Researches:
Article title: Nurses’ Perceived Readiness in Evidence-Based Practice: An Organizational Assessment
Authors: Rainier Moreno-Lacalle, Mark Job G. Bascos, Cheryll M. Bandaay, Marian Tibalao Barrientos, et al.
Publication title: Journal of Nursing Practice Applications & Review of Research
Abstract:
Background: Globally, nursing service departments of various hospitals encounter challenges in implementing Evidence-based Practice (EBP). Critical to the improvement of nursing outcomes is the practice of EBP. That is why EBP is considered a state of the art in the hospital organization. Organizational assessment, therefore, is needed to determine the hospital nursing service readiness in EBP.
Objective: The aims of the study are two-fold: (1) to identify the sources of nurses’ knowledge and to determine the extent of knowledge-practice gap, skills, and attitude; and (2) to describe middle- and top-level managers of a hospital on evidence-based practice.
Method: Descriptive, concurrent mixed-methods design was employed. The Promoting Action on Research Implementation in Health Services (PARIHS) model served as the theoretical framework where Context, Evidence, and Facilitation are considered important elements to the successful adoption of EBP. A survey questionnaire on EBP perceived knowledge, attitude, and practices by Malik et al. (2015) was responded to by 240 eligible staff nurses from a tertiary level, national government-funded hospital in the Philippines. The qualitative component of the study involved review of records, focus group discussions of seven middle-managers, and structured interviews of four top-level managers.
Results: The results revealed that the nursing service institution scored low to moderate readiness on evidence and facilitation elements of the framework, while moderate to high on contextual readiness on EBP. Three themes emerged in the qualitative data, namely: willingness to learn, research and EBP were difficult, and unmotivated to do EBP.
Conclusion: Nursing services of the institution point to the need to strengthen readiness on EBP. Of the three elements of the PARIHS framework, Context element scored favorable on EBP. The Evidence and Facilitation elements of the institution may need to be strengthened through the partnership between the academe and hospital.
Full text link https://tinyurl.com/5h2fxrrz
Article title: Frailty as part of the disablement process: calling for health economic interventions
Authors: Rainier Moreno- Lacalle
Publication title: Evidence-Based Nursing 25(2), May 2021
Abstract:
No available
Full text link https://tinyurl.com/46v3efbz
Article title: Nurses’ Concepts and Experiences in Shared Decision-Making
Authors: Rainier Moreno-Lacalle and Mary Grace C. Lacanaria
Publication title: Journal of Nursing Practice Applications & Review of Research 10(2), 2020
Abstract:
Background: Shared decision-making with nurses is proven to be effective in improving patient outcomes. However, the concept is understood and interpreted in different ways. Nurses’ concepts and experiences can bring light to different understanding and interpreta-tions.
Objective: The objective of this study is to explore nurses’ concepts and experiences in shared decision-making.Methods: The study employed qualitative descriptive design, using focus group discus-sions. Aeight hospitals located in Baguio City Tprovinces in the Philippines. There were 38 nurse participants in this study. Twenty-two (22) were staff nurses (or line managers), and 16 were nurse supervisors/head nurses (or middle managers).
Results: -The experiences of nurses in shared decision-making involve family inclusion, courtesy and respect, listening to both sides, and organizational considerations.Conclusion: Shared decision-making is a dynamic concept involving the active role of pa-and social factors
Full text link https://tinyurl.com/4p3jv9hz
Article title: Intuition in Evidence-Based Practice: A Scoping Review
Authors: Rainier Moreno-Lacalle, Racquel Estrada, Jefferson Galanza
Publication title: Philippine Journal of Nursing Education 29, 2019
Abstract:
Purpose: The purpose of this paper is to conduct a scoping review to identify and map the literature along intuition in evidence-based practice.
Background: Intuition is an increasing concept affecting nurses’ evidence-based practice and decision-making. However, the extent of studies and attitude regarding the role of intuition in evidence-based practice has not been fully explicated.
Methods: Scoping review by Arksey & O’Malley in 2005 was used as a research design. We searched five electronic databases (CINAHL, EBSCOHost, Google Scholar, Proquest, Research gate, and Science Direct) for published and unpublished literature along intuition in evidence-based practice. The first stage was done by the second author by culling and scoring the relevance of each title. Then each abstract was reviewed and followed up by the first and third authors using Modified Criteria for Optimal Grading. Finally, studies had undergone appraisal using the General Appraisal Tool (GAT) to ensure quality inclusion in this review. After selection, we charted, collated, summarized, and reported the results of the reviewed studies.
Results: After searching 17, 593 articles and three stages of appraisal, we downsized the reviewed studies to 23. We found out that studies exploring explicitly intuition in evidence-based practice (EBP) used a variety of research designs wherein the majority of these are qualitative, literature reviews, and discussion papers. Seven studies used Patricia Benner’s Model of Proficiency as their framework while 17 are favorable to the use of intuition in EBP in decision-making.
Conclusions/ Recommendations: There is a sufficiently high number of studies that warrant the conduct of integrative review but not more-focused systematic reviews. Further primary research on intuition in evidence-based practice can be done, in particular, there is a need to substantiate the role of intuition in evidence-based practice.
Full text link https://tinyurl.com/4vdx4vfj
Article title: Comparative Analysis Between Nursing Competency Standards of Australia and the Philippines
Authors: Rainier C. Moreno-Lacalle
Publication title: Belitung Nursing Journal 5(5), September 2019
Abstract:
The Philippines as one of the top producers of nurses worldwide must benchmark its national nursing standards to the rest of the world. Therefore, the standards must be compared and contrasted with other countries like Australia. The main purpose of this study is to compare and contrast nurse's competency and performance indicators between the Philippines and Australia nursing competency systems. This is a review article guided by Donnelly and Weichula's Qualitative-Comparative Analysis (QCA). The process includes identification of the condition of interest, dichotomization and development of truth tables. Two official documents namely the Philippines' National Nursing Core Competency Standards and Australia's National Competency Standards for the Registered Nurse were selected as the condition of interest. Findings show that Australia adopted a one pronged-generalist, non-linear approach, and policy-based nursing education system while the Philippines emphasized on three-pronged specialization, work-based, and linear approach nursing competency standards. The Australia and Philippine nursing competency trails a different path in adopting standards for the nursing education system. The strengths and weaknesses of each national nursing competency standard were discussed.
Full text link https://tinyurl.com/2p9nudda
Article title: Emancipation through nursing within the context of health disparities
Authors: Rainier Moreno-Lacalle and Rozzano Locsin
Publication title: Belitung Nursing Journal 5(2):65-74, April 2019
Abstract:
Background: Health disparity can be observed using the lens of emancipation through nursing.
Objective: This paper aims to describe the concept of emancipation through nursing, situate its position within the theory of ’Emancipation through Nursing,’ and illuminate the implications of caring within the context of health disparity.
Methods: The sequential process of Rodgers’ Evolutionary Concept Analysis and Chinn and Kramer’s Process of Theory Construction were applied. Review of the literature utilizing six major databases was conducted using the keywords ‘emancipation’ or ‘empowerment’ and ‘health disparity’ and ‘nursing’ and with year restrictions from 2000-2017.
Results: Findings revealed that the attributes of the concept of ‘emancipation through nursing’ are conscientization or critical consciousness, correct and adequate health information, co-construction of a creative process for health service, and collective action. These attributes were preceded by the following antecedents: marginalization, hegemony, the oppressed and the emancipator, centering, and liberation. The resulting features of enlightenment, enervation, empowerment, and evolvement served as constructs that collectively structured the theory of Emancipation through Nursing in the Context of Health Disparities.
Conclusion: Nurses worldwide will benefit from descriptions and illuminations of the concepts of emancipation and nursing within the theory of Emancipation through Nursing in the Context of Health Disparities.
Full text link https://tinyurl.com/2wkrv426
Article title: Workplace Incivility and Its Influence on Professional Quality of Life amongst Nurses from Multicultural Background: A Cross-sectional Study
Authors: Abdualrahman Saeed Alshehry, Nahed Alquwez, Joseph Almazan, Ibrahim Mohammed Namis, Rainier C. Moreno-Lacalle, Jonas Preposi Cruz
Publication title: Journal of Clinical Nursing 28(1), February 2019
Abstract:
Aims and Objectives
To investigate the workplace incivility of nurses working in two Saudi hospitals and analyse its influence on the nurses’ professional quality of life (ProQOL).
Background
The prevalence and economic impact of workplace incivility cannot be overstated and disregarded. To the current authors’ knowledge, no extensive study on this topic has been conducted in Saudi Arabia. The influence of workplace incivility to ProQOL of nurses from different cultural backgrounds has never been thoroughly investigated.
Design
Descriptive, cross-sectional design.
Methods
A sample of 378 nurses working in two government hospitals in Saudi Arabia were surveyed using the Nursing Incivility Scale and the ProQOL Scale version 5 from February to May 2018. A multivariate multiple regression analysis was conducted to analyse the multivariate effect of workplace incivility on the nurses’ ProQOL. The study adhered to the STROBE guideline (See Supporting Information File 1).
Results
The nurses perceived a moderate level of workplace incivility from the different sources of uncivil acts measured in this study. Among the five sources of incivility explored in this study, the nurses reported the majority of workplace incivility experienced from patients/visitors (M = 2.44, SD = 0.80), while the lowest was from supervisors (M = 1.90, SD = 0.66). The mean scores of the respondents in the compassion satisfaction, burnout and secondary traumatic stress subscales were 36.50 (SD = 6.30), 26.43 (SD = 4.81) and 26.47 (SD = 6.06), respectively. General incivility, supervisor incivility, physician incivility and patient/visitor incivility showed a significant multivariate effect on the three ProQOL subscales.
Conclusions
Nurses’ experience of workplace civility and its sources were associated with ProQOL. Relevance to clinical practice. The findings of this study can be used as guide in establishing human resource policies towards achieving nurses’ needs, reducing workplace incivility and improving ProQOL.
Full text link https://tinyurl.com/2p942atf
Article title: Nurses’ perceived spiritual climate of a hospital in Saudi Arabia
Authors: J.P. Cruz RN, PhD, N. Alquwez RN, PhD, H.M. Albaqawi RN, PhD, S.M. Alharbi RN, BSN, R.C. Moreno-Lacalle RN, MSN
Publication title: International Nursing Review 65(1), September 2018
Abstract:
Aim
This study investigated the spiritual climate of a hospital in Saudi Arabia as perceived by nurses.
Background
A spiritually conducive environment improves patient, nurse and organizational outcomes. Despite being important, no studies have investigated this area in the Muslim-dominated Middle Eastern countries.
Introduction
A snapshot on the degree of spiritual climate perception may provide insight into the aspects that may need improvement and may become basis for the creation of health and nursing policies directed towards creating a spiritually-accepting and respecting clinical workplace.
Method
A sample of 219 nurses employed in a 500-bed capacity hospital in Saudi Arabia was included in this cross-sectional study utilizing the spiritual climate scale.
Results
The nurses perceived their hospital's spiritual climate to be fair. The item ‘I am encouraged to express spirituality in this clinical area’ received the lowest mean, whereas the item ‘My spiritual views are respected in this clinical area’ received the highest mean. Being Saudi, having less total experience as a nurse, and having greater total experience as a nurse in Saudi Arabia and in the present hospital positively influenced the perception of the spiritual climate among nurses.
Conclusion
The findings stress the need to improve the spiritual climate in the hospital.
Implications for nursing and nursing policy
Hospitals are recommended to create policies to implement interventions geared towards creating a spiritually-friendly environment. Hospitals are encouraged to create a safe place where nurses can freely express their spirituality regardless of preference or religious denomination. Spiritual education may be provided by hospitals as part of continuing education. Managers may also focus on the existential spirituality of nurses, especially for spiritually-sensitive environments such as Saudi Arabia.
Full text available upon request to the author/s.
Article title: The Future of Nursing Science: Consilience in Evidence-Based Practice
Authors: Rainier C. Moreno-Lacalle, PhD, RN
Publication title: The Philippine journal of nursing 88(1):33-40, January 2018
Abstract:
Nursing science needs to adopt a paradigm that can be used to apply its knowledge. Notably, how nursing science is applied in nursing practice or education remains confusing. This article aims to discuss the pros and cons of the two ways to implement nursing science, that is, evidence-based practice (including translational research and research utilization) and intuitive nursing. Also, I differentiated evidence-based practice (EBP), translational research (TR), and research utilization (RU). I argued that EBP as the paradigm of choice will be the optimal strategy for the future of nursing science. Adopting EBP improves patient, organizational, and staffing outcomes. While basing clinical decisions on intuition alone may imperil patient's safety due to multiple cognitive biases inherent in our intellectual devices. Combining EBP, TR, RU, and intuitive nursing resulted in a model Consilience in Evidence-based Practice. Implications of the model for nursing practice, education, and research were also discussed.
Full text link https://tinyurl.com/3xv9ss3j
Article title: The Effect of Psychoeducation for Depression: A Meta
Authors: Rainier Moreno-Lacalle
Publication title: The Philippine journal of nursing 86(2): 36-43, December 2016
Abstract:
Background/Objective: Depression is a global mental health problem. Therefore, mental health professionals need to develop interventions that are evidence-based and cost-effective. One of the psychosocial interventions is psychoeducation. However, a recent Google search on the effect of psychoeducation for depression suggests conflicting results calling for an analysis of studies to establish psychoeducation effectiveness. The goal of the meta-analysis is to examine randomized controlled trials (RCTs) overall effectiveness of psychoeducation for depression.
Methods: EBSCOhost, PsychINFO, and Science Direct databases were searched using the keywords ‘psychoeducation,’ ‘group psychoeducation,’ ‘mental health education,’ ‘depression,’ ‘depressive disorder,’ and ‘dysthymia’ with year restriction of 2010-2016. In this meta-analysis, the effect size (using Hedges’ g value), Q statistics, and I2 were calculated under the random effects model aided by CMA v.3. To test for publication bias, trim-and-fill analysis and fail-safe N were computed too.
Results: A total of 1,560 patients from 11 studies were included in this analysis. Post-intervention results had Hedges’ g-value of -0.293 (95% CI= -0.552—0.035) of psychoeducation for depression meaning low effect. Although notably, the overall effect size leans towards psychoeducation. The p-value is significant at .05 level, favoring psychoeducation (p=0.026). The studies were also found to be highly heterogeneous (Q (10) = 55.467, p<.05, I2 =81.971) under the random effects model, suggesting high inconsistency on the studies included in this meta-analysis. In testing for publication bias, the imputed effect size using trim-and-fill approach was -0.38558 (95% CI= -0.64926- -0.12189) while the result of fail-safe N suggested that 48 nil or null results would be needed to increase the p-value associated with the average effect above an alpha level of 0.05.
Conclusions: This meta-analysis may suggest that psychoeducation has low effect on depression. Longer and more interactive approach can be done to ensure its long-term and maximal effectiveness. Publication bias is unlikely in this meta-analysis. The findings provide valuable information for future psychoeducation to improve content, design, quality, and process that will benefit patients with depression. Keywords: Psychoeducation, Mental Health Promotion, Depression, Depressive disorders
Full text link https://tinyurl.com/fdew7r8f
Article title: Nurturing the Seeds of Evidence-Based Practice: Early Ambulation among Cardiac Surgery Patients
Authors: Rainier Moreno-Lacalle
Publication title: International Journal of Evidence-Based Healthcare 14(Supplement 1): S19, December 2016
Abstract:
Background:
Management of cardiovascular diseases is an essential and a timely global health issue. Extensive research on early ambulation for cardiac surgery patients has been conducted, but no evidence-based paper has evaluated the overarching effects in improving patient care outcomes.
Objectives:
To evaluate the effects of early ambulation on cardiac surgery patients on improving patient care outcomes.
Methods:
A systematic review was conducted. Six electronic database were searched: Health source: Nursing/ Academic Edition, CINAHL, Cochrane Library, MEDLINE, The National Guidelines Clearinghouse, and The Joanna Briggs Institute from 2000–2015. Each study was appraised using different quality tools: for observational cohort and cross sectional studies, randomized controlled trial, and systematic review/ meta-analysis is used National Heart, Lung, and Blood Institute Quality Assessment Tool, and for the clinical guideline,the AGREE (Appraisal of Guidelines, Research and Evaluation) collaboration tool.
Results:
The evidence-based review involved five-thousand fifty-one (n = 5051) participants, with study sizes ranging between 31–4091 patients. Early ambulation time ranges from 2–4 hours after the patient has been stabilized while the late ambulation ranges from 12–24 hours. As to the patient outcomes, three studies utilized vascular complications as an outcome: hematoma, bleeding, false aneurysm, and arteriovenous fistula. Secondary end points were also considered, such as patient comfort, lesser hospital costs (where early ambulatory patients have lesser charge of US$105), vasovagal collapse, back pain (OR = 0.19, 95% CI: 0.08–0.45, p < 0.001), urinary problems(OR = 0.35, 95% CI:0.14–0.90, p = 0.03), mixed venous oxygen saturation using ejection fraction, and lastly general well-being and satisfaction level (p = 0.0005 for vitality scale and p = 0.014 for the total general well-being).
Conclusion:
Evidence from the review indicates that early ambulation may improve patient care outcomes. Caution may be instated since there are idiosyncratic effects that can pose problems toward the patients such as arrhythmia or bleeding. Overall, healthcare providers may render cost-effective and scientifically-grounded interventions.
Full text available upon request to the author/s.
Article title: Integrative Review of Outcomes-Based Education in Nursing
Authors: Rainier Moreno-Lacalle
Publication title: Philippine Journal of Nursing Education 26, October 2016
Abstract:
The need for initial evaluation of Outcomes-based Education (OBE) in nursing is needed, not only to identify its weakness in order to counteract the pitfalls more so to gain insights and lessons for the cause of improving nursing education. The aim of this study is to evaluate OBE in nursing. An integrative review was employed using the databases: CINAHL, ERIC, Google scholar, and MEDLINE, searching from the year of inception to 2015. The final assessment includes six research articles relevant to the study. The overall evaluation of OBE in nursing is equivocal. That is, there are conflicting evaluations to countries that have pioneered the OBE implementation in nursing. Chief among the attributions of the result are methodological weakness of available studies, poor understanding, conflicting interpretation, sloppy implementation, teacher-related factors, and contextual differences in the application of OBE in nursing. On a positive note, OBE in nursing is generally perceived as student-centered, well-balanced, collaborative, life-long learning, and systemic alignment in nursing education. Therefore, it is recommended that future studies could use randomized controlled trials or meta-analysis as to the effectiveness of OBE in nursing. There might also be a need to revisit the implementation of OBE from institutional outcomes to course learning outcomes implementation.
Full text available upon request to the author/s.
Article title: The effect of psychoeducation for depression: A meta-analysis 2010-2016
Authors: Rainier Moreno-Lacalle
Publication title: The Philippine journal of nursing 86(2):36-43, July 2016
Abstract:
Background/Objective: Depression is a global mental health problem. Therefore, mental health professionals need to develop interventions that are evidence-based and cost-effective. One of the psychosocial interventions is psychoeducation. However, a recent Google search on the effect of psychoeducation for depression suggests conflicting results calling for an analysis of studies to establish psychoeducation effectiveness. The goal of the meta-analysis is to examine randomized controlled trials (RCTs) overall effectiveness of psychoeducation for depression.
Methods: EBSCOhost, PsychINFO, and Science Direct databases were searched using the keywords 'psychoeducation,' 'group psychoeducation,' 'mental health education,' 'depression,' 'depressive disorder,' and 'dysthymia' with year restriction of 2010-2016. In this meta-analysis, the effect size (using Hedges' g value), Q statistics, and I² were calculated under the random effects model aided by CMA v.3. To test for publication bias, trim-and-fill analysis, and fail-safe N were computed too.
Results: A total of 1,560 patients from 11 studies were included in this analysis. Post-intervention results had Hedges' g-value of -0.293 (95% CI= -0.552-0.035) of psychoeducation for depression meaning low effect. Although notably, the overall effect size leans towards psychoeducation. The p-value is significant at .05 level, favoring psychoeducation (p=0.026). The studies were also found to be highly heterogeneous (Q = 55.467, p<.05, I² =81.971) under the random effects model, (10) suggesting high inconsistency on the studies included in this meta-analysis. In testing for publication bias, the imputed effect size using trim-and-fill approach was - 0.38558 (95% CI= -0.64926- -0.12189) while the result of fail-safe N suggested that 48 nil or null results would be needed to increase the p-value associated with the average effect above an alpha level of 0.05.
Conclusions: This meta-analysis may suggest that psychoeducation has low effect on depression. Longer and more interactive approach can be done to ensure its long-term and maximal effectiveness. Publication bias is unlikely in this meta-analysis. The findings provide valuable information for future psychoeducation to improve content, design, quality, and process that will benefit patients with depression.
Full text link https://tinyurl.com/3bpcpy3r
Article title: Wellness Within Illness: An Evolutionary Concept Analysis
Authors: Rainier Moreno-Lacalle
Publication title: The Philippine Journal of Nursing 85(2): 45-49, July 2015
Abstract:
The concept of wellness has no single, universal acceptable definition. The situation gives room to developing and refining wellness both as a concept and an experience. This paper aimed to substantiate the concepts surrounding wellness within an illness experience. Beth Rodger's evolutionary method of concept analysis provided the organizing framework for this paper. The data source was a search of literature published from 2010-2016 on CINAHL, Medline, EBSCO, and Google scholar database. Trailing process is organized with particular focus on antecedents, attributes, and consequences. The analysis found four attributes of wellness within illness namely: normalizing, independence, empowerment, and finding meaning strengthened by antecedents such as strong social support, motivation, constructive coping strategies, and cognitive reframing. Subsequently these may lead to adaptation to illness, being well, and living to illness. Looking at wellness and illness in dichotomy may lead to rote deftness thus expansion of the panorama of wellness within an illness experience may lead to more depth on the scientific understanding and varied application. Increased conceptual understanding and knowledge development on wellness will enable nurses in facilitating patient's adaptation during illness.
Full text link https://tinyurl.com/272vd2b2
Paper Presentations:
Article title: Nurturing the seeds of evidence-based practice: Early ambulation among cardiac surgery patients
Authors: Rainier Moreno-Lacalle
Conference title: Optimizing Health care, Chiang Mai, Thailand, June 2016
Article title:Deconstruction and Reconstruction of Florence Nightingale Leadership Theory
Authors: Rainier Moreno-Lacalle
Conference title: Caring Beyond Borders, January 2016