Factors influencing application of evidence-based practice among nurses

Abstract

Evidence-based practice (EBP) involves the application of care that is based on scientific evidence, to ensure the delivery of quality patient care. Generally, there is a dearth of documentary evidence on the evolution of EBP and standardization of nursing practice in the developing world. This study was conducted to determine factors influencing application of EBP specifically at the Kenyatta National Hospital, in Nairobi, Kenya. Nurses working in medical and surgical wards, the surgical outpatient clinic (SOPC) and medical outpatient clinics (MOPC) were purposefully selected. A sample size of 156 was determined, with 130 nurses consenting to be interviewed and 14 nurse managers discussing and informing the interview guide to gather qualitative facts and to determine their knowledge on EBP and the extent of EBP application in the wards. Results of the descriptive analysis suggested that over 92% of the respondents agreed that EBP was not widely used and not factored into current practices. Major factors that affect application of evidence-based nursing are: level of education, ability to review literature, and nursing practice guide (hospital policy and ward routines). It appears research evidence is not fully utilized in patients’ care, although self-rating among nurses indicates that nurses with a Bachelor's degree are better placed to apply research evidence in nursing care. Other major limitations to EBP application are resources and time. Hospital management should therefore invest in and develop comprehensive policy that entrenches EBP in patients’ care. In addition, a deliberate policy stance to train more nurses to degree and postgraduate levels will positively impact on adoption of EBP.