Reported use of evidence in clinical practice: a survey of rehabilitation practices in Norway

Jennifer L Moore,Ian D Graham,Elisabeth Troøyen Gundersen,Svein Friis,Jan E Nordvik

doi:10.1186/s12913-018-3193-8

Abstract

BackgroundThe South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway’s population. Physical medicine and rehabilitation services are provided by 9 public hospital trusts and 30 private rehabilitation facilities. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians’ self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway.MethodsA cross-sectional study using an online survey was conducted with public hospitals and private rehabilitation centers. The survey, which was distributed throughout the region, included the EBPIS, 8 questions related to EBP in the health region, and demographics. Response frequencies were calculated and described. Internal consistency and factor structure of the EBPIS and its subscales were determined. Associations and differences in groups with similar demographics, EBPIS scores, and use of EBPs were identified.ResultsA total of 316 individuals completed the survey, including allied health clinicians, nurses, psychologists, social workers, and physicians. The EBPIS mean score was 30/72. A factor analysis identified that the EBPIS can be divided into 3 subscales: literature search and critical appraisal (α = .80), knowledge sharing (α = .83), and practice evaluation (α = .74). EBP activities reported were primarily related to literature searches, critical appraisal, and discussing evidence. Approximately 65 and 75% of respondents agreed that the same OMs and evidence based interventions were used within the local clinic respectively. Fewer agreed that the same OMs (13%) and evidence-based interventions (39%) are used regionally.ConclusionThe EBPIS and its subscales demonstrated excellent internal consistency. Practice variability exists in rehabilitation throughout Southeastern Norway. An increased emphasis on use of EBP throughout the region is needed.

Highlights

The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway’s population
To understand the use of Evidence-based practice (EBP) in South-Eastern Norway, we developed an online survey that included a Norwegian translation of the EBP Implementation Scale (EBPIS) that was initially published by Stokke and colleagues [26], questions related to organizational and regional implementation of EBPs, and participant demographics
Psychometric analysis of the EPB implementation scale During this study, we examined the internal consistency of the EBPIS and conducted a factor analysis

Summary

Introduction

The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway’s population. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians’ self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway. While EBP is considered critical to high quality care, provision of health care that is based on experience instead of evidence has been observed across all disciplines in primary and specialty health care [4]. These practices may lead to health care that is less efficient [5], less effective [6], and may limit health outcomes [7]

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Discussion

Conclusion