Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC)

NCT03269331 | Completed

• 1 other identifier: FDG#20160029E
• Study Type: observational
• Target: 131
• Locations: 1 country
• Sites: 1

Brief Summary

The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. While magnet facilities require a commitment to evidence-based nursing practice, military facilities currently lack such a requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful path toward developing high-reliability organizations. Currently, little is known regarding the effectiveness of specific EBP models and frameworks within the military culture. The purpose of this investigation is to determine the effectiveness of the Advancing Research and Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment Facility (MTF) beginning with nursing services. Research questions:

1. 1.What is the current state of organizational culture and readiness for EBP within the MTF's nursing services?
2. 2.Will utilization of the ARCC model significantly improve EBP beliefs, knowledge, and practice in MTF nurses over a two-year period?
3. 3.Is the ARCC model feasible for implementation in Air Force MTF's?

Conditions

Evidence-Based Practice; Nurse's Role

Keywords

nursing practice; evidence-based practice models; military nursing; clinical inquiry

Outcome Measures

Primary Outcomes (4)

• Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time

  25-item assessment of organizational readiness and perceived strengths and barriers for EBP implementation. A 5-point Likert scale with, 1 (not at all) through 5 (very much) measures item response to questions focused on the extent that EBP is included in current organizational culture. For example, "To what extend do you believe that EBP is practiced in your organization?" Overall, the instrument measures the relationship between cultural factors and the organization's implementation of EBP over a 6-month time frame. Validity is reported with content and face validity and internal consistency reliabilities greater than 0.85

  baseline, month 3, month 12

• Evidence-Based Practice Beliefs (EBPB) Scale changes over time

  16-item assessment of an individual's beliefs regarding the value of EBP and capability for EBP implementation in clinical nursing practice. A 5-point Likert scale with, 1 (strongly disagree) through 5 (strongly agree) measures item response to statements about EBP, such as: "I believe EBP takes too much time"… "I am clear about the steps of EBP." It is anticipated, based on the results of several studies, that higher scores on the EBPB scale are associated with greater implementation of EBP and better healthcare outcomes. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85.

  baseline, month 3, month 12

• Evidence-Based Practice Implementation (EBPI) Scale changes over time

  18-item instrument to measure the extent to which healthcare workers integrate scientific evidence in their clinical practice. A 5-point ordinal scale with frequencies listed from 0 times (0 pt.), 1-3 times (1 pt.), 4-5 times (2 pt.), 6-7 times (3 pt.) and \> 8 times (4 pt.) is used to assess how often each item has applied over the past 8 weeks. For example, how often have you: "Used evidence to change my clinical practice…", "Accessed the National Guidelines Clearinghouse…" Total scores are summed where higher scores indicate greater integration of EBP in the healthcare workers practice. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85.

  baseline, month 3, month 12

• EBP Knowledge Assessment Questionnaire (EBP-KAQ) changes over time

  27-item multiple-choice objective knowledge measure of examine EBP knowledge.

  baseline, month 3, month 12

Secondary Outcomes (1)

• Nursing process outcomes changes over time

  baseline, month 3, month 12

Other Outcomes (1)

• Feasibility metrics changes over time

  baseline, month 3, month 12

Study Arms (2)

ARCC EBP Model

CTEP EBP Immersion Course

Behavioral: CTEP EBP Immersion

Control Group

No CTEP EBP Immersion Course

Interventions

CTEP EBP Immersion BEHAVIORAL

36 continuing ed credits, virtual library access, collaboration with expert mentors

ARCC EBP Model

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

David Grant Medical Center active duty nurses and technicians

You may qualify if:

• Nurse (active duty) assigned to DGMC
• Medical/Surgical technician (active duty) assigned to DGMC
• month retain-ability from time of enrollment

You may not qualify if:

• Disciplines outside of Nursing (PA, MD, Occupational Therapy (OT), Physical Therapy (PT), etc.)
• Nurse/technician General Schedule (GS),VA, Contractor employed at David Grant Medical Center (DGMC)
• Anticipated/Scheduled Permanent Change of Station (PCS) in next 15 months

Sponsors & Collaborators

• David Grant U.S. Air Force Medical Center: lead
• Ohio State University: collaborator

Study Sites (1)

David Grant Medical Center

Fairfield, California, 94535, United States

Location

Related Publications (17)

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Study Officials

• Laurie A Migliore, PhD

  Staff

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: FED
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Nurse Scientist/Chief, Nursing Research

Study Record Dates

• First Submitted: August 22, 2017
• First Posted: August 31, 2017
• Study Start: September 15, 2017
• Primary Completion: December 31, 2019
• Study Completion: December 31, 2019
• Last Updated: February 4, 2021

Record last verified: 2021-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)