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Evidence-Based PracticeARCCNCT03269331

Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC)

An observational study of Evidence-Based Practice and Nurse's Role, run by David Grant U.S. Air Force Medical Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Evidence-Based Practice, Nurse's Role
What is being tested?
CTEP EBP Immersion
How many people
131 participants
Where
1 siteUnited States
Study dates
15 Sep 2017to 31 Dec 2019
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: David Grant Medical Center active duty nurses and technicians

Who may be able to join

  • Nurse (active duty) assigned to DGMC
  • Medical/Surgical technician (active duty) assigned to DGMC
  • 15 month retain-ability from time of enrollment

Who cannot join

  • Disciplines outside of Nursing (PA, MD, Occupational Therapy (OT), Physical Therapy (PT), etc.)
  • Nurse/technician General Schedule (GS),VA, Contractor employed at David Grant Medical Center (DGMC)
  • Anticipated/Scheduled Permanent Change of Station (PCS) in next 15 months

Trial locations and contacts

1 site in 1 country.

United States1 site

  • David Grant Medical Center

    Fairfield, California, 94535

Other trials in United States

About this study

Official title: Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model for Military Treatment Facility (MTF) Implementation of Nursing Evidence-Based Practice (EBP)

The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. While magnet facilities require a commitment to evidence-based nursing practice, military facilities currently lack such a requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful path toward developing high-reliability organizations. Currently, little is known regarding the effectiveness of specific EBP models and frameworks within the military culture. The purpose of this investigation is to determine the effectiveness of the Advancing Research and Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment Facility (MTF) beginning with nursing services.

Research questions:

Read more
  1. What is the current state of organizational culture and readiness for EBP within the MTF's nursing services?
  2. Will utilization of the ARCC model significantly improve EBP beliefs, knowledge, and practice in MTF nurses over a two-year period?
  3. Is the ARCC model feasible for implementation in Air Force MTF's?

This study includes an intervention group (n=70) of active duty nurses and technicians who attend an intensive 5-day EBP Immersion Workshop and a control group (n=70) who do not. The intervention group will have access to specialized resources such as: a) Center for Transdisciplinary Evidence-Based Practice (CTEP) expert EBP mentors, b) EBP toolkit and resources, c) one year of free access to the Ohio State University (OSU) virtual library. Control group participants will have standard MTF education opportunities. Established valid and reliable survey measures (EBP attitudes, knowledge, beliefs) will be hosted electronically by CTEP at baseline, three, and twelve months. Online measures include institutional and nursing process measures (EBP implementation, policy changes, and publications) over the two-year study period. De-identified data from the anonymous survey measures will be shared by CTEP with this study team. Data analysis will include Student's t-tests to explore differences between groups. Repeated measures ANOVA or the nonparametric equivalent (Friedman's test or Skillings-Mack test) will be used to compare three time points within groups. Feasibility metrics and demographics will be reported with descriptive statistics.

Read the detailed description

Further study details as provided by David Grant Medical Center, Travis Air Force Base, California

Being tested
CTEP EBP Immersion
Keywords
nursing practice, evidence-based practice models, military nursing, clinical inquiry

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CTEP EBP ImmersionBehavioural

    36 continuing ed credits, virtual library access, collaboration with expert mentors

Study groups in NCT03269331
Study groupRoleWhat they receive
ARCC EBP ModelCTEP EBP Immersion Course
Receives: Behavioral: CTEP EBP Immersion
Control GroupNo CTEP EBP Immersion Course

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time

    25-item assessment of organizational readiness and perceived strengths and barriers for EBP implementation. A 5-point Likert scale with, 1 (not at all) through 5 (very much) measures item response to questions focused on the extent that EBP is included in current organizational culture. For example, "To what extend do you believe that EBP is practiced in your organization?" Overall, the instrument measures the relationship between cultural factors and the organization's implementation of EBP over a 6-month time frame. Validity is reported with content and face validity and internal consistency reliabilities greater than 0.85

    Measured: baseline, month 3, month 12

  2. Evidence-Based Practice Beliefs (EBPB) Scale changes over time

    16-item assessment of an individual's beliefs regarding the value of EBP and capability for EBP implementation in clinical nursing practice. A 5-point Likert scale with, 1 (strongly disagree) through 5 (strongly agree) measures item response to statements about EBP, such as: "I believe EBP takes too much time"… "I am clear about the steps of EBP." It is anticipated, based on the results of several studies, that higher scores on the EBPB scale are associated with greater implementation of EBP and better healthcare outcomes. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85.

    Measured: baseline, month 3, month 12

  3. Evidence-Based Practice Implementation (EBPI) Scale changes over time

    18-item instrument to measure the extent to which healthcare workers integrate scientific evidence in their clinical practice. A 5-point ordinal scale with frequencies listed from 0 times (0 pt.), 1-3 times (1 pt.), 4-5 times (2 pt.), 6-7 times (3 pt.) and > 8 times (4 pt.) is used to assess how often each item has applied over the past 8 weeks. For example, how often have you: "Used evidence to change my clinical practice…", "Accessed the National Guidelines Clearinghouse…" Total scores are summed where higher scores indicate greater integration of EBP in the healthcare workers practice. Validity is reported with content and face validity as well as internal consistency reliabilities greater than 0.85.

    Measured: baseline, month 3, month 12

  4. EBP Knowledge Assessment Questionnaire (EBP-KAQ) changes over time

    27-item multiple-choice objective knowledge measure of examine EBP knowledge.

    Measured: baseline, month 3, month 12

Secondary outcomes (1)

  1. Nursing process outcomes changes over time

    projects, policy changes, publications

    Measured: baseline, month 3, month 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2017
  2. Study start15 Sep 2017
  3. Primary completion31 Dec 2019
  4. Study completion31 Dec 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
131 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03269331
Sponsor's protocol ID
FDG#20160029E
Acronym
ARCC
Status last verified
Feb 2021
First submitted
22 Aug 2017
Last updated
4 Feb 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Breckenridge-Sproat ST, Throop MD, Raju D, Murphy DA, Loan LA, Patrician PA. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice. Clin Nurse Spec. 2015 Nov-Dec;29(6):329-37. doi: 10.1097/NUR.0000000000000161.

    PubMed 26444511

  • Barrera M Jr, Castro FG, Strycker LA, Toobert DJ. Cultural adaptations of behavioral health interventions: a progress report. J Consult Clin Psychol. 2013 Apr;81(2):196-205. doi: 10.1037/a0027085. Epub 2012 Jan 30.

    PubMed 22289132

  • Bryan CJ, Jennings KW, Jobes DA, Bradley JC. Understanding and preventing military suicide. Arch Suicide Res. 2012;16(2):95-110. doi: 10.1080/13811118.2012.667321.

    PubMed 22551041

  • Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families; Board on the Health of Select Populations; Institute of Medicine; Denning LA, Meisnere M, Warner KE, editors. Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs. Washington (DC): National Academies Press (US); 2014 Feb 11. Available from http://www.ncbi.nlm.nih.gov/books/NBK222170/

    PubMed 25057692

  • Kenny DJ, Richard ML, Ceniceros X, Blaize K. Collaborating across services to advance evidence-based nursing practice. Nurs Res. 2010 Jan-Feb;59(1 Suppl):S11-21. doi: 10.1097/NNR.0b013e3181c3c011.

    PubMed 20010273

  • Melnyk BM. Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nurs Adm Q. 2012 Apr-Jun;36(2):127-35. doi: 10.1097/NAQ.0b013e318249fb6a.

    PubMed 22407205

  • Melnyk BM, Bullock T, McGrath J, Jacobson D, Kelly S, Baba L. Translating the evidence-based NICU COPE program for parents of premature infants into clinical practice: impact on nurses' evidence-based practice and lessons learned. J Perinat Neonatal Nurs. 2010 Jan-Mar;24(1):74-80. doi: 10.1097/JPN.0b013e3181ce314b.

    PubMed 20147834

  • Melnyk BM, Fineout-Overholt E, Giggleman M, Cruz R. Correlates among cognitive beliefs, EBP implementation, organizational culture, cohesion and job satisfaction in evidence-based practice mentors from a community hospital system. Nurs Outlook. 2010 Nov-Dec;58(6):301-8. doi: 10.1016/j.outlook.2010.06.002.

    PubMed 21074647

  • Melnyk BM, Fineout-Overholt E, Gallagher-Ford L, Kaplan L. The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. J Nurs Adm. 2012 Sep;42(9):410-7. doi: 10.1097/NNA.0b013e3182664e0a.

    PubMed 22922750

  • Melnyk BM, Gallagher-Ford L, Thomas BK, Troseth M, Wyngarden K, Szalacha L. A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence-Based Practice and Shortcomings in Hospital Performance Metrics Across the United States. Worldviews Evid Based Nurs. 2016 Feb;13(1):6-14. doi: 10.1111/wvn.12133. Epub 2016 Feb 1.

    PubMed 26873371

  • Muller A, McCauley K, Harrington P, Jablonski J, Strauss R. Evidence-based practice implementation strategy: the central role of the clinical nurse specialist. Nurs Adm Q. 2011 Apr-Jun;35(2):140-51. doi: 10.1097/NAQ.0b013e31820f47e9.

    PubMed 21403488

  • Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996 Jan 13;312(7023):71-2. doi: 10.1136/bmj.312.7023.71. No abstract available.

    PubMed 8555924

  • Sammer CE, Lykens K, Singh KP, Mains DA, Lackan NA. What is patient safety culture? A review of the literature. J Nurs Scholarsh. 2010 Jun;42(2):156-65. doi: 10.1111/j.1547-5069.2009.01330.x.

    PubMed 20618600

  • Ubbink DT, Guyatt GH, Vermeulen H. Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. BMJ Open. 2013 Jan 24;3(1):e001881. doi: 10.1136/bmjopen-2012-001881.

    PubMed 23355664

  • Wallen GR, Mitchell SA, Melnyk B, Fineout-Overholt E, Miller-Davis C, Yates J, Hastings C. Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship programme. J Adv Nurs. 2010 Dec;66(12):2761-71. doi: 10.1111/j.1365-2648.2010.05442.x. Epub 2010 Sep 6.

    PubMed 20825512

Questions about this trial

What is this clinical trial studying?

An observational study of Evidence-Based Practice and Nurse's Role, run by David Grant U.S. Air Force Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time (time frame: baseline, month 3, month 12). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03269331, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2021.

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