Genetic counselors, along with the National Society of Genetic Counselors, desire evidence-based research and data assessing the value of genetic counseling in genetic service delivery. This pilot study was designed to gather data about genetic counseling outcomes as well as analyze the feasibility of a study looking at new genetic outcome measures in the prenatal setting. Implementation of the methods used for data collection were evaluated by analysis of the appropriateness, acceptability, feasibility, fidelity, and adoption of the research protocol at three sites. We found that there is a hierarchy between implementation outcomes and it may be necessary to satisfy one implementation outcome before the next one can be achieved. We also found that patient engagement is a key component to evaluating the success of methods used for data collection. These findings may be useful to individuals designing future research studies used to measure genetic counseling outcomes.

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Prevalence of autism spectrum disorder (ASD) has increased 150% over the last 20 years, affecting all communities, with future projections of further rise. This is a particular concern for the public education system, where laws mandate that schools provide meaningful education to all students. Resources must be in place to provide the level of support children with ASD require for a successful educational experience. These resources are often expensive and require specialized training to secure. Rural schools face unique barriers meeting the standards set forth through federal law. To determine the most productive use of available resources as well as to identify critical needs, a study was conducted in a rural community to assess stakeholder perceptions of students with ASD. We provided an online needs assessment questionnaire to stakeholders involved with children who have ASD in a rural school district. These stakeholders included parents, caregivers, educators, and community care providers of children with ASD. Also included were individuals 12 years and older with an ASD educational classification. In addition to the online assessment, we invited participants who wished to elaborate further on their responses for an in- person interview. We used mixed methods for analysis of the data. To determine response patterns among groups, descriptive statistics were used. Further analysis included consensual qualitative research methods to analyze open-ended questions in the survey and the in-person interviews. Results show that stakeholders perceive needs for better training, resources, and peer relationships as a focus for improvement within the rural community. The results will have greatest implications for the school district as it allocates resources to better meet the needs of students with ASD within the community. Key points of feedback to the local school district will focus on training and support resources, primarily for educators, but also for families. Accessible (e.g., free, online) training options will be the first recommendation for immediate implementation.

OBJECTIVE:: Evidence-based interventions for pill swallowing training exist but are primarily implemented in pediatric specialty hospitals. Given increasing interest in the translation of brief and effective interventions to the wider population, there is a need to examine medication acceptance in a normative sample. METHODS:: Participants (N ≤ 304) completed the Medication Acceptance Survey, which assessed child/adolescent liquid and pill medication history and acceptance as well as parental interest in pill swallowing training. RESULTS:: Results showed that 30 "40% of youth had rejected/refused a pill or liquid formulation. Over half were unable to swallow a standard size pill or small capsule. Despite these difficulties, most parents did not express interest in an empirically supported pill swallowing training intervention. CONCLUSIONS:: The results provide directions for future research as well as the translation of pill swallowing interventions to primary care.

Evidence-based practice (EBP) in children’s mental health has the potential to treat childhood psychological concerns in a more effective and cost-efficient way. Despite the American Psychological Association’s commitment to EBP utilization, current efforts to disseminate and implement EBP into routine care have been slow. This slow uptake may adversely affect children and families by limiting their access to effective care. These consequences may be exacerbated in rural communities due to lack of qualified professionals and resources necessary to implement EBP. Previous research has identified several individual clinician factors and mental health agency characteristics that may influence the success of implementation efforts. These factors include clinician demographic variables (e.g., education level, theoretical orientation, discipline, years of clinical experience, caseload size), clinician attitudes toward EBP, clinician knowledge of EBP, agency characteristics (e.g., setting, size, supervision method, available funding), organizational culture, and organizational climate. The current study investigated how these variables are associated and affect EBP implementation in rural areas. Fifty-five rural mental health providers who provide therapy services to children completed questionnaires assessing current use of EBP, attitudes toward and knowledge of EBP, and agency culture and implementation climate. Results indicated that rural clinicians possessed relatively positive attitudes toward EBP, perceived their organization’s culture and climate as conducive to EBP use, and were just as knowledgeable about EBP as clinicians from urban and mixed rural-urban samples. However, clinician knowledge of evidence-based therapy techniques was not related to EBP utilization. Results also indicated that organizational culture was negatively associated with EBP use and suggests that further research is needed to clarify how clinician and agency variables affect EBP utilization in rural areas. These findings have important implications for EBP training programs. Specifically, extended supervision and consultation models should be incorporated into continuing education workshops and content related to organizational factors (e.g., strategies for fostering an organizational culture and climate conductive to EBP use) should be included. Findings from this study also highlight the need for more effectiveness research to be conducted in rural settings to address the unique barriers experienced by rural clinicians.

When bedside acute care nurses support their clinical practice with current best evidence, patient outcomes improve. Most bedside acute care nurses base their clinical decision-making on tradition and not the application of evidence based practice (EBP). The ability to appraise research is a critical component in the application of EBP and best care practices. The purpose of the DNP project was to obtain 5 content experts' evaluations of an education module for bedside nurses on how to analyze a research report, complete a literature review, and create a table of evidence (TOE). The theoretical framework guiding the project was the Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model, which supports the integration of research in clinical practice. The content experts provided qualitative, summative evaluations to strengthen the content. Recommendations included adding information to the content of the module that would identify the differences in analyzing quantitative and qualitative research, providing more information related to the 51 criteria of the RAC used to guide nurses when analyzing a research article, and providing a script and talking points to assist other facilitators when implementing the module. A final suggestion by the experts included presenting the EBP module in two parts: part 1, how to analyze an article and part 2, how to pool the data. The project has the potential to improve nurses' knowledge and the application of evidence based practice to enhance social change through improved clinical outcomes for patients.

Indiana University-Purdue University Indianapolis (IUPUI) / The implementation of evidence into practice is a complex process. Estimates indicate that it takes seventeen years on average for research to be translated into practice. Delay in implementation of evidence-based practice (EBP) results in poor patient outcomes and negative impacts to healthcare systems. While many factors contribute to delayed implementation of evidence, organizational characteristics of healthcare institutions have a significant impact on implementation. Leaders play a critical role by influencing these organizational characteristics to support evidence-based practice implementation. A key leadership role within acute care healthcare organizations is that of the front-line nurse manager (NM). Front-line nurse managers have responsibility for nursing unit operations and clinical nurses who deliver patient care under the nurse managers supervision. The relationship between NM leadership competencies and implementation of EBP is not well understood. Therefore, there is a critical need to identify how NM leadership behaviors influence the implementation of EBP. This dissertation examined the relationship between NM leadership behaviors and implementation of EBP. Results link the role of the NM to evidence-based clinical practice, and describe competencies and education needed for NM development. With an understanding of the NM leadership behaviors associated with implementation of EBP, healthcare leaders can develop education, processes, and interventions to increase competencies on NM leadership behaviors. Better implementation support by NMs will result in an improvement in use of EBPs. To examine the NM leadership behaviors that are associated with implementation of EBP, the following activities were completed: (1) an integrative review of the literature related to NM competencies associated with implementation, (2) identification and description of nurse manager competencies associated with EBP implementation using the Delphi method, and (3) examination of NM leadership behaviors associated with implementation of EBP during the COVID-19 pandemic response through a multi-site descriptive correlational survey of NMs and their nursing staff. Results of these studies demonstrate the importance of NM leadership characteristics and behaviors on EBP implementation.

Do you want to demonstrate the significance or vaIue of your integrated program? In this presentation, four researchers will tell their stories about how they collected good data in "real world" clinic settings. Practical recommendations will be provided for getting started in program evaluation in a way that will impact not only your developing program but also the field of integrated care. The audience will have the opportunity to frame their own questions and begin developing methods with feedback.

Excerpt: Nursing and nurse leaders have the opportunity to advance nursing practice and improve patient outcomes unlike any time in the past.