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

February 2, 2021 updated by: Laurie Migliore, David Grant U.S. Air Force Medical Center

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:

  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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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

Study Type

Observational

Enrollment (Actual)

131

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • California
      • Fairfield, California, United States, 94535
        • David Grant Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

David Grant Medical Center active duty nurses and technicians

Description

Inclusion Criteria:

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

Exclusion Criteria:

  • 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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
ARCC EBP Model
CTEP EBP Immersion Course
Behavioral: CTEP EBP Immersion
36 continuing ed credits, virtual library access, collaboration with expert mentors
Control Group
No CTEP EBP Immersion Course

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Organizational Culture & Readiness for System-Wide Implementation of EBP Scale (OCRSIEP) changes over time
Time Frame: baseline, month 3, month 12
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
baseline, month 3, month 12
Evidence-Based Practice Beliefs (EBPB) Scale changes over time
Time Frame: baseline, month 3, month 12
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.
baseline, month 3, month 12
Evidence-Based Practice Implementation (EBPI) Scale changes over time
Time Frame: baseline, month 3, month 12
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.
baseline, month 3, month 12
EBP Knowledge Assessment Questionnaire (EBP-KAQ) changes over time
Time Frame: baseline, month 3, month 12
27-item multiple-choice objective knowledge measure of examine EBP knowledge.
baseline, month 3, month 12

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nursing process outcomes changes over time
Time Frame: baseline, month 3, month 12
projects, policy changes, publications
baseline, month 3, month 12

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility metrics changes over time
Time Frame: baseline, month 3, month 12
Costs, mentors, staff retention
baseline, month 3, month 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

David Grant U.S. Air Force Medical Center

Collaborators

Ohio State University

Investigators

  • Principal Investigator: Laurie A Migliore, PhD, staff

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 15, 2017

Primary Completion (ACTUAL)

December 31, 2019

Study Completion (ACTUAL)

December 31, 2019

Study Registration Dates

First Submitted

August 22, 2017

First Submitted That Met QC Criteria

August 30, 2017

First Posted (ACTUAL)

August 31, 2017

Study Record Updates

Last Update Posted (ACTUAL)

February 4, 2021

Last Update Submitted That Met QC Criteria

February 2, 2021

Last Verified

February 1, 2021

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • FDG#20160029E

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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