Miia Jansson

Background Evidence‐based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC. Aim To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors. Design A systematic review. Data Sources CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar. Methods Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis. Results The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies. Conclusion The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs. Implications for the Profession We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice. Registration, and Reporting Checklist The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist. Patient/Public Contribution None.

Aim To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. Design A descriptive, qualitative approach. Methods Semi‐structured in‐person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. Results The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two‐way communication. Conclusion New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. Impact The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. Reporting Method We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. Patient or Public Contribution Patients were involved as the study population.