Evidence-based Practice Beliefs Scale Research Articles

Psychometric properties of the Japanese version of the evidence-based practice beliefs scale among clinical nurses

Psychometric properties of the Japanese version of the evidence-based practice beliefs scale among clinical nurses

Barriers and facilitators of the nurse providing evidence-based preoperative visit-care for transcatheter aortic valve replacement: a mixed-methods study based on an evidence application setting

BackgroundPreoperative visit-care for transcatheter aortic valve replacement (TAVR) plays a crucial role in improving the quality of care and patient safety. However, preoperative care for TAVR patients is still in its early stages in China, with the care often being experience-based. The application of relevant evidence in nursing practice is necessary. Little is known regarding the facilitators and barriers to apply and compliance to the evidences about preoperative visit-care for TAVR in nursing.MethodsThe Nurse’s Compliance Checklist was used to investigate the evidence-based compliance of nurses (n = 21) who worked in the TAVR team in the evidence-based implementation setting. Meanwhile, an Evidence-Based Practice Beliefs Scale, and Influencing Factors Checklist were used to investigate all nurses (n = 66) who work in the same setting. Stakeholders (Middle and senior-level nursing administrators, frontline clinical nurses, and patients) interview was carried out to further disclose the barriers and facilitators in the process of evidence-based practice.ResultsThe results of this study showed that only 1 evidence implemented fully (100%) by nurses, 3 evidences with 0% implementation rate, and implementation rate of the other evidences were 9.5∼71.4%. The overall score of nurses’ evidence-based nursing belief level was (3.52 ± 0.82). Three domains of barriers were identified: the Context Domain included lack of nursing procedures, inadequate health education materials, insufficient training; the Practitioner Domain included insufficient attention, lack of relevant knowledge, high work pressure and uncertainty of expected results, and Patient Domain included lack of relational knowledge. Facilitating factors included leadership support, nurse’ high evidence-based nursing belief, high executive ability and enthusiasm for learning.ConclusionThe study indicated that the nurses’ compliance of evidence-based practice in preoperative visit-care for TAVR was in lower level. There were some factors influencing the application of the evidences. The study revealed potential modifiable barriers to the successful implementation of evidence-based preoperative visit-care, including a lack of preoperative visit- care routine, related knowledge and training. Leadership support and nurse training should be considered to improve nurses’ compliance with evidence-based practice.

Developing and evaluating an evidence-based practice research competency enhancement program for clinical nurses in Korea: a pilot study

BackgroundEvidence-based practice (EBP) is crucial for delivering high-quality healthcare and effective self-care. Enhancing clinical nurses’ research competencies through structured mentorship is key to the widespread application of EBP. This study evaluated a newly developed Research Competency Enhancement Program (RCEP), aimed at bolstering EBP among experienced nurses.MethodsConducted in a tertiary university hospital in Korea, this single-group study employed a pretest-post-test design and a mixed-methods approach. The RCEP involved 11 experienced clinical nurses in an 8-week intervention, featuring mentor-led workshops, interactive sessions, and resource-driven activities. Data were collected using the Evidence-Based Practice Beliefs Scale (EBPB), the Evidence-Based Practice Attitude Scale (EBPA), and the Research Practice Ability (RPA) tool, alongside qualitative feedback. These measures assessed the program’s feasibility, acceptability, and preliminary effectiveness.ResultsThe quantitative analysis indicated significant improvements in research competency post-intervention. Mean scores on the EBPB and RPA scales increased (Z = -2.53, p = .011; Z = -2.66, p = .008). Participants described the RCEP as inspirational and challenging, creating an environment conducive to research. Facilitators included mentor support and innovative learning tools, while barriers were internet connectivity and scheduling conflicts. Suggestions for improvement included more hands-on sessions, small team collaborations, and integration with academic institutions.ConclusionThe RCEP, facilitated by EBP mentors, significantly improved the research competencies and attitudes of clinical nurses towards EBP. The study underscores the importance of continual RCEP refinement, integrating structured, interactive, and collaborative elements to further empower nurses in evidence-based practice. The program shows promise in enhancing research competencies and fostering a commitment to EBP in clinical settings.

SURVEY ON EVIDENCE–BASED PRACTICE BELIEFS AND IMPLEMENTATION AMONG UNDERGRADUATE NURSING STUDENTS AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY IN 2022

Background: Evidence-based practice (EBP) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Nowadays, EBP is a gold standard in caring fields and assessing the quality of nursing education in many countries around the world. Although EBP has many benefits for patients and training, there is a paucity of published research on the beliefs and implementation of EBP in Vietnam for nursing students. Objectives: This study aimed to describe the EBP beliefs and EBP implementation among 45 undergraduate nursing students at Can Tho University of Medicine and Pharmacy in February 2022. Materials and methods: A convenience sample of 45 undergraduate nursing students was surveyed in this descriptive, cross–sectional study. The EBP Beliefs Scale (EBPB-S) and the EBP Implementation for Students Scales (EBPI-S) by Fineout-Overholt et al. were employed to collect data regarding the respondents’ beliefs and implementation of EBP, respectively. Data collected include (1) undergraduate nursing students ( 3rd and 4th levels), (2) those who hadn’t joined the EBP course until the research time, and (3) answered enough questions. Descriptive statistics were used to analyze data. Results: Half of the respondents had seen their teachers and physicians using EBP, and most believed in the value of using EBP to develop professional competency. 100% of respondents had never used UpToDate databases to find evidence. Undergraduate nursing students weren’t confident applying EBP in clinical practice daily (M=62.89, SD=12.04), and implementing EBP less than once within 8 weeks before the study (M=9.28, SD=8.19). Conclusions: EBP beliefs and implementations were low in undergraduate nursing students. EBP courses should be initiated to increase EBP beliefs and implementation in undergraduate nursing students to advance nursing science, enhance practice for future nurses, and improve patient outcomes.

Validation of short version of evidence-based practice instruments among nurses in clinical practice: Evidence-based practice beliefs, implementation, and organizational culture

ABSTRACT Objective: The objective of the study is to validate the short version of evidence-based practice (EBP) instruments among nurses in clinical practice. Methods: An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians. The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales: the shortened versions of the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice (OCRSIEP) survey. With the use of descriptive statistics, the data were analyzed and presented in frequencies and percentages, while inter-item correlation coefficient (ICC) and the Kaiser-Meyer–Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis. Results: Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61, EBP Implementation Scale ranged from 1.84 to 1.94, and the OCRSIEP Scale ranged from 1.93 to 2.19. All the three shortened scales accordingly had good internal reliability, 29.30 ± 9.93 out of 80 for the EBP Beliefs Scale, 19.56 ± 7.37 out of 72 for the EBP Implementation Scale, and 66.32 ± 20.35 out of 125 for the OCRSIEP Scale. Conclusion: This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

Faculty Readiness and Learning Needs for Incorporating Virtual Healthcare into the Curriculum

Objective: Virtual healthcare technologies are becoming increasingly acceptable and available to patients and providers to deliver care. Although common in practice settings, many nursing schools have not integrated virtual care concepts into the curriculum. One reason may be because faculty are not prepared to teach these concepts. The purpose of this study was to assess the virtual healthcare learning needs of faculty. Methods: An exploratory, descriptive study design was used to evaluate faculty receptiveness and readiness to teach virtual nursing care concepts. Thirty-seven full time faculty members were asked to complete an anonymous survey consisting of demographic, open-ended, and Likert scale items based on the technology acceptance model, the Virtual Clinical Practicum Attitude Survey, and the Evidence-Based Practice Beliefs scale. Quantitative data was evaluated using descriptive statistics and qualitative data with a thematic analysis process. Results: Twenty-two faculties completed a survey regarding their beliefs about virtual healthcare technologies. Most respondents believe that virtual care improves access for patients and that students should have training in these technologies. However, few had used virtual technology in their own clinical practices and wanted further education about them. Faculty was receptive to integrating virtual care into the curriculum and reported their learning needs could be met through didactic content and simulation activities with faculty as learners. Conclusion: An opportunity exists to prepare faculty to teach virtual healthcare concepts. Addressing faculty learning needs could aid in the successful integration of virtual healthcare concepts into the curriculum, thus, better preparing students to deliver virtual care to their future patients.

Attitude and Behaviour of Standardized Training Students to Evidence-Based Practice: A Cross-Sectional Questionnaire Survey

Although evidence-based practice provides the best diagnosis and treatment decisions for patients, there is no relevant theoretical basis for designing an evidence-based practice curriculum for medical students. Also, no study has been conducted to investigate the attitude and behaviour of evidence-based practice among resident doctors in China. Therefore, this study aims to identify the beliefs and implementation of evidence-based practice among registered resident doctors in Lianyungang First People's Hospital. A descriptive cross-sectional design was used to recruit 257 participants conveniently. Beliefs about the evidence-based practice was evaluated using the Evidence-Based Practice Beliefs scale. In addition, the implementation of Evidence-Based Practice was evaluated using the Evidence-Based Practice Implementation scale. Participants' rate of evidence-based practice was 71.60%. Cronbach's alpha was more than 0.90 for each scale. Participants who had learned about evidence-based medicine gave significantly higher scores on the Evidence-Based Practice Beliefs scale and Evidence-Based Practice Implementation scale than those who did not. This study demonstrates that resident doctors develop a positive attitude towards evidence-based practice but exercise it to a lesser extent. Integrating the theory course of evidence-based medicine at the undergraduate level with the practice course at the standardized training stage is crucial to improving their practice, aiming to enhance that patients receive the best available care based on high-quality evidence.

Engaging Students as EBP Ambassadors in a Rural Hospital

Purpose: A regional research consortium provided a forum to optimize resources and fill gaps in services for all stakeholders. Through the consortium, an academic practice partnership was formed with a state university’s nursing program to assist a rural, critical access hospital’s nursing staff gain evidence-based practice (EBP) knowledge and skills. The aim of this project was to create, implement, and evaluate the effectiveness of student led workshops to educate and empower critical access hospital staff nurses with EBP knowledge and skills. Sample: A convenience sample of staff nurses who attended monthly staff meetings was used. Sixteen nurses completed the pre-test, and 19 nurses completed the post-test. Method: The EBP Implementation Scale and EBP Beliefs Scale was used in a pretest/posttest design to evaluate staff nurse beliefs about EBP and implementation of EBP in their nursing practice. Findings: The nurses reported increased knowledge and application of EBP. The students developed professional and leadership skills. Conclusions: A healthcare research consortium provided a forum that connected academia and practice and fostered sharing of expertise and resources. Partnerships between nursing programs and rural, critical access hospitals may be an option for optimizing resources. Keywords: critical access hospital, rural hospital, evidence-based practice, nursing students, academic-practice partnerships DOI: https://doi.org/10.14574/ojrnhc.v21i2.687 Acknowledgments: Thank you to the staff and administration at Gibson General Hospital for their cooperation and support of this project. Thank you to these former students who demonstrated extraordinary leadership throughout this project: Amber Parsons, BSN, RN; Katie Halbig, BSN, RN; Rebecca Horn, BSN, RN; Jenna Spiller BSN, RN; Kim Bell, BSN, RN; Rachel Goldstein, BSN, RN; Lucy Hardison, BSN, RN; Anne Kiboi, BSN, RN; Anna Heckman, BSN, RN; Sarah Mehringer, BSN, RN; Allison Schroering, BSN, RN; and Grace Voyles, BSN, RN.

Psychometric Properties of the Short Versions of the EBP Beliefs Scale, the EBP Implementation Scale, and the EBP Organizational Culture and Readiness Scale.

Evidence-based practice (EBP) is a problem-solving approach to clinical decision making that leads to a higher quality and safety of health care. Three valid and reliable scales that measure EBP attributes, including the EBP Beliefs Scale, the EBP Implementation Scale, and the Organizational Culture and Readiness Scale for System-Wide Integration of EBP, are widely used but require approximately 5min each to complete. Shorter valid and reliable versions of these scales could offer the benefit of less time for completion, thereby decreasing participant burden. The aim of this study was to determine the psychometric properties of the three shortened EBP scales, adapted from the longer versions. This study used a descriptive survey design with 498 nurses who completed the three original EBP scales along with a shortened version of each scale. Exploratory factor analysis was conducted with principal components extracted to examine the factor structure of each EBP measure for the three shortened EBP scales. Item intercorrelations and the Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) were used to confirm the validity of using factor analysis. Reliability of each scale using Cronbach's α was examined. Convergent validity of the three shortened EBP scales was assessed by correlating each shortened scale with its longer scale. Factor analysis supported the construct validity of each of the three shortened scales, as all item intercorrelations were greater than 0.40, and KMO values were 0.62 to 0.74. The shortened scales Cronbach alphas were 0.81 for the EBP Beliefs Scale, 0.89 for the EBP Implementation Scale, and 0.87 for the EBP Culture and Readiness Scale. The three shortened EBP scales had acceptable convergent validity (r=0.42-.072) for the correlations between the shortened and longer scales. The three shortened EBP scales, which are valid and reliable, can be used as an alternative to the longer three scales to decrease participant burden when conducting program evaluations, research, or organizational assessments.

Beliefs and implementation of evidence-based practice among nurses in the nursing homes of a Swiss canton: An observational cross-sectional study.

Aims and objectivesExamine beliefs about EBP and its level of implementation among nurses working in nursing homes in a bilingual canton of Switzerland and explore associations between these aspects and nurses’ sociodemographic and professional characteristics.BackgroundAlthough evidence‐based practice (EBP) is recognised as an effective strategy for improving the quality and safety of care, little is known about its use in nursing homes. Nurses’ beliefs about EBP and their implementation of it in Switzerland’s nursing homes have never been explored.DesignAn observational cross‐sectional study.MethodsBeliefs about and implementation of EBP were evaluated using validated French‐ and German‐language versions of the EBP Beliefs Scale and the EBP Implementation Scale, developed by Melnyk and Fineout‐Overholt (Melnyk, Fineout‐Overholt, & Mays, 2008, Worldviews on Evidence‐Based Nursing, 5, 208). The STROBE checklist for cross‐sectional studies was used in reporting this study.ResultsThe participation rate was 40.6% (N = 194). Most participants stated that they had some knowledge of EBP and held favourable beliefs about it. Nevertheless, 37.1% of participants found the concept complicated and 36.1% found it time‐consuming. Participants were more likely to implement stages in the EBP process linked to direct clinical practice rather than those which required scientific knowledge and skills.ConclusionMost participants had favourable beliefs about EBP, but the level of implementation of EBP among nurses in their daily clinical practice was sub‐optimal.Relevance to clinical practiceA greater emphasis should be put on fostering the use of EBP among nurses working in nursing homes. This could be achieved via training and the development of individual, institutional and contextual strategies promoting the integration of EBP in clinical settings.

An exploration of evidence-based practice work files for occupational therapy students during clinical placements: a descriptive cross-sectional study

BackgroundBachelor students of occupational therapy are expected to work in accordance with evidence-based practice (EBP). The EBP work file, a learning tool in a Word document format, covering all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine the attitudes and behaviours of occupational therapy students’ in relation to applying evidence-based practice during their second-year clinical placement. We compared cohorts who received training in EBP work files with those who did not receive such training.MethodsA descriptive, cross-sectional comparative study was conducted. Five cohorts of second-year occupational therapy students took part in the study. The students answered two questionnaires, the EBP Beliefs Scale and the EBP Implementation Scale, after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, mean and standard deviations of all participating students’ scores across both questionnaires. ANOVA with Bonferroni correction was conducted to analyse the differences between the mean totals of the questionnaires.ResultsIn this study, 126 occupational therapy students participated (response rate = 57.3%). The students reacted positively to EBP, although few were practicing EBP. The students believed that EBP resulted in the best clinical care for patients, but they lacked confidence in their own ability to apply EBP. The students in Cohort 5, who received extra instruction and assignments via the EBP work file, rated their EBP behaviour statistically lower than the students in Cohort 1, who did not receive extra training on the EBP work file.ConclusionsAdditional EBP work file assignments were insufficient in terms of supporting students in the implementation of EBP during clinical placements. It is, therefore, important to facilitate the learning strategies of EBP skills and demonstrate how students can practise this competency during clinical placements. Including clinical instructors in EBP teaching and learning seems essential.

Enhancing utility and understanding of evidence based practice through undergraduate nurse education

BackgroundThe concept of evidence-based practice is globally relevant in current healthcare climates. However, students and teachers struggle with integrating evidence based practice effectively into a curriculum. This has implications for nurse education and in particular the way in which research is presented and delivered to students.A new undergraduate Evidence Based Practice module (Evidence Based Nursing 1) was developed in a large University within the United Kingdom. It commenced in October 2014 running in year one of a 3 year undergraduate nursing programme. This study sought to formally evaluate attitudes and beliefs, knowledge level and utilization of evidence based practice though using two validated questionnaires: Evidence Based Practice Beliefs Scale© and Evidence Based Practice Implementation Scale©.MethodThis was a pilot study using quantitative pre and post-test design. Anonymised data was collected from Year 1 undergraduate student nurses in the September 2014 intake (n = 311) at two time points. Time 1: pre-module in September 2014; and Time 2: post –module in August 2015. All data was collected via Survey Monkey.ResultsResults demonstrate that the educational initiative positively impacted on both the beliefs and implementation of evidence based practice. Analysis highlighted statistically significant changes (p < 0.05) in both the Evidence Based Practice Beliefs Scale (7/16 categories) and the Evidence Based Practice Implementation Scale (13 / 18 categories).ConclusionsThe significance of integrating evidence based practice into undergraduate nurse education curriculum cannot be underestimated if evidence based practice and its positive impact of patient care are to be appreciated in healthcare settings internationally.

Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers.

To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk etal. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk etal.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk etal.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to evaluate the effectiveness of organisational strategies aimed at increasing professionals' confidence in Evidence-Based Practice, supporting its use and implementation.

Changes in evidence-based practice beliefs and implementation after a postgraduate educational program: A before-and-after study over one year

Healthcare professionals are increasingly expected to use research evidence to improve healthcare outcomes. The aim of this study was to examine change in beliefs and implementation of evidence-based practice (EBP) one year after participation in a 15 ECTS postgraduate educational program in EBP. We conducted a before-and-after study among 158 healthcare professionals in a postgraduate program in EBP. Participants completed the Norwegian version of the EBP Beliefs Scale and the EBP Implementation Scale at baseline and one year after the program. Results indicated increased scores from pre-test to one year follow up on the EBP Beliefs Scale and the EBP Implementation Scale. Participants in evidence-based network groups reported higher scores on the EBP Implementation Scale than those who did not participate in these groups. Further research should examine other factors that may facilitate implementation of evidence-based practice.

Findings From a Pilot Study: Bringing Evidence-Based Practice to the Bedside.

To translate research supporting inpatient care outcomes and provide evidence-based care, registered nurses (RNs) need continuing education and mentoring support to adopt evidence-based practice (EBP). The aim of this study was to assess a demonstration project intended to pilot and evaluate a structured EBP education with mentoring innovation for nurses in a multihospital system. Nurses from five units in five hospitals were included in an education with mentoring innovation to implement the Johns Hopkins Nursing Evidence-Based Practice Model and the Advancing Research and Clinical practice through close Collaboration (ARCC) Model. To determine outcomes, the EBP beliefs scale (EBPB) and implementation scale (EBPI) were administered before and after the education with mentoring innovation. Eighty-three RNs completed both preintervention surveys. A total of 57 RNs completed the postintervention surveys. In addition, qualitative data were obtained from focus groups involving 24 participants. Statistical analysis indicated positive movement toward EBP in project participants. Qualitative analysis revealed perceived successes and challenges involved with implementing an evidence-based program, provided logistical lessons learned, and indicated that nurses at all levels of practice require mentoring and coaching to foster EBP sustainment. The engagement of nurses in this project supported professional development and clinical application of evidence at the point of care. The pilot project's outcome informed a decision by health system administrators to fund more nurse driven EBP projects in the five hospitals. This innovative program provides a replicable structure for deployment and appraisal of EBP nursing model implementation.

Evidence-Based Practice Beliefs and Implementation among the Nursing Bridge Program Students of a Saudi University

This study aimed to measure the evidence-based practice (EBP) beliefs and implementation among Saudi nursing students enrolled in the bridge program. It also sought to identify the factors that influence EBP beliefs and implementation. A convenience sample of 188 nursing bridge program students at a university in Saudi Arabia was surveyed in this descriptive, cross-sectional study. The EBP Beliefs Scale (EBP-B) and the EBP Implementation Scale (EBPI) were employed to collect data regarding the respondents' beliefs and implementation of EBP, respectively. Descriptive and inferential statistics were used to analyze the data. All of the items in the EBP beliefs scale received good endorsement rate (60.6 - 89.4%). A very low overall mean score of 22.57 was reported by the respondents in the implementation of EBP. The EBP beliefs of the respondents was primarily influenced by awareness on EBP (β = 0.26, p <0.001), followed by gender (β = -0.20, p<0.001), age (β = 0.17, p<0.05), and attendance at EBP trainings/seminars (β = 0.16, p<0.05). Attendance to EBP training and seminars (β = 0.19, p<0.01), gender (β = 0.18, p<0.05) and awareness on EBP (β = 0.15, p<0.05) were identified as factors that influence EBP implementation. Despite the positive responses on the belief scale, the implementation of EBP by the respondents is very poor. Education and training courses should be initiated to increase the implementation of EBP among the nursing bridge program students.

A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence-Based Practice and Shortcomings in Hospital Performance Metrics Across the United States

Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe. The purpose of this study was to describe: (a) the EBP beliefs and level of EBP implementation by chief nurse executives (CNEs), (b) CNEs' perception of their hospitals' EBP organizational culture, (c) CNEs' top priorities, (d) amount of budget invested in EBP, and (e) hospital performance metrics. A descriptive survey was conducted. Two-hundred-seventy-six CNEs across the United States participated in the survey. Valid and reliable measures included the EBP Beliefs scale, the EBP Implementation scale, and the Organizational Culture and Readiness scale for EBP. The Centers for Medicare and Medicaid Services Core Measures and the National Database of Nursing Quality Indicators (NDNQI) were also collected. Data from this survey revealed that implementation of EBP in the practices of CNEs and their hospitals is relatively low. More than one-third of the hospitals are not meeting NDNQI performance metrics and almost one-third of the hospitals are above national core measures benchmarks, such as falls and pressure ulcers. Although CNEs believe that EBP results in high-quality care, it is ranked as a low priority with little budget allocation. These findings provide a plausible explanation for shortcomings in key hospital performance metrics. To achieve higher healthcare quality and safety along with decreased costs, CNEs and hospital administrators need to invest in providing resources and an evidence-based culture so that clinicians can routinely implement EBP as the foundation of care.

Athletic Trainers' Beliefs About and Implementation of Evidence-Based Practice.

Understanding the beliefs about and use of evidence-based practice (EBP) among athletic trainers (ATs) will help to determine appropriate strategies to improve implementation. To examine the ATs' beliefs about and use of EBP. Cross-sectional study. Online survey instrument. A total of 467 ATs responded to the survey request, a response rate of 11.67%. A total of 385 (9.6%) completed the EBP Beliefs Scale and 342 (8.5%) completed the EBP Implementation Scale. The EBP Beliefs Scale and EBP Implementation Scale were administered. The surveys collected demographic information in addition to information about participants' beliefs regarding EBP and implementation of EBP in clinical practice. The ATs demonstrated a level of neither agree nor disagree (56.00 ± 7.86) on the EBP Beliefs Scale. Belief scores were higher among those ATs required to document for third-party reimbursement (P = .001), those with access to current research through professional journals other than the Journal of Athletic Training (P = .02), and those with a doctoral degree (P = .01). A low level of implementation (9.00 ± 11.38), representing the implementation of EBP approximately 0 times in the previous 8 weeks, was found on the EBP Implementation Scale. Implementation scores were higher among preceptors (P = .01), those required to document for third-party reimbursement (P < .001), those with access to current research through professional journals (P = .002), and those with a doctoral degree (P = .01). Participants had a positive attitude toward EBP; however, they were not implementing EBP concepts when providing patient care. This suggests that additional information and EBP resources are needed so ATs can better implement EBP in practice. To provide the best patient care and to promote EBP within the profession, clinicians should make EBP a priority and advocate for EBP implementation.

Factor Analytical Examination of the Evidence-Based Practice Beliefs Scale: Indications of a Two-Factor Structure

Background: Promotion of Evidence-Based Practice (EBP) in nursing appears to be developing slowly. Research indicates that nurses’ beliefs in EBP may play an even more significant role than knowledge and resources in making implementation feasible. To address this issue, measurement of nurses’ beliefs regarding EBP is paramount. Aims and objectives: This study explores the internal consistency reliability and the construct factor structure of the Norwegian version of the original Evidence-Based Practice Beliefs Scale (EBP-BS). Methods: The study has a Non-experimental exploratory survey design. A Norwegian translation of the EBP-BS was tested in a convenience sample of 118 healthcare professionals (95% nurses) attending a continuing education program at a University College in Norway. The response rate was 95% (n = 112). The internal consistency of the scale was measured by Cronbach’s alpha, and an explorative Principal Component Analysis (PCA) was used to explore the construct structure. Results: The overall internal consistency of the EBP-BS was acceptable. The PCA indicated a four-factor structure. The psychometric properties of two of the factors were too weak for expanding to a four-factor model. Based on our investigation of the EBP-BS, we suggest a two-factor structure model. The factors were named 1) General knowledge and confidence concerning EBP and 2) Task specific beliefs in EBP. This finding differs from previous results that indicated a unidimensional structure. Conclusion: As a starting point, reliable and valid measurement of nurses’ beliefs about EBP is required in order to identify possible obstacles and to optimize implementation in the individual clinical setting. Our results indicate that the EBP-BS has a two-factor structure. Further exploration of the factor structure is needed. Further empirical research may contribute to the resolving of controversies concerning basic understandings of the concept of EBP.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study

Background and PurposePhysiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students.MethodsWe invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations.ResultsIn total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p<0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only.ConclusionsA multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs’ abilities to apply EBP knowledge and skills when supervising students.