Abstract
BackgroundHealth authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers.AimsThe present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital.MethodsCross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP). The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation.ResultsNurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence.ConclusionSkills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice.
Highlights
Health authorities in several countries have decided that the health care services should be evidence-based
The present study aimed to identify the sources of knowledge on which nurses base their practice, barriers they consider hinder evidence-based practice and the skills they identify in finding, reviewing and using researchbased evidence
The ranking of sources of information showed that the five most frequently used sources in supporting clinical practice were: 1) information learned about each patient as an individual, 2) knowledge based on personal experience, 3) information obtained from hospital policy and protocols, 4) information obtained from experienced nurses, and 5) information obtained from discussion with physicians (Table 2)
Summary
Health authorities in several countries have decided that the health care services should be evidence-based. Flodgren et al [10] conducted a systematic review where the purpose was to identify which organizational infrastructures promote evidence-based practice in nursing services. The absence of relevant literature may be due to the fact that it is difficult to carry out intervention studies in organizations such as hospitals, because ongoing changes makes it difficult to decide which interventions have led to change. It is unclear which individual factors must be present for practice to be evidence-based. Successful implementation is the function of knowledge, context and facilitation according to the frame work “Promoting action on Research Implementation in Health Care” (PARiHS) [13]
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