Evidence-Based Practice and Associated Factors Among Health Care Providers Working in Public Hospitals in Northwest Ethiopia During 2017

Abstract

Background: Despite the fact that evidence-based practice (EBP) is believed to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia is not evidence-based. Understanding the extent of and barriers to EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia. Objective: This study aimed to assess reported level of EBP and associated factors among health care providers working in public hospitals in northwest Ethiopia. Methods: A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire that was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP Implementation Scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation. Results: The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β = –0.10; P < 0.05); having been trained as a bachelor's degree-level nurse (β = 3.45; P < 0.001) or a bachelor's degree-level midwife (β = 2.96; P < 0.001), a general practitioner (β = 7.86; P < 0.001), or a specialist physician (β = 15.04; P < 0.001) rather than a diploma-level nurse; working in a pediatrics ward (β = –1.74; P < 0.05); and reporting as barriers either a lack of clarity on the importance of EBP (β = –0.93; P < 0.05) or a lack of orientation sessions on new health priorities (β = –0.91; P < 0.05). Conclusions: Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia. ( Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)

Mapping publication outputs, collaboration networks, research hotspots, and most cited articles in systematic reviews and meta-analyses of medicine and health sciences in Ethiopia: analyses of 20 years of scientific data

“…For example, a recent study in Ethiopia showed that half of health care providers were unable to find resources for implementing an evidence-based practice that attributed to lack of training and poor health facility infrastructures, such as computers and internet. 50 Therefore, there is a pressing need to develop an evidence base that addresses the requirements of the developing countries and getting this evidence into the hands of those who deliver healthcare is fundamental to improvements in healthcare delivery and health outcomes. 51 The findings from this study can provide useful up-to-date evidence on the landscape of SR and MA research and it is a wake-up call to balance generation of new knowledge and implementation by decision-makers.…”

Current status of methodological and reporting quality of systematic reviews and meta-analyses in medicine and health science fields in Ethiopia: Leveraging quantity to improve quality

“…How ever, the proper implementation of methodological standards in low-income countries, such as Ethiopia is poor. 21 Most health care decision-making tools were based on evidence from developed countries without considering the cultural and socioeconomic differences, and translation into context was limited. 22 Therefore, the increase in publication of high quality SR and MA can be helpful to improve the accuracy of context-specific decision-making.…”

Prepričanja in implementacija na dokazih podprte prakse med visokošolsko izobraženimi medicinskimi sestrami in zdravstveniki (2. del)

“…V literaturi raziskovalci povezujejo več individualnih ovir, ki učinkujejo na odnos in implementacijo na dokazih podprte prakse v klinična okolja (Dessie et al, 2020;Aynalem, Yazew, & Gebrie, 2021). Dagne, Beshah, Kassa, & Dagnaw (2021) ugotavljajo, da se izobraževanje iz raziskovanja in dokazih podprte prakse v zdravstveni negi pokažejo kot dejavniki, povezani tako s prepričanji kot implementacijo na dokazih podprte prakse.…”