ORCID Profile
0000-0002-0667-5995
Current Organisation
Edith Cowan University
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Publisher: Research Square Platform LLC
Date: 07-07-2020
DOI: 10.21203/RS.3.RS-37978/V1
Abstract: Background Despite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report uncertainty in both knowledge and confidence to implement sustained evidence-based change in clinical areas. This study aimed toexplore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practices, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators of evidence-based change. Methods This qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained by a nominal group workshop and in idual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes. Results One overarching core finding emerged from four major categories to fulfil the aim of this study: Fear can stop change and midwives lack the confidence and time to implement new evidence-based practices, however having high level midwives in leadership roles is a huge advantage. Conclusion This study confirms what is known about the hinderances and helpers of translating latest evidence into everyday practice, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop intervention strategies applicable to midwives initiating evidence-based practice change in clinical areas.
Publisher: Research Square Platform LLC
Date: 08-07-2020
DOI: 10.21203/RS.3.RS-40581/V1
Abstract: Background Despite the ongoing production of new scientific evidence in the field of maternity care, midwives continue to face challenges when translating latest evidence into evidence-informed care, and report reticence towards implementing evidence-based change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to implement evidence-based practice, and test the usability of the Capability, Opportunity, Motivation and Behaviour model and Transtheoretical Domains Framework to analyse the barriers and facilitators to evidence-based change. Methods This qualitative study formed part of a larger Participatory Action Research (PAR) project designed to improve the processes by which midwives implement evidence-based practice change in clinical areas. Data were obtained from a focus group workshop and in idual face-to-face interviews between July – September 2019. Thematic analysis was used to interpret the transcribed data, which were then coded and categorised into meaningful themes. Results One overarching core finding emerged from four major categories: Fear can stop change and midwives are reticent towards evidence-based change however, inter-disciplinary collaboration and midwives in leadership roles is a huge advantage. Conclusion This study confirms what is known about the helpers and hinderances of evidence-based change, and provides valuable insight into the usability of behavioural theories and context assessment tools to both diagnose and develop implementation strategies applicable to midwives in clinical areas.
Publisher: Research Square Platform LLC
Date: 28-10-2020
DOI: 10.21203/RS.3.RS-40581/V2
Abstract: Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Methods This qualitative study formed part of a larger Action Research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: “For midwives, medical opposition and workplace culture are the biggest challenges”, “Fear can stop change: it’s personal for midwives” and “Midwives are tired of fighting the battle for EBP they need knowledge and the confidence to bring about practice change.” The other major category highlighted factors midwives’ considered helpers of EBP: “Having stakeholder buy-in and strong midwifery leadership is a huge advantage.” When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.
Publisher: Research Square Platform LLC
Date: 04-03-2023
DOI: 10.21203/RS.3.RS-40581/V3
Abstract: Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Methods This qualitative study formed part of a larger Action Research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Results Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: “For midwives, medical opposition and workplace culture are the biggest challenges”, “Fear can stop change: it’s personal for midwives” and “Midwives are tired of fighting the battle for EBP they need knowledge and the confidence to bring about practice change.” The other major category highlighted factors midwives’ considered helpers of EBP: “Having stakeholder buy-in and strong midwifery leadership is a huge advantage.” When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Conclusion Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2021
DOI: 10.1186/S43058-020-00100-X
Abstract: Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). This qualitative study formed part of a larger action research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were obtained from eight Western Australian midwifery leaders who were employed in either managerial or executive positions within their organisation. Five midwives attended a focus group workshop and three opted for face-to-face interviews. Thematic analysis was used to code the transcribed data and group alike findings into sub-categories, which were collapsed to four major categories and one overarching core finding. These were mapped to a matrix combining the COM-B and TDF to establish the usability of these tools in midwifery contexts. Four major categories were developed from the data collected in this study. Three reported the hindrances midwives’ experienced when trying to initiate new EBPs: ‘For midwives, medical opposition and workplace culture are the biggest challenges’, ‘Fear can stop change: it’s personal for midwives’ and ‘Midwives are tired of fighting the battle for EBP they need knowledge and the confidence to bring about practice change.’ The other major category highlighted factors midwives’ considered helpers of EBP: ‘Having stakeholder buy-in and strong midwifery leadership is a huge advantage.’ When mapped to the TDF and COM-B, these findings provided valuable insight into the helpers of and hindrances to evidence-based practice in midwifery. Midwives are motivated to initiate evidence-based change yet have limited knowledge of implementation processes or the confidence to lead practice change. Factors such as inter-disciplinary buy-in, clear instruction for midwives and support from midwifery leaders were considered beneficial to implementing practice change in clinical areas. The TDF when used in combination with the COM-B was deemed useful to midwives wanting to lead practice change projects in clinical areas.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.WOMBI.2018.09.007
Abstract: The purpose of this study was to identify midwives' attitudes towards women using substances during pregnancy, which informed the development of an integrated care pathway for the provision of optimal care. A mixed methods research design was used, that included an online survey via the online survey tool Qualtrics™ which collected quantitative data, and interviews and focus groups were used to collect qualitative data. Participants held a positive or neutral view towards women who used substances during pregnancy, and the participants had an empathetic perception of the issue of substance use within pregnancy, believing that women were using substances due to the environment and circumstances that they lived in, and that they had been raised and socialised in. Caring for women during pregnancy with substance misuse issues is complex and requires coordination and multidisciplinary care. Midwives have the capacity to provide sensitive midwifery care but require the framework to ensure women needing additional resources during pregnancy receive the services available and specific to their needs. The midwives in this study were supportive of developing an integrated care pathway to allow for collaborative care, and to enable a specialised midwifery approach.
Publisher: Wiley
Date: 14-10-2019
DOI: 10.1111/JOCN.15027
Publisher: Wiley
Date: 18-05-2023
DOI: 10.1111/JAN.15690
Abstract: To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. Scoping review. A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers’ workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty‐five studies met the inclusion criteria. The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Scoping Review checklist. Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non‐normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient‐to‐nurse ratios. The review also highlighted changes to the work environment and worsened work environments, including staffing shortages. Focused efforts from health organizations to prioritize supportive conditions, policies focused on improved work environments, staffing adequacy and fair and reasonable workloads will enhance retention of the current workforce and future planning for pandemics. Understanding workload challenges faced by frontline health professionals during the pandemic can improve planning, including policies and procedures, and resource allocation for future pandemic or emergency situations. In addition, extended periods of high workloads can impact staff retention. As many countries return to life after COVID‐19, it is important that healthcare organizations examine staff pressures and identify ways to support staff moving forward. This will be vital for the future sustainability of the workforce. No patient or public contribution.
Publisher: Springer Science and Business Media LLC
Date: 16-01-2023
DOI: 10.1186/S12913-022-08975-3
Abstract: Over the past decade, an industry has emerged around Clinical Practice Guideline (CPG) development in healthcare, which has increased pressure on guideline-producing organisations to develop CPGs at an accelerated rate. These are intended to improve the quality of care provided to patients while containing healthcare costs and reducing variability in clinical practice. However, this has inadvertently led to discrepancies in CPG recommendations between health organisations, also challenging healthcare providers who rely on these for decision-making and to inform clinical care. From a global perspective, although some countries have initiated national protocols regarding developing, appraising and implementing high-quality CPGs, there remains no standardised approach to any aspect of CPG production. A scoping review of the literature and document analysis were conducted according to Joanna Brigg’s Institute methodology for scoping reviews. This comprised two qualitative methods: a comprehensive review of the literature (using CINAHL, Scopus and PubMeD) and a document analysis of all national and international guideline development processes (manual search of health-related websites, national/international organisational health policies and documents). A set of clear principles and processes were identified as crucial to CPG development, informing the planning, implementation and dissemination of recommendations. Fundamentally, two common goals were reported: to improve the quality and consistency of clinical practice (patient care) and to reduce the duplication or ratification of low-grade CPGs. Consultation and communication between CPG working parties, including a wide range of representatives (including professional organisations, regional and local offices, and relevant national bodies) is essential. Further research is required to establish the feasibility of standardising the approach and disseminating the recommendations.
Location: United States of America
No related grants have been discovered for Dr Annemarie De Leo.