Capability beliefs on, and use of evidence-based practice among four health professional and student groups in geriatric care: A cross sectional study.

Disa K Sommerfeld,Emmanuel Manalo,Anna Kiessling,Anne-Marie Boström,Annika W Stenhols

doi:10.1371/journal.pone.0192017

Abstract

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months’ employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students’ high EBP capability beliefs might inspire staff in this matter.

Highlights

Implementation of evidence-based guidelines, i.e. evidence-based recommendations, into evidence-based practice (EBP) is a complex task
The aim of this study was twofold; to compare self-reported capability beliefs on EBP between health professional and student groups, and to compare the use of EBP between four health professional groups in a hospital-based acute geriatric care setting in Sweden
On the question of use of EBP among health professionals in clinical practice, our study found an area of improvement, among registered nurses and occupational therapists

Summary

Introduction

Implementation of evidence-based guidelines, i.e. evidence-based recommendations, into evidence-based practice (EBP) is a complex task. Several studies have been published on health professionals’ knowledge, attitudes and skills to apply EBP and the use of EBP in practice revealing that the gap between what is done and what should be done still exists [3,4,5]. Different individual and organisational barriers of implementation have been proposed, such as lack of motivation, lack of EBP knowledge, heavy workload, other staff/management not supportive of EBP, lack of resources, lack of authority to change practice and workplace culture resistant to change [6,7,8]. Known facilitators include audit and feedback, local opinion leaders, and support from managers and colleagues [6,9,10]

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Discussion

Conclusion