scielo.br/pdf/reeusp/v45nspe2/10.pdf. DOI: 10.1590/S0080-62342011000800010

29 Correia SEN, Oliveira VM, Gomez CRP. Dimensions of social innovation and the roles of organizational actor: the proposition of a framework. Rev Adm Mackenzie [Internet]. 2016 Dec; [cited 2017 Mar 18]; 17(6):102-33. Available from: http://www.scielo.br/pdf/ram/v17n6/1678-6971-ram-17-06-0102.pdf. DOI: 10.1590/1678-69712016/administracao.v17n6p102-133
 


Submetido em:
20/04/2017

Aceito em:
30/09/2017

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