Exploring Perceptions of a Learning Organization by RNs and Relationship to EBP Beliefs and Implementation in the Acute Care Setting

Abstract

Health care professionals are expected to provide patient care based on best evidence. The context of the acute care setting presents a challenging environment for registered nurses (RNs) to utilize research and implement best evidence in practice. No organizational infrastructure has been identified that offers acute care RNs the support needed for evidence-based practice (EBP). The value of "learning organizations" has long been understood by corporate leaders. Potentially, the dimensions of a "learning organization" may offer a supportive EBP infrastructure for acute care RNs. (1) What is the relationship of the characteristics of the learning organization to registered nurses' beliefs regarding EBP? (2) Is there an impact of EBP beliefs on RNs' implementation of EBP? A descriptive, survey design study was conducted. Three established questionnaires were distributed to 1,750 RNs employed within six acute care hospitals. There were 594 questionnaires returned for a response rate of 34%. RNs rated their organizations in the mid-range on the dimensions of learning organization. Perceptions of the learning organization were found to be significant, although relatively small, predictors explaining 6% of knowledge beliefs, 11% of value beliefs, and 14% of resource beliefs. EBP beliefs explained 23% of EBP implementation reported by RNs. The study results indicate relationships between RNs' reported perception of a learning organization and EBP beliefs, and between EBP beliefs and implementation. However, findings were mixed. Overall, nurses rated their organizations the lowest in the dimensions of "promote inquiry and dialogue" and "empower people toward a collective vision." Leaders have an opportunity to offer a more supportive infrastructure through improving their organization in these two areas. RN beliefs explained 23% of EBP implementation in this study with a residual 77% yet to be identified. Acute care hospitals were perceived mid-range on learning organization dimensions by RNs, indicating an opportune area for leaders to strengthen their organizational infrastructure.