Nursing practice, knowledge, attitudes and perceived barriers to evidence‐based practice at an academic medical center

Abstract

Aim. This paper is a report of a study describing nurses' practices, knowledge, and attitudes related to evidence-based nursing, and the relation of perceived barriers to and facilitators of evidence-based practice.Background. Evidence-based practice has been recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. Barriers and facilitators for the adoption of evidence-based practice in nursing have been identified by researchers.Healthcare organizations have been challenged to foster an environment conducive to providing care based on evidence and not steeped in ritualized practice. Results. Organizational barriers (lack of time and lack of nursing autonomy) were the top perceived barriers. Facilitators were learning opportunities, culture building, and availability and simplicity of resources. Statistically significant correlations were found between barriers and practice, knowledge and attitudes related to evidence-based practice. What is already known about this topicNurses experience many barriers to evidence-based practice.Time is one of the most commonly-noted barriers to nurses employing evidence-based practice.Evidence-based practice improves the quality of care and patient safety. What this paper addsHigher perceived barriers related to availability and understanding of research were associated with lower knowledge and use of evidence-based practice, although effect size was small.The use of a computerized approach to implementing the instruments, as compared to paper methods used in research to date.Descriptive research can provide a baseline assessment for strategic planning efforts to move organizations toward evidence-based practice. Implications for practice and\or policyNurses need time away from the responsibilities of bedside care, autonomy over their practice, education in finding and assessing evidence, access to evidence, and mentorship to shepherd them through the implementation process and reinforce didactic learning.A research-based needs assessment is needed to provide an evidence-based foundation for organizational strategic planning efforts and educational initiatives to support evidence-based practice. 5Managers need to understand the ability of clinical nurses to implement evidence-based practice in the actual practice environment and to document the effectiveness of initiatives undertaken to promote evidence-based practice.6

Cultural adaptation to Brazil and psychometric performance of the “Evidence-Based Practice Questionnaire”

“…In the equivalence assessment, agreement for items 1 and 14 was 57%; item 18, 71% and 85% for items 3,4,7,9,12,16,19,20,23,28 and 29. The suggestions were analyzed in a discussion meeting with the researcher, the advisor, and the members of the research group on cultural adaptation of measurement instruments.…”

“…A study conducted with nurses, of various levels of training, in California also found the highest average score in this area. (12) The lowest mean scores were found in the domain related to knowledge and skills associated to EBP. The items questioned the frequency of literature review and the elaboration of research questions.…”

“…Similar results were found in international studies and in the original study. (9,12,24) In the analysis of the reliability through stability, a ICC of 0.90 was obtained for the questionnaire as a whole, which shows the temporal stability of the instrument.…”

“…The results show important information about adopting EBP among these professionals and suggest strategies for its dissemination. (12)(13)(14)(15) The EBPQ was recently adapted and validated for the Spanish language, obtaining a reduced version, however suitable for use in that culture. (13) This version was used in a study in Spain to diagnose the factors that nurses perceive as facilitators to EBP.…”

Level of Knowledge on Evidence-based Infection Control and Influencing Factors on Performance among Nurses in Intensive Care Unit

“…표준지침으 로 통용되는 CDC의 감염관리 관련 근거기반 실무지침에 관한 지식의 경우, 중환자실 간호사의 정답률은 약 40%에 그쳤고, 실무지침의 수행률 역시 60% 수준으로 저조하였다 (Labeau et al, 2009;Plost & Nelson, 2007). (Brown, Wickline, Ecoff, & Glaser, 2009;Oh, 2008). 특히 임상적으로 복잡한 상황에서의 신속하고 명확한 의사 결정 능력이 요구되는 특수 간호 환경의 중환자실 간호사들에게서 그 수행의 어려움이 보 다 높은 것으로 보고되고 있다 (Oh, 2008;Pirret, 2007).…”