Do educational interventions aimed at nurses to support the implementation of evidence-based practice improve patient outcomes? A systematic review

Wu, Yanni; Brettle, Alison; Zhou, Chunlan; Ou, Jiexia; Wang, Yanfang; Wang, Siqi

doi:10.1016/j.nedt.2018.08.026

Cited by 54 publications

(46 citation statements)

References 37 publications

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“…This overview includes a total of 22 SRs: 16 identified in the original overview [12,28,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] and six new SRs [8,29,[45][46][47][48] (Table 2A and 2B). One SR [33] was published in French and all others were published in English.…”

Section: Description Of Included Systematic Reviewsmentioning

confidence: 99%

“…Most SRs assessed a range of outcomes, which could be categorised as knowledge, skills, attitudes, and behaviour, and in many cases were related to critical appraisal. Two SRs focused on patient outcomes and process of care [29,48]. For two other SRs, these outcomes were also pre-specified, but not reported in the included primary studies.…”

Section: Description Of Included Systematic Reviewsmentioning

confidence: 99%

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What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

et al. 2021

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Background Evidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour. Methods and findings This is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up. Conclusions Teaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments. Study registration The protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262. Update of the overview Young T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: 10.1371/journal.pone.0086706.

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Section: Description Of Included Systematic Reviewsmentioning

confidence: 99%

Section: Description Of Included Systematic Reviewsmentioning

confidence: 99%

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

et al. 2021

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“…Evidence in this regard then, is defined as credible knowledge from different sources including research, professional/clinical experience, patient experiences/preferences, and local data and information [4,5]. There are numerous examples of improved patient outcomes following implementation of best practice guidelines such as reductions in length of hospital stay [6] and adverse patient events related to falls and pressure ulcers in long-term care settings [7].…”

Section: Introductionmentioning

confidence: 99%

Measures of evidence-informed decision-making competence attributes: a psychometric systematic review

et al. 2020

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Background: The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing. Methods: The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings. Results: A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6-25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach's alphas ranging from 0.45-0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.

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“…Education and training in EBP are reported as basic and essential approaches to enhance EBP [9,11,12]. The international Sicily Statement had put forward an EBP curriculum framework to facilitate EBP education and training programs [13], and research training, EBP skills, and knowledge have been embedded in nursing education [12]. Melnyk et al [8] have also published 13 EBP competencies for clinical nurses and a further 11 for advanced nurses.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of the Chinese version of the evidence-based practice profile questionnaire (EBP2Q)

McEvoy

et al. 2020

BMC Med Educ

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Background: Evidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP 2 Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China. Methods: Based on established guidelines for the development of questionnaires, the English EBP 2 Q was translated and cross-culturally adapted. The Chinese version of the EBP 2 Q (EBP 2 Q-C) was validated using a sample of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated. Results: The content validity index demonstrated good content validity (≥0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis (χ 2 /df = 2.001; RMSEA = 0.065; SRMR = 0.077; and CFI = 0.884). The Spearman's rank correlation analysis of the EBP 2 Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses' highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach's α and the Cronbach's α for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability. Conclusions: Except for the convergent validity of the Sympathy domain, the EBP 2 Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.

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Do educational interventions aimed at nurses to support the implementation of evidence-based practice improve patient outcomes? A systematic review

Cited by 54 publications

References 37 publications

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

Measures of evidence-informed decision-making competence attributes: a psychometric systematic review

Development and validation of the Chinese version of the evidence-based practice profile questionnaire (EBP2Q)

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