Determinants of an evidence-based practice environment: an interpretive description

Abstract

Background Despite the available research to inform nursing practice, many patients still fail to receive evidence-based care. Several evidence-based practice (EBP) models have been developed to guide nurses through the steps in the process, yet these models have not been uniformly adopted or consistently used. The original purpose of this research was to gather perspectives and experiences of nurses using the Iowa Model of EBP to help inform its introduction into other practice settings. As a more in-depth understanding was gained, the emphasis of the study shifted towards understanding the determinants of the EBP environment. Method The study was conducted in an 800-bed comprehensive academic medical centre in the USA with a 25-year history of using the Iowa Model of EBP. Semi-structured in-depth interviews were conducted with twelve nurses from various roles to ascertain their perspectives and experiences using the model. The interview transcripts were reviewed alongside relevant published literature and internal documents in a process of synthesising, theorising, and conceptualising. Data were collected during the first half of 2019. Results Four determinants of the local EBP environment were identified from the perspectives and experiences of participants: (1) the importance of a shared model to guide staff through the EBP process; (2) support for EBP in the form of education, hands-on training, and knowledge infrastructure; (3) active team facilitation by direct care nurses, nurse managers, nurse specialists, and nurse scientists; and (4) a culture and leadership that encourages EBP. Conclusion Introducing an EBP model is an essential first step for an organisation to improve consistent and reliable evidence-based care; to be most effective, this should be done in conjunction with efforts to optimise the EBP environment.

Organizational Factors Associated with Evidence-Based Practice Knowledge, Attitudes, and Implementation among Nurses in Saudi Arabia

“…Additionally, the majority of nurses indicated that their hospitals support EBP by providing EBP trainings. Hospital work environment support for EBP in the form of education, hands-on training, and a culture that encourages EBP were determinants of EBP supportive environment [ 38 ]. Our study was one of the few studies that examined staff nurses’ perceptions of EBP nursing leadership support and work environment support and their relations with nurses’ EBP competencies.…”

Nurse Practitioners’ Perception on Research Utilization and Possible Barriers; A Saudi Arabian Experiential Perspective during Covid-19 Pandemic

“…Abuhammad al et al [35] study conducted in the same middle eastern region concurred the same results even emphasizing that showed the highest concerns on the topic. Duff et al [22] and Ozga et al [15] studies showed conforming these barriers results thereby stating the importance of education, hands-on training and knowledge infrastructure to be as critical as active team facilitation by senior nurses and other administration officers who all can make that big difference in overcoming this particular research utilization barriers. Another study plainly stated access to literature as a major problem and its provision as part of professional education may be a way to acquire knowledge and appropriately utilize current innovations [36].…”

“…The professional development or continuing education of nurses through research utilization has an inherent power to increase quality of healthcare [21]. In the United States, research utilization was included in job description and nurses who utilized research to solve clinical problem were recognized and rewarded [22]. This could be the pandemic situation considering the perception of respondents about research utilization.…”

Becoming an Agile Change Conductor

“…In United States healthcare delivery organizations, 40% of patients do not receive evidence-based care, ~25% of patients are harmed, and at least 30% of annual healthcare spending is wasted ( 1 – 3 ). Harm events include medication errors, injuries, infection, prolonged hospitalization, or other unintended consequences ( 2 ).…”