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The Advancing Research & Clinical Practice through Close Collaboration (ARCC) Model.

The Advancing Research & Clinical Practice through Close Collaboration (ARCC) Model.

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This paper is a report of the effectiveness of a structured multifaceted mentorship programme designed to implement evidence-based practice in a clinical research intensive environment. Barriers to implementing evidence-based practice are well-documented in the literature. Evidence-based practice is associated with higher quality care and better pa...

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Context 1
... Advancing Research & Clinical Practice through Close Collaboration (ARCC) model was first conceptualized in 1999 by Melnyk as a mentorship framework to assist advanced practice nurses in implementing EBP. Melnyk and Fineout-Overholt (2002) have further developed the model, which now serves as a guide to advance system-wide implementation and sustainability of EBP (see Figure 1). The first step in the ARCC model is an organizational assessment of the culture and readiness for EBP so that EBP facilitators and barriers can be identified, together with a plan to overcome them. ...
Context 2
... from this study provide additional support for relationships within the ARCC Model (see Figure 1). Organizational mentors were central in the implementation of EBP and the movement toward a sustained EBP culture. ...

Citations

... Health facility mentoring is defined as providing mentoring support for the health managers who support individual providers and the facility systems that support interventions [30][31][32]. For this research, the mentorship will be conducted by mentors who are graduated female doctors. ...
... Health facility mentoring is defined in this research as providing mentoring for individual providers and the facility systems that support implementing midwifery interventions [30][31][32]. ...
Article
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Introduction: Bangladesh introduced professional midwives in 2018 to address gaps in sexual and reproductive health services, focusing on improved maternity care. Facility mentoring has been introduced in selected facilities within the government to enable midwives as they move into their new roles. Objectives: To describe a protocol (1) to determine if introducing international standard midwives in rural sub-district hospitals in Bangladesh, both with and without facility mentoring, improve the availability and quality of maternal and newborn health care compared to the facility without midwives; and (2) to explore the experiences of the midwives, and the maternity staff and managers that they joined, following their introduction. Methods: This will be a mixed-methods study to examine differences between selected hospitals grouped into three categories: without midwives (only nurses), with midwives, and both with midwives and mentorship. Hospital selection will be based on choosing those with the highest birth caseload. The quantitative component will consist of facility observations and clinical data extraction to assess their (hospital and midwives) readiness (birth preparedness and complication readiness) and clinical care to explore whether facilities with newly introduced midwives have improved availability and quality of care. We will use facility assessment tools to extract clinical data. In addition, we will use a structured open-ended interview guideline to conduct focus groups and in-depth interviews to understand the perceptions, attitudes, and experiences among maternity staff (e.g., nurses and paramedics) and health managers (e.g., facility manager, residential medical officer, consultants), as well as the midwives themselves toward the newly introduced midwives and the quality of care. We plan to use a fixed effect logistic regression to compare the relationship between variables in the three hospital types for each observed data point. For analyzing qualitative data, we will adopt content analysis and use NVivo to identify themes related to perceptions, attitudes, and experiences. Expected results: The introduction of professional midwives may improve the quality of maternal health care in rural settings. The addition of a mentoring program can support midwives in transitioning into their new roles and introduce improved care quality.
... Also, According to Cruz et al. [14], attending trainings/seminars on research and EBP may improve awareness on this concept, thus encouraging positive beliefs towards it. Several other studies have reported an improvement in the EBP beliefs after implementing EBP educational interventions among health practitioners [35][36][37] and students [23,38]. ...
Article
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Background Evidence-based practice (EBP) is an important competency of undergraduate nursing students which should be cultivated before graduation by increasing future healthcare providers’ knowledge, skills and attitudes towards EBP. This study aimed to describe nursing students’ competencies (attitudes, knowledge, skills) in Evidence-based practice (EBP) and to determine factors predicting EBP competency. Methods A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse (Tunisia) among 365 nursing students. Data were collected using the validated Evidence Based Practice Competencies Questionnaire (EBP-COQ). Multiple linear regression was performed to determine factors predicting EBP competencies. Results The overall score of EBP-COQ questionnaire was 3.26 ± 0.53 out of 5. The attitude, skills and knowledge subscales received 4.04 ± 0.41; 3.05 ± 0.77 and 2.70 ± 0.74 as mean scores respectively. Multiple linear regression analysis (table 4) revealed that significant related factors were academic level (β = 0.271, p = 0.001), English-language reading skills (β = 0.435, p < 0.001), facing staff resistance in implementing a new evidence-based procedure (β = − 0.081, p = 0.035) difficulties in obtaining full-text papers (β = − 0.127, p < 0.001) and training in methodology (β = 0.232, p < 0.001) and also in statistics (β = 0.205, p < 0.001). Conclusions These results help to understand students’ attitudes, knowledge and skills in EBP and can be therefore a starting point to develop effective strategies for EBP curricula.
... In North America, guidelines are also used to assess the quality and outcomes of implemented interventions and to consequently allocate resources as needed. Moreover, evidence-based best practice guidelines have been reported to improve the quality of care (Wallen et al., 2010). No. 30 ISSN: 2363-9849 highly robust methods (Cooper, 2017;Gough et al., 2012). ...
Article
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Since 2001, attacks attributed to extremist movements or “lone actors” have intensified and spread around the world, prompting governments to invest significant sums of money into preventing violent radicalization. Nonetheless, knowledge regarding best practices for prevention remains disparate, and the effectiveness of current practices is not clearly established. Consequently, we conducted a systematic review on the outcomes of primary and secondary prevention programs in the field of violent radicalization. Of the 11,836 documents generated, 33 studies published between 2009 and 2019 were eligible for inclusion as they comprised an empirical (quantitative or qualitative) evaluation of a prevention initiative using primary data. The majority of these studies evaluated programs targeting violent Islamist or “general” radicalization. Negative or iatrogenic effects mostly stemmed from programs aimed at specific ethnic or religious groups or focusing on surveillance and monitoring. Positive effects were noted in programs aimed at improving potential protective factors against violent radicalization. However, the reviewed studies had numerous limitations (i.e., weak experimental designs, small/biased samples, unclear definitions, incomplete methodological sections, and conflicts of interests) that hinder one’s confidence in their conclusions. Also, many studies lacked a logic model, failed to differentiate between intermediate and final outcomes, and often did not assess for negative outcomes. Encouragingly, however, some of the most methodologically sound studies contained results attesting to the effectiveness of improving protective factors against violent radicalization.
... The ARCC Ó Model is one of the often-used frameworks for guiding the implementation of EBP (Speroni et al., 2020). Many studies have demonstrated that use of the ARCC Model leads to improvements in clinicians' knowledge and beliefs about the value of EBP and their ability to implement it, which is associated with greater implementation of evidence-based care and improved outcomes, both for patients and clinicians (Gorsuch et al., 2020;Levin et al., 2011;Melnyk et al., 2017;Wallen et al., 2010). Practice change models focus on guiding clinicians through the specific steps of a practice change initiative, such as the Seven Steps of EBP (Melnyk & Fineout-Overholt, 2019); Iowa Model (Buckwalter et al., 2017); or Johns Hopkins Model (Dang & Dearholt, 2017). ...
... Studies conducted in nursing careers have demonstrated that mentorship fosters and sustains changes to clinical practice, including behaviors related to evidence-based care (Wallen et al. 2010, Levin et al. 2011, Jeffers et al. 2008, Spiva et al. 2017, Friesen et al. 2017. These studies often center on Melnyk's Advancing Research & Clinical Practice through Close Collaboration (ARCC) model, which serves as a guide for implementation and sustainability of EBM at the system level by assessing organizational readiness and identifying facilitators for EBM (Wallen et al. 2010). ...
... Studies conducted in nursing careers have demonstrated that mentorship fosters and sustains changes to clinical practice, including behaviors related to evidence-based care (Wallen et al. 2010, Levin et al. 2011, Jeffers et al. 2008, Spiva et al. 2017, Friesen et al. 2017. These studies often center on Melnyk's Advancing Research & Clinical Practice through Close Collaboration (ARCC) model, which serves as a guide for implementation and sustainability of EBM at the system level by assessing organizational readiness and identifying facilitators for EBM (Wallen et al. 2010). EBM mentorship in nursing and the ARCC model will be discussed in further detail in Chapter 14. ...
Chapter
Probability and statistics are employed daily in our clinical practice for several tasks, including explaining risk thresholds to patients, gaining access to clinical recommendations, understanding scientific publications, and writing investigation papers for analysing numerical data and treatment choices. Consequently, unintended statistical fraud can come from several locations. Study misconduct among biomedical researchers is notoriously tricky to identify, and little is known about its prevalence or underlying causes. Biostatistics is a synthesis of theory and practice, representing the experience of modelling biological and medical phenomena. Biostatistics is somewhat unusual in the statistical field because it involves the study of real-world datasets. The development of the future generation of biostatistical scientists in many areas of medical science can meet and incorporate several of these issues. The “Theoretical minimum” of the great Russian physicist Lev Davidovič Landau influenced the biostatistical minimum. The theoretical minimum entailed learning all a physics student required to work under Landau. Landau was a difficult man: his theoretical minimum included almost everything he knew, which no one else could know, of course. On the contrary, Leonard Susskind and George Hrabovsky used the words theoretical minimum to mean precisely what you need to know to advance to the next level in their beautiful novels. As a result, the biostatistical minimum should include the elements of biostatistics that clinicians should be aware of when correctly interpreting research findings. Understanding p-values, confidence intervals, Student’s t-tests, the Z test, the chi-square test goodness of fit, and other tests, as well as ANOVA tables and basic statistical models, are all essential.
... En Amérique du Nord, les lignes directrices sont également employées dans l'évaluation des effets et de la qualité des interventions implémentées, pour ensuite allouer les ressources en fonction des besoins. De plus, il a été démontré que les lignes directrices pour la pratique basées sur les données probantes contribuent à améliorer la qualité des soins (Wallen et al., 2010). ...
Research
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Au cours de la dernière décennie, l’inquiétude suscitée par les violences extrémistes a poussé les gouvernements à déployer des efforts importants et investir des sommes considérables dans le développement de programmes de prévention et de lutte contre la radicalisation et l’extrémisme violents. Malgré ces efforts et ces investissements, les connaissances actuelles sur les meilleures pratiques en matière de prévention restent disparates et l’efficacité des pratiques présentement utilisées n’a pas encore été clairement démontrée. Ce constat s’applique particulièrement aux programmes de prévention tertiaire, soit les programmes qui visent à « déradicaliser » et/ou à désengager les individus impliqués dans des groupes extrémistes et à les réintégrer dans la société. De plus, les revues systématiques de programmes de prévention tertiaire actuellement disponibles sont limitées sur le plan méthodologique ou ont une portée restreinte. Pour remédier à ces lacunes, le RPC-PREV a réalisé une revue systématique de la littérature sur l’efficacité des programmes de prévention tertiaire dans le domaine de la radicalisation violente.
... In North America, guidelines are also used to assess the quality and outcomes of implemented interventions and consequently allocate resources as needed. Moreover, evidence-based best practice guidelines have been reported to improve the quality of care (Wallen et al., 2010). ...
Research
Full-text available
In the last decade, growing concerns about extremist violence have led governments to make important efforts and invest significant sums of money in developing programs to prevent and counter violent radicalization and extremism. Despite these efforts and investments, current knowledge regarding best practices in prevention remains disparate, and the effectiveness of practices used at present has not yet been clearly established. This is especially true for tertiary prevention programs, i.e., those that aim to “deradicalize” and/or disengage individuals from extremist groups and reintegrate them into society. Moreover, the currently available systematic reviews of tertiary prevention programs have methodological limitations or are restricted in scope. To address this knowledge gap, CPN-PREV conducted a systematic review of the literature on the effectiveness of tertiary prevention programs in the field of violent radicalization. The goals of our systematic review were as follows: 1) To describe the outcomes of tertiary PVE programs in terms of reducing the risk of violent radicalization; 2) To identify specific program modalities associated with a higher chance of success or failure for the targeted populations; 3) To assess the quality of the literature in order to identify knowledge gaps and studies that should be given more (or less) weight in the interpretation of results; and 4) To formulate preliminary recommendations for program providers, policymakers, practitioners, and researchers working in the field of PVE.
... Another possible explanation could be the difference in the institutional policy and training of also a useful source of recommended evidence that can be incorporated into clinical practice. 37 In this study the most commonly identified barriers to the practice of EBM were lack of critical appraisal skill, lack of EBM knowledge, negative attitudes toward EBM, and insufficient time to search for evidence. Similarly, a study conducted in Gaza reported that the main factors affecting the practice of EBM were lack of knowledge needed to practice EBM and negative attitudes toward EBM. ...
Article
Full-text available
Background: Evidence-based medicine (EBM) is an important component of modern medicine and is essential for the provision of high-quality health services. Little is known about the level of EBM use among Ethiopian medical students. This study aimed to assess the factors associated with EBM practice among medical interns in teaching hospitals in northwestern Ethiopia. Methods: A cross-sectional study was conducted using a random sample of medical interns in teaching hospitals of northwest Ethiopia. Binary logistic regression analysis was used to identify factors associated with EBM practice. The strength of the interaction between variables was calculated using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Results: Completed questionnaire was obtained from 403 (95.3%) of 423 medical interns. About 48.4% of respondents had a good EBM practice. EBM knowledge (AOR = 1.86, 95% CI = 1.220-2.835), attitude to EBM (AOR = 2.05, 95% CI = 1.318-3.193), ability to appraise evidence (AOR = 2.35, 95% CI = 1.570-3.517), and having sufficient time to search for evidence (AOR = 1.67, 95% CI = 1.065-2.627) were factors significantly associated to EBM practice. Conclusion: This study demonstrates that the main factors affecting medical intern's practice of EBM were lack of critical appraisal skill, lack of knowledge needed to practice EBM, negative attitudes toward EBM, and insufficient time to search for evidence. Providing EBM training to the needs of medical interns would overcome the barriers identified in this study, as well as assist medical interns and other clinical staffs to ensure the correct application of EBM in to clinical practice.
... The total number of articles directly targeting the OT context were only five, 33% of all included articles (Emond et al. 2015;Gotlib et al. 2015;Häggman-Laitila, Mattila & Melender 2016;Landers 2015;Munten et al. 2010), whilst one was from the acute hospital care context (Breimaier, Halfens & Lohrmann 2015), two from the high acuity context (Chan et al. 2017;Harris et al. 2015), two from the ICU context (Ploeg et al. 2016;Wallen et al. 2010) and five that were conducted in a general healthcare/clinical care context (Friedman et al. 2009;Guerrerro et al. 2016;Holleman et al. 2009;Newhouse et al. 2012;Shatpattananunt, Petpichetchian & Kitrungrote 2015). ...
... A total of 7 out of 15 articles (Breimaier et al. 2015(Breimaier et al. :1744Chan et al. 2017:5;Emond et al. 2015:2;Gotlib et al. 2015:345;Holleman et al. 2009;Shatpattananunt et al. 2015:363;Wallen et al. 2010Wallen et al. :2763 recommended audit and feedback as a continuous process of measuring performance (of both process and outcome), aggregating data into reports and discussing findings with OT nurses. Audit and feedback are defined as the summary of clinical performance of healthcare at a specified period of time in order to change the behaviour of professional healthcare workers regarding a specific practice (Gotlib et al. 2015:345). ...
... Audit and feedback include recommendations for action used to increase group awareness of their own or others' practice (Chan et al. 2017:5). Audit and feedback help OT nurses to monitor improved care processes and patient outcomes (Wallen et al. 2010(Wallen et al. :2763. ...
Article
Full-text available
Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT.
... The total number of articles directly targeting the OT context were only five, 33% of all included articles (Emond et al. 2015;Gotlib et al. 2015;Häggman-Laitila, Mattila & Melender 2016;Landers 2015;Munten et al. 2010), whilst one was from the acute hospital care context (Breimaier, Halfens & Lohrmann 2015), two from the high acuity context (Chan et al. 2017;Harris et al. 2015), two from the ICU context (Ploeg et al. 2016;Wallen et al. 2010) and five that were conducted in a general healthcare/clinical care context (Friedman et al. 2009;Guerrerro et al. 2016;Holleman et al. 2009;Newhouse et al. 2012;Shatpattananunt, Petpichetchian & Kitrungrote 2015). ...
... A total of 7 out of 15 articles (Breimaier et al. 2015(Breimaier et al. :1744Chan et al. 2017:5;Emond et al. 2015:2;Gotlib et al. 2015:345;Holleman et al. 2009;Shatpattananunt et al. 2015:363;Wallen et al. 2010Wallen et al. :2763 recommended audit and feedback as a continuous process of measuring performance (of both process and outcome), aggregating data into reports and discussing findings with OT nurses. Audit and feedback are defined as the summary of clinical performance of healthcare at a specified period of time in order to change the behaviour of professional healthcare workers regarding a specific practice (Gotlib et al. 2015:345). ...
... Audit and feedback include recommendations for action used to increase group awareness of their own or others' practice (Chan et al. 2017:5). Audit and feedback help OT nurses to monitor improved care processes and patient outcomes (Wallen et al. 2010(Wallen et al. :2763. ...
Article
Full-text available
Best practice guidelines (BPGs) exist for operating theatre (OT), but strategies to implement them are lacking. To address the gap, an integrative review was undertaken to identify strategies which can be used to implement BPGs in OT. This article aimed to summarise the best existing literature in order to identify and describe strategies for the implementation of BPGs in OT. An extensive search was undertaken to include relevant literature from February 2005 to March 2020 using the following databases: CINAHL, Medline, Biomed Central, Academic Search Complete and Health Source: Nursing/Academic Edition (EBSCOhost) and the Cochrane library. This integrative literature review followed the methodology proposed by Whittemore and Knafl, namely: (1) identification of the research problem, (2) search of the literature, (3) evaluation of the data, (4) analysis of the data and (5) presentation of the results. On completion of the critical appraisal, 15 (n = 15) articles met the inclusion criteria and relevant data were synthesised. The review identified six strategies facilitating implementation of BPGs in OT, namely, communication, education materials and mass media, academic detailing, opinion leaders, audit and feedback, and teamwork and collaboration. The review validated strategies for the implementation of BPGs in OT. Implementation of BPGs is essential to both provide and improve patient care and to benefit health outcomes. This review is expected to contribute to the provision of strategies to implement BPGs in OT.