***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians . However , most work has focused on medical practice s ; and nursing is not well represented in existing systematic review s. The purpose of this article is to report findings from a systematic review of interventions aim ed at increasing research use in nursing . Objective To assess the evidence on interventions aim ed at increasing research use in nursing . Methods A systematic review of research use in nursing was conducted using data bases ( Medline , CINAHL , Healthstar , ERIC , Cochrane Central Register of Controlled Trials , and Psychinfo ) , grey literature , ancestry search ing ( Cochrane Data base of Systematic Review s ) , key informants , and manual search ing of journals . R and omized controlled trials and controlled before- and after- studies were included if they included nurses , if the intervention was explicitly aim ed at increasing research use or evidence -based practice , and if there was an explicit outcome to research use . Method ological quality was assessed using pre-existing tools . Data on interventions and outcomes were extracted and categorized using a pre-established taxonomy . Results Over 8,000 titles were screened . Three r and omized controlled trials and one controlled before- and after- study met the inclusion criteria . The method ological quality of included studies was generally low . Three investigators evaluated single interventions . The most common intervention was education . Investigators measured research use using a combination of surveys ( three studies ) and compliance with guidelines ( one study ) . Research er-led educational meetings were ineffective in two studies . Educational meetings led by a local opinion leader ( one study ) and the formation of multidisciplinary committees ( one study ) were both effective at increasing research use . Conclusion Little is known about how to increase research use in nursing , and the evidence to support or refute specific interventions is inconclusive . To advance the field , we recommend that investigators : ( 1 ) use theoretically informed interventions to increase research use , ( 2 ) measure research use longitudinally using theoretically informed and psychometrically sound measures of research use , as well as , measuring patient outcomes relevant to the intervention , and ( 3 ) use more robust and method ologically sound study design s to evaluate interventions . If investigators aim to establish a link between using research and improved patient outcomes they must first identify those interventions that are effective at increasing research use This descriptive survey assessed the perception of  evidence -based practice ( EBP ) among nurses in the United States . Although evidence -based healthcare results in improved patient outcomes and reduced costs , nurses do not consistently implement evidence -based best practice s. A descriptive survey was conducted with a r and om sample of 1015 RNs who are members of the American Nurses Association . Although nurses believe in evidence -based care , barriers remain prevalent , including resistance from colleagues , nurse leaders , and managers . Differences existed in responses of nurses from Magnet ® versus non-Magnet institutions as well as nurses with master ’s versus nonmaster ’s degrees . Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine ’s 2020 goal that 90 % of clinical decisions be evidence -based The choice of study design for guideline implementation studies will determine the confidence with which the observed effects can be attributed to the interventions under study . In general , cluster r and omized trials , of which there are different types , provide the most robust design . However , the use of these design s has implication s for the power , conduct and analysis of studies . Wherever possible , design s allowing head-to-head comparisons , which incorporate baseline measures of performance , should be used BACKGROUND The Quality in Acute Stroke Care ( QASC ) trial evaluated systematic implementation of clinical treatment protocol s to manage fever , sugar , and swallow ( FeSS protocol s ) in acute stroke care . This cluster-r and omised controlled trial was conducted in 19 stroke units in Australia . AIM To describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocol s and , postimplementation , to determine which of these barriers eventuated as actual barriers . METHODS Preimplementation : Workshops were held at the intervention stroke units ( n = 10 ) . The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocol s , the second workshop involved bedside clinicians . Postimplementation , an online survey with stroke champions from intervention sites was conducted . RESULTS A total of 111 clinicians attended the preimplementation workshops , identifying 22 barriers covering four main themes : ( a ) need for new policies , ( b ) limited workforce ( capacity ) , ( c ) lack of equipment , and ( d ) education and logistics of training staff . Preimplementation enablers identified were : support by clinical champions , medical staff , nursing management and allied health staff ; easy adaptation of current protocol s , care-plans , and local policies ; and presence of specialist stroke unit staff . Postimplementation , only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption of the FeSS protocol s , namely , no previous use of insulin infusions ; hyperglycaemic protocol s could not be commenced without written orders ; medical staff reluctance to use the ASSIST swallowing screening tool ; poor level of engagement of medical staff ; and doctors ' unawareness of the trial . LINKING EVIDENCE TO ACTION The process of identifying barriers and enablers preimplementation allowed staff to take ownership and to address barriers and plan for change . As only five of the 22 barriers identified preimplementation were reported to be actual barriers at completion of the trial , this suggests that barriers are often overcome whilst some are only ever perceived rather than actual barriers Venous thromboembolism ( VTE ) is a significant cause of morbidity and mortality in hospitalized medical patients . Evidence -based guidelines exist for preventing VTE ; unfortunately , these guidelines are not always adhered to by clinicians . The aim of this study was to evaluate the acceptability , utility and clinical impact of an educational outreach visit ( EOV ) on nurses ' provision of mechanical prophylaxis to hospitalized medical patients using a prospect i ve , uncontrolled , before- and -after design . Nurses received a 1-to-1 educational session on mechanical VTE prevention by a trained nurse facilitator . The EOV intervention was design ed by a multidisciplinary group of healthcare professionals using social marketing theory . Eighty-five of the 120 eligible nurses ( 71 % ) attended the EOV . The median length of each visit was 11.5 minutes ( interquartile range [ IQR ] , 10 - 15 ) and the median time spent arranging and conducting each visit was 63 minutes ( IQR , 49 - 85 ) . Eighty-four ( 99 % ) of the 85 participants gave a verbal commitment to trial the new evidence -based mechanical VTE prevention practice s. However , there were no measurable improvements in the proportion of patients risk assessed ( -1.7 % improvement ; 95 % confidence interval [ CI ] , -7.0 to 10.3 ; P = .68 ) or provided appropriate mechanical prophylaxis ( -0.3 % improvement ; 95 % CI , -13.4 to 14 ; P = .96 ) . Research ers conclude that EOV should not be used to improve  nurses ' use of mechanical VTE prevention because it has no measurable impact on clinical practice and is re source intensive , requiring 4.5 minutes of preparation for every minute spent face to face with participants . Further research into the specific mechanism of action is required to explain the variability in clinical effect seen with this intervention AIM To assess the impact of leadership facilitation strategies on nurses ' beliefs of the importance and frequency of using evidence in daily nursing practice and the perception of organizational readiness in an acute care hospital . BACKGROUND Integrating evidence in practice is a prominent issue for hospital nursing as knowledge and skills , beliefs , organizational infrastructure and nursing leadership must all be addressed . DESIGN Prospect i ve , descriptive comparative . METHOD Three surveys were used in this prospect i ve descriptive comparative study . Evidence -Based Practice Beliefs Scale , the Implementation Scale and Organizational Culture & Readiness for System-Wide Integration Survey measured change before and after facilitating strategies for evidence -based practice enculturation . Data were collected in December 2008 ( N = 427 ) and in December 2010 ( N = 469 ) . RESULTS Leadership facilitated infrastructure development in three major areas : incorporating evidence -based practice outcomes in the strategic plan ; supporting mentors ; and advocating for re sources for education and outcome dissemination . With the interventions in place , the total group scores for beliefs and organizational readiness improved significantly . Analyses by job role showed that direct care nurses scores improved more than other role types . No differences were found in the implementation scores . CONCLUSION Successful key strategies were evidence -based practice education and establishing internal opportunities to disseminate findings . Transformational nursing leadership drives organizational change and provides vision , human and financial re sources and time that empowers nurses to include evidence in practice Nurses play a critical role in managing a patient 's pain , from initial evaluation to ongoing patient education . However , little information exists on current gaps in nurses ' knowledge and their pain-related decision making . To this end , an educational intervention-the INROADS initiative-was design ed to improve the knowledge of nurses involved in patient management as well as to guide them toward practice s that are consistent with currently available evidence . The results from an evaluation of this intervention show that nurses participating in the INROADS program were 52 % more likely to make evidence -based care choices for their patients , compared with a control group of demographically similar nurses . The effect of this program may reinforce it as a model for the design of future interventions for pain management INTRODUCTION Primary care providers , particularly pediatric nurse practitioners , are an integral force involved in tackling the obesity epidemic among youth . The majority of nurse practitioners , however , report low proficiency regarding their ability to adequately prevent and treat pediatric overweight . In response , the National Association of Pediatric Nurse Practitioners ( NAPNAP ) developed the evidence -based Healthy Eating and Activity Together ( HEAT ) Clinical Practice Guideline ( CPG ) to improve provider behavior and efficacy . METHOD Thirty-five nurse practitioners attending the NAPNAP Annual Conference participated in an intensive 4-hour HEAT CPG training session . Pre-training and post-training data were collected on provider knowledge , practice behaviors , and barriers in relation to the prevention of overweight among youth . RESULTS Post-training results revealed significant improvements in ( a ) practitioner knowledge ( assessment of patient growth , family history , psychosocial functioning , nutrition , and physical activity ) ; ( b ) practitioners ' intent to improve behavior ( i.e. , increased intent to use behavior modification and counseling aim ed at patient and family behavior change ) ; and ( c ) practitioners ' report of increased confidence in ability to address barriers . DISCUSSION Study findings demonstrate preliminary support for the HEAT CPG as an effective tool aim ed at helping providers to improve their ability to maintain patients ' healthy weight . Future research is needed to verify the effects of HEAT CPG on long-term improvements in care 
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CONCLUSION Guidelines were implemented in a heterogeneous way and the interventions were delivered once and mainly on a local basis .
RELEVANCE TO CLINICAL PRACTICE Educational interventions to implement guidelines could be beneficial in enhancing nurses '  evidence -based decision-making and care practice .
The combination of teaching and learning methods proved useful , and educational interventions should be supported with simultaneous strategies .