Understanding the motivation of nurses toward the continued use of an evidence-based practice in a tertiary clinical practice setting: An application of planned behaviour theory

Abstract

Introduction: In the last two to three decades, research findings have gradually been permeating the culture of nursing. Increasingly, nurses are expected to integrate evidencebased practices into specific nursing policy/protocols and patient care decisions (Polit and Beck, 2004; Rogers, 2004). In truth, research utilization is dependent on nurses' direct or indirect of evidence in the clinical setting (Estabrooks, 1999). To date, researchers have been able to conclude that the more positive a nurse's attitude the more likely the nurse will research findings (Ehrenfeld & Eckering, 1991; Camiah, 1997; Estabrooks, 1999; Olade, 20203,2004). The nursing literature reveals a dearth of studies examining nurses' actual ongoing use of research and the related factors/challenges affecting their continued of research findings in clinical practice. Purpose: Why do some nurses continue to research while others do not where organizational policy supports the ongoing of evidence-based practice? The purposes of this study are to validate whether nurses' are continuing to the RNAO's Falls Risk Prevention Best Practice Guidelines (BPG) policy/protocol in 2 units of a tertiary clinical care setting, to examine practicing nurse's attitudes, beliefs and perceptions related to their intention continue to the policy/protocol; to examine the importance of each variable (beliefs, subjective norms, perceived behavioural controls) related to their intention to continue to the policy/protocol; and to examine nurses' perceptions and experiences regarding the facilitators, barriers and organizational structures that impact their continued of research in their practice setting. Methods: This survey correlation design study used Ajzen's Theory of Planned Behaviour (Godin & Kok, 1996) as a theoretical framework to examine practicing nurse's attitudes, beliefs, perceptions related to their intention to continue to the Registered Nurse's of Ontario Association (RNAO)'s Falls Risk Prevention Best Practice Guideline (BPG) in their clinical practice. Findings: Sixty four percent of surveyed nurses (n=22/44) report using the Falls protocol (a direct type of research) always (18%) and/or often (46%) in their clinical practice. They also reported using the Falls Protocol on their previous shift an average of 2.6 patients per nurse. The main sources of falls research education where nurses first learnt about the RNAO's BPG were during their nursing practice (46%), a form of continuing education (27%), or in a conference/ seminar setting (18%). Composite mean scores related to surveyed nurses attitudes, social norm