Validation of scales measuring self-efficacy and outcome expectancy in evidence-based practice

Background: Evidence-based practice (EBP) is embraced internationally as an ideal approach to improve patient outcomes and provide cost-effective care. However, despite the support for and apparent benefits of evidence-based practice, it has been shown to be complex and difficult to incorporate into the clinical setting. Research exploring implementation of evidence-based practice has highlighted many internal and external barriers including clinicians’ lack of knowledge and confidence to integrate EBP into their day-to-day work. Nurses in particular often feel ill-equipped with little confidence to find, appraise and implement evidence. Aims: The following study aimed to undertake preliminary testing of the psychometric properties of tools that measure nurses’ self-efficacy and outcome expectancy in regard to evidence-based practice. Methods: A survey design was utilised in which nurses who had either completed an EBP unit or were randomly selected from a major tertiary referral hospital in Brisbane, Australia were sent two newly developed tools: 1) Self-efficacy in Evidence-Based Practice (SE-EBP) scale and 2) Outcome Expectancy for Evidence-Based Practice (OE-EBP) scale. Results: Principal Axis Factoring found three factors with eigenvalues above one for the SE-EBP explaining 73% of the variance and one factor for the OE-EBP scale explaining 82% of the variance. Cronbach’s alpha for SE-EBP, three SE-EBP factors and OE-EBP were all >.91 suggesting some item redundancy. The SE-EBP was able to distinguish between those with no prior exposure to EBP and those who completed an introductory EBP unit. Conclusions: While further investigation of the validity of these tools is needed, preliminary testing indicates that the SE-EBP and OE-EBP scales are valid and reliable instruments for measuring health professionals’ confidence in the process and the outcomes of basing their practice on evidence.

The theory and practice on pre-qualification in bidding procedure

资格预审是招标程序中重要环节.通过对投标人的资质和业绩等审查既能保证不符合 要求的投标人尽可能早地退出无谓竞争的行列,避免了大量人力"物力的损失和浪费, 又能促进建筑市场优胜劣汰,提高企业竞争力.同时鉴于目前资格预审和建筑市场存在 的问题,笔者以为通过强化资格预审可以有效推进建筑市场信用体系建设,促进行业健康发展,并且深入探讨了资格预审体系建立的具体对策和措施.

Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses

Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia. This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context. Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy. Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia. Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.

Not a dirty word : arts entrepreneurship and higher education

While the majority of creative, performing, and literary artists are self-employed, relatively few tertiary arts schools attempt to develop capabilities for venture creation and management (and entrepreneurship more broadly) and still fewer do so effectively. This article asks why this is the case. It addresses underlying conceptual and philosophical issues encountered by arts educators, arguing that in all three senses of the term: new venture creation; career self-management; and being enterprising, entrepreneurship is essential to career success in the arts. However, the practice of entrepreneurship in the arts is significantly different from the practice of entrepreneurship in business, in terms of the artist’s drivers and aims, as well as the nature of entrepreneurial opportunities, contexts and processes. These differences mean that entrepreneurship curricula cannot simply be imported from Business schools. This article also examines the arts-idiosyncratic challenge of negotiating distinctive and potentially conflicting entrepreneurial aims, using career identity theory. It concludes by suggesting strategies by which adaptive entrepreneurial artist identities can be developed through higher education programs.

Beyond the inner city : real and imagined places in creative place policy and practice

As the economic and social benefits of creative industries development become increasingly visible, policymakers worldwide are working to create policy drivers to ensure that certain places become or remain ‘creative places’. Richard Florida’s work has become particularly influential among policymakers, as has Landry’s. But as the first wave of creative industrial policy development and implementation wanes, important questions are emerging. It is by now clear that an ‘ideal creative place’ has arisen from creative industries policy and planning literature, and that this ideal place is located in inner cities. This article shifts its focus away from the inner city to where most Australians live: the outer suburbs. It reports on a qualitative research study into the practices of outer-suburban creative industries workers in Redcliffe, Australia. It argues that the accepted geography of creative places requires some recalibration once the material and experiential aspects of creative places are taken into account.

Pandemic (H1N1) Influenza 2009 and Australian emergency departments : implications for policy, practice and pandemic preparedness

Objective: To describe the reported impact of Pandemic (H1N1) 2009 on EDs, so as to inform future pandemic policy, planning and response management. Methods: This study comprised an issue and theme analysis of publicly accessible literature, data from jurisdictional health departments, and data obtained from two electronic surveys of ED directors and ED staff. The issues identified formed the basis of policy analysis and evaluation. Results: Pandemic (H1N1) 2009 had a significant impact on EDs with presentation for patients with ‘influenza-like illness’ up to three times that of the same time in previous years. Staff reported a range of issues, including poor awareness of pandemic plans, patient and family aggression, chaotic information flow to themselves and the public, heightened stress related to increased workloads and lower levels of staffing due to illness, family care duties and redeployment of staff to flu clinics. Staff identified considerable discomfort associated with prolonged times wearing personal protective equipment. Staff believed that the care of non-flu patients was compromised during the pandemic as a result of overwork, distraction from core business and the difficulties associated with accommodating infectious patients in an environment that was not conducive. Conclusions: This paper describes the breadth of the impact of pandemics on ED operations. It identifies a need to address a range of industrial, management and procedural issues. In particular, there is a need for a single authoritative source of information, the re-engineering of EDs to accommodate infectious patients and organizational changes to enable rapid deployment of alternative sources of care.

Disaster triage : evidence, consistency and standard practice

Triage has military origins, with the initial purpose being to direct care to those most likely to be able to return to the battlefield. Conversely, modern disaster triage attempts to ensure both the prioritisation of care for those who need it most and a fair distribution of resources, so that health responders are able to ‘do the most for the most’...

An exploratory study to examine the phenomenon and practice of ambulance ramping at hospitals within the Queensland Health Southern Districts and the Queensland Ambulance Service

Background: Ambulance Ramping, defined anecdotally as a practice where patients brought to emergency departments by ambulance experience delays to admission, has become more frequent in Australian emergency departments over the last few years. Previous research has shown a link between emergency department overcrowding, ambulance diversion and adverse outcomes for patients. However, there is very little research about Ambulance Ramping. The literature has no consistent definition of Ambulance Ramping, no description of how it is managed, and limited research on the effects it has on patient and service delivery outcomes...

Explicit, latent and meta-criteria : types of criteria at play in professional judgement practice

This paper engages with debates about whether comprehensive prior specification of criteria and standards is sufficient for informed professional judgement. A preoccupation has emerged with the specificity and explication of criteria intended to regulate judgement. This has resulted in criteria-compliance in the use of defined standards to validate judgements and improve reliability and consistency. Compliance has become a priority, the consequence being the prominence of explicit criteria, to the lack of acknowledgement of the operation of latent and meta-criteria within judgement practice. This paper examines judgement as a process involving three categories of assessment criteria in the context of standards-referenced systems: explicit, latent and meta-criteria. These are understood to be wholly interrelated and interdependent. A conceptualisation of judgement involving the interplay of the three criteria types is presented with an exploration of how they function to focus or alter assessments of quality in judgements of achievement in English and Mathematics.

Professional development in the contemporary educational context : encouraging practice wisdom

Preparing social work students to be effective practitioners is a complex and challenging task undertaken in a dynamic environment both in terms of the field of social work and the higher education sector. There have been recommendations that self knowledge, empirical knowledge, theoretical knowledge and procedural knowledge are the keys to high standards of social work practice. This paper suggests that the concept of practice wisdom is a useful focus for integrating these different aspects of informed practice and for focusing educational programmes for social work. As practice wisdom is more about process than possessed characteristics then there are important motivational and value-based considerations in developing wise practitioners. This discussion considers motivational and personal narrative aspects of practice wisdom so that it can be integrated into social work teaching.

Joined-up practice : five areas of exemplary practice for social workers and educators to re-engage homeless youth

Young people seen as ‘at risk’ are a substantial focus across a wide range of policy and practice fields in national and international contexts. This article addresses two of those fields, youth homelessness and youth failing to obtain a basic education that will give them access to employment and full community participation as active citizens. By comparing solutions to the problems of youth homelessness and youth educationally at risk, the article distils key meta-characteristics useful for both social workers and educators in mutually supporting some of the most at risk young people in our communities today. This is what the authors term ‘a joined-up practice’.

Public realm and transport, international best practice case studies and opportunities for Brisbane

This report was prepared for Lat 27 Pty Ltd for the purpose of conducting a City Centre Public Realm and Active Transport Study for Urban Renewal Brisbane, Brisbane City Council. In this review, we highlight some key learnings and recommendations from innovative projects across the globe to inform public realm design and help facilitate active transport in subtropical Brisbane. Traditionally, Australian cities have been have been based on northern European models. This report is informed by the view that planners and urban designers must look beyond that paradigm to redefine and re-conceptualise our city in a different way, one that values our unique local identity and climate. In re-designing Brisbane’s public realm, therefore, design interventions and responses must celebrate our unique identity and outdoor lifestyle and address the subtropical climate's reality of life in warm humid summers and cool dry winters. The current period of rapid urban change, and the imperative to adapt to climate change, together offer an opportunity to prioritise and integrate design features that provide shade and shelter from sun and summer rain, open and permeable urban environments that facilitate cooling air movement, and connections to water and nature, so that the urban built form co-exists within an inviting, functional and memorable natural landscape. To inform this transformation, this review provides insight into international experiences and best practices. To date, although there is much practice-based knowledge, academic studies outlining learnings and recommendations from case studies (especially in a subtropical context) remain rare. Thus, a range of sources (industry reports, websites, journal articles and books) have been utilised.