Evidence-based Practice Beliefs Research Articles

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.

Evaluating the Impact of an Evidence-Based Practice Education Program in a Nurse Residency Program on Evidence-Based Practice Beliefs, Implementation, and Competency.

This quality improvement project examined implementation of the John Hopkins Nursing evidence-based practice (EBP) model, a standardized EBP education curriculum, in a hospital-based nurse residency program. We found that EBP education increased nurse residents' EBP beliefs, implementation frequency, and competencies. Our findings suggest that adopting existing EBP curricula is a convenient and effective approach to EBP education. Staff development professionals should continue to support and advocate for the adoption of EBP education within their organizations.

A Study of Medical Surgical Nurses Leaders' Evidence-Based Practice Attributes: Critical Implications for Practice.

The purpose of this study was to determine medical-surgical nurse leaders' evidence-based practice (EBP) attributes, perceived barriers to EBP, and whether there were differences in leaders' EBP competencies and EBP implementation by demographic and organizational factors. Leaders are crucial to the development of cultures that support EBP implementation, but little is known about medical-surgical nurse leaders' capacity to perform this aspect of their role. A cross-sectional design using survey methodology was used. The survey contained demographic/work setting questions and 3 instruments to measure EBP beliefs, implementation, and competencies. Senior leaders self-reported higher EBP attributes compared with nurses in other roles; nurses with an MSN or higher reported greater frequency of EBP implementation. A regression revealed that EBP competencies, EBP beliefs, having a DNP degree, and working in an Academy of Medical-Surgical Nurses Premier Recognition In the Specialty of Med-surg unit or a Pathway to Excellence® organization had significant, positive effects on EBP implementation scores (R2 = 0.37). Findings demonstrate there is a range of EBP beliefs and competencies, and barriers to EBP among medical-surgical nurse leaders. Because medical-surgical nursing is the largest acute care practice specialty in the United States and many other countries, leaders fully integrating EBP into their practice would be a substantial contribution to advancing EBP in healthcare.

Budgetary investment in evidence-based practice by chief nurses and stronger EBP cultures are associated with less turnover and better patient outcomes.

Hospitals and healthcare systems strive to meet benchmarks for the National Database of Nursing Quality Indicator (NDNQI) measures, Centers for Medicare & Medicaid Services (CMS) Core Measures, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcome indicators. Prior research indicates that Chief Nursing Officers and Executives (CNOs, CNEs) believe that evidence-based practice (EBP) is important for ensuring the quality of care, but they allocate little funding to its implementation and report it as a low priority in their healthcare system. It is not known how EBP budget investment by chief nurses affects NDNQI, CMS Core Measures, and HCAHPS indicators or key EBP attributes and nurse outcomes. This study aimed to generate evidence on the relationships among the budget devoted to EBP by chief nurses and its impact on key patient and nurse outcomes along with EBP attributes. A descriptive correlational design was used. An online survey was sent to CNO and CNE members (N = 5026) of various national and regional nurse leader professional organizations across the United States in two recruitment rounds. Data collected included CNO/CNE EBP Beliefs, EBP Implementation, and perceived organizational culture of EBP; organizational culture, structure, personnel, and resources for EBP; percent of budget dedicated to EBP; key performance measures (NDNQI, CMS Core Measures, HCAHPS); nurse satisfaction; nurse turnover; and demographic questions. Descriptive statistics were used to summarize sample characteristics. Kendall's Tau correlation coefficients were calculated among EBP budget, nursing outcome measures, and EBP measures. One hundred and fifteen CNEs/CNOs completed the survey (a 2.3% response rate). The majority (60.9%) allocated <5% of their budget to EBP, with a third investing none. An increase in EBP budget was associated with fewer patient falls and trauma, less nursing turnover, and stronger EBP culture and other positive EBP attributes. A greater number of EBP projects were also associated with better patient outcomes. Chief nurse executives and CNOs allocate very little of their budgets to EBP. When CNEs and CNOs invest more in EBP, patient, nursing, and EBP outcomes improve. System-wide implementation of EBP, which includes appropriate EBP budget allocation, is necessary for improvements in hospital quality indicators and nursing turnover.

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

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

Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review.

Using evidence-based practice (EBP) improves the implementation of safe, high-quality healthcare for patients, reduces avoidable costs, and plays a crucial role in bridging knowledge-action gaps and reducing health inequities. EBP combines the best available evidence in the relevant literature with patient preferences and values and healthcare professionals' (HCPs) expertise. Systematic searches of ten bibliographic databases, unpublished works, and the Grey Literature Report sought studies published up to 30 September 2022. The 15 studies retained involved 2712 nurses. Three types of effective educational interventions were identified: (1) multifaceted educational strategies incorporating mentoring and tutoring; (2) single educational strategies, often delivered online; and (3) multifaceted educational strategies using the five steps of EBP. Eleven primary outcomes (EBP beliefs, EBP self-efficacy, perceived EBP implementation, EBP competencies, EBP knowledge, EBP skills, EBP attitudes, EBP behaviors, EBP desire, EBP practice, and perceptions of organizational culture and readiness) were assessed using 13 qualitative and quantitative instruments. Ensuring the successful implementation of EBP requires effective educational strategies. Computer-based learning seems the most cost-effective and efficient strategy, when considering caregivers' characteristics, the clinical field, and educational interventions across the pre-, peri-, and post-implementation processes.

Equipping Nurses to Lead Evidence-Based Practice: An Opportunity for Professional Nursing Associations.

The aim of this study was to describe the evidence-based practice (EBP) attributes among California nurse leaders who are members of a professional nursing organization. Nurse leaders are pivotal for successful EBP implementation. The Association of California Nurse Leaders' (ACNL) mission to equip nurses to lead self, others, and systems propelled them to conduct a study of members' EBP beliefs, knowledge, competencies, and implementation. Evidence-based practice attributes of California nurse leaders were measured using valid and reliable scales via an anonymous, electronic survey. Although ahead in the subjective EBP scales, California nurse leaders' perceptions of organizational EBP culture were comparable with those of a similar national sample. Scores still indicated opportunities for improvement. Nurse leaders must be prepared to lead EBP in their organizations. Professional organizations such as ACNL have an opportunity to help leaders by conducting research and assessing and meeting their members' learning needs.

Psychometric properties of the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice.

Patient safety metrics declined due to COVID-19-related strains placed on hospitals and hospital systems. Because evidence-based practice (EBP) can improve patient outcomes and quality of care and empower clinicians, a renewed focus on organizational EBP culture is needed. The Advancing Research and Clinical practice through close Collaboration (ARCC©) Model describes how to use a system-wide approach to advance and sustain EBP in hospital systems to improve outcomes. EBP culture is a key variable that directly impacts EBP knowledge, beliefs, competency, and implementation. The ARCC© Model uses the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice (OCRSIEP) to identify organizational characteristics that influence clinician and patient outcomes. Although the scale has been reported to have excellent reliability, a comprehensive psychometric analysis has yet to be performed that confirms its construct validity. The aim of this study was to describe the OCRSIEP's construct validity and reliability via an in-depth psychometric analysis. OCRSIEP assessment data were obtained from a prior national study with 2344 nurses from 19 hospitals and healthcare systems. Descriptive statistics summarized the sample and distributions of the 25 scale items. Construct validity was assessed via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha assessed reliability. A one-factor model was supported by EFA with item Q17b excluded (i.e., to what extent are decisions generated from upper administration). Model fit indices for CFA indicated a good fit (CFI=0.978, TLI=0.973, RMSEA=0.077, SRMR=0.027). Cronbach's alpha was 0.96 for all items and 0.97 with item Q17b excluded, both indicating outstanding internal consistency. The OCRSIEP is valid and reliable and can be used to assess EBP culture and readiness in hospitals and healthcare systems at the organizational level.

EBP education and skills building for leaders: An RCT to promote EBP infrastructure, process and implementation in a comprehensive cancer center.

Implementation of evidence-based practice (EBP) in healthcare remains challenging. The influence of leadership has been recognized. However, few randomized trials have tested effects of an educational and skills building intervention for leaders in clinical settings. Test effects of an EBP leadership immersion intervention on EBP attributes over time among two cohorts of leaders at a national comprehensive cancer center. A stratified, randomized, wait-list group, controlled design was conducted. Participants received the evidence-based intervention one year apart (2020, n=36; 2021, n=30) with EBP knowledge, beliefs, competencies, implementation self-efficacy, implementation behaviors, and organizational readiness measured at pre- and post-intervention, and one- and two-year follow-ups. Participants applied learnings to a specific clinical or organization priority topic. Baseline outcomes variables and demographics did not differ between cohorts except for age and years of experience. Both cohorts demonstrated significant changes in EBP attributes (except organizational readiness) post-intervention. Mixed linear modeling revealed group by time effects at 3-months for all EBP attributes except implementation behaviors and organizational readiness after the first intervention, favoring cohort 2020, with retained effects for EBP beliefs and competencies at one year. Following Cohort 2021 intervention, at 12-weeks post-intervention, implementation behaviors were significantly higher for cohort 2021. An intensive EBP intervention can increase healthcare leaders' EBP knowledge and competencies. Aligning EBP projects with organizational priorities is strategic. Follow-up with participants to retain motivation, knowledge and competencies is essential. Future research must demonstrate effects on clinical outcomes.

Psychometric properties of the evidence-based practice mentorship scale.

Evidence-based practice (EBP) improves the quality of care, decreases healthcare costs, and improves job satisfaction. However, nurses and other clinicians, as well as their institutions, struggle to consistently implement EBP. The Advancing Research and Clinical practice through close Collaboration (ARCC©) Model established that a cadre of EBP mentors is key to improving EBP knowledge, beliefs, competency, and implementation in clinicians. Yet, there has not been a valid and reliable measure of EBP mentorship. The aim of this study was to determine the psychometric properties of the new 8-item EBP Mentorship Scale. This scale measures the degree to which clinicians perceive that EBP mentorship is available to them. The EBP Mentorship Scale data were obtained from a previous national cross-sectional descriptive study with 2344 nurses from 19 hospitals and healthcare systems. Descriptive statistics summarized the sample and distributions of the scale items. Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were conducted. Cronbach's alpha of the scale was 0.99. A one-factor model was supported by EFA and retained for CFA. Model fit indices for CFA indicated a good fit. The new EBP Mentorship Scale is valid and reliable and can be used to assess the level of EBP mentorship support available in hospitals and healthcare systems. EBP mentors are key in sustaining an EBP organizational culture and enhancing clinician EBP knowledge, beliefs, competency, and implementation.

How nursing stakeholders in the Republic of Ireland define evidence-based practice and why it matters.

Evidence-based practice (EBP) has garnered increasing exposure in professional healthcare discourse over three decades. While the term is used frequently, its interpretation varies widely. An accurate, shared understanding of what EBP means is essential to the achievement of EBP implementation in clinical practice. As part of a national study in the Republic of Ireland, nurses, midwives, educators, and students shared their personal understanding of what EBP was to them. To establish nurses', midwives', educators', and students' knowledge and understanding of the concept of EBP in the Republic of Ireland. In a national study exploring EBP beliefs, implementation, and organizational readiness for EBP among nurses, midwives, educators, and students, an open-ended question invited participants to explain what EBP is, in their own words. Content analysis was used to interpret participants' responses. Five themes emerged from the data from the single open-ended question: (1) varying definitions of EBP, (2) best practice, (3) nurses' and midwives' role in EBP, (4) knowledge, and (5) barriers and facilitators of EBP. The dominant finding centered on the substantial conflation of EBP with research utilization and other concepts such as quality improvement. Poor knowledge and understanding of EBP is a fundamental challenge to EBP implementation. Conflation of EBP with research utilization and other healthcare concepts is not uncommon among nurses and midwives globally and has persisted for some time. This has the potential to hinder the advancement of EBP in nursing and midwifery and, therefore, measures to enhance EBP knowledge and promote EBP implementation are key. Professional regulating bodies, educators, and clinical and educational organizations all have a role to play. The findings from this aspect of this national study offer a realistic, context-specific starting point for tailored educational interventions for clinicians, educators, and students and identify professional and organizational strategies that promote EBP as the expectation and "the way things are done here."

Barriers to implementing evidence-based nursing practice from the hospitals' point of view in China: A regional cross-sectional study

BackgroundThere is a widespread international agreement that healthcare should be based on high-quality evidence; however, bridging the gap from evidence to practice is still problematic. Although barriers to the implementation of evidence-based nursing practice have been identified, most studies have focused on clinical nurses' perceptions of the barriers to evidence-based nursing practice, with a lack of investigation into barriers from the hospitals' viewpoint. ObjectivesTo identify existing barriers to implementing evidence-based nursing practice from the hospitals' viewpoint. DesignA descriptive study employing a regional cross-sectional survey. Settings and participantsA convenience sample of 91 hospitals in Guangdong Province, China. MethodsThe survey used an online questionnaire containing basic hospital information and an open-ended question. Descriptive statistics were used to analyse basic hospital data. Responses to the open-ended question were analysed with thematic analysis. ResultsThe sample consisted of 89 valid responses to the open-ended question. Five themes were identified: (1) knowledge (70.8 %); (2) environmental context and resources (42.7 %); (3) social influences (7.9 %); (4) intentions (7.9 %); and (5) beliefs about capabilities (1.1 %). ConclusionIntroduced early in 2001, China has embraced evidence-based nursing for more than 20 years. However, lack of knowledge is still the top barrier to implementing evidence-based nursing practice in hospitals in China. The findings indicate a need for more evidence-based nursing practice teaching strategies towards further enhancing clinical nurses' and nursing managers' evidence-based nursing practice beliefs, knowledge, and skills.

Medical-surgical nurses' EBP beliefs and competencies.

The lack of evidence-based practice (EBP) knowledge and inability to implement EBP among nurses is a major barrier to quality nursing care. The literature shows that nurses highly value the use of EBP, however, they lack necessary EBP competencies. Although medical-surgical nurses were included in studies examining cross-sections of the nursing workforce, no studies exist specifically investigating their EBP beliefs and EBP competencies. The purpose of this study was to describe medical-surgical nurses' self-reported EBP beliefs and competencies. A descriptive, cross-sectional design employing survey methodology was used. A total of 1,709medical-surgical nurses participated for a response rate of 13%. The findings revealed that medical-surgical nurses had positive beliefs about EBP. However, they rated themselves competent in only 2EBP competencies of 24. Medical-surgical nurses working in units or organizations that had a special designation such as Academy of Medical-Surgical Nurses Premier Recognition in the Specialty of Med-Surg (AMSN PRISM; p=.001) or Pathway to Excellence (p=.006) reported greater EBP competency scores. Also, nurses educated at the master's level or higher had better EBP competency scores (p < .0001). Medical-surgical nurses need support at the personal and organizational levels to improve their EBP competence and increase uptake of EBP in their practice. Therefore, individual nurses must reflect on their EBP competence level and pursue opportunities to develop these essential attributes. Leaders must also create practice environments where EBP is valued, and barriers to EBP implementation are eliminated. Faculty in prelicensure and graduate programs should integrate EBP into their curricula and assess students' EBP competencies.

Engaging advanced practice nurses in evidence-based practice: An e-mentoring program.

Mentoring is highly valued in the nursing profession and essential to building an evidence-based practice (EBP) culture. However, many organizations have a limited number of EBP mentors, who have limited non-clinical time to engage in mentoring. This project aimed to test whether an e-mentoring approach to nursing inquiry could enhance EBP beliefs (EBPB), increase EBP Implementation (EBPI), and improve Organizational Culture and Readiness for System-Wide Implementation of EBP (OCRSIEP). A pre-experimental pilot intervention project was implemented utilizing a pretest-posttest design with Advanced Practice Registered Nurses' (APRNs) in clinical practice. The OCRSIEP, EBPB, and EBPI scales were used to measure organizational readiness for EBP implementation, individual beliefs regarding the value of EBP, and the extent to which nurses integrate scientific evidence into their clinical practice, respectively. The Wilcoxon-Signed Rank test was used to analyze the difference between pretest and posttest scores of an EBP E-mentoring program. A post-hoc analysis was performed to calculate effect sizes. [Correction added on 13 May 2022, after first online publication: The Methods section was revised to add additional details.] RESULTS: Eleven APRNs completed the pretest and posttest surveys. When comparing the pre-and post-intervention scores, the median EBPB scores increased from 61 (IQR: 56-69) to 70 (IQR: 64-73), median EBPI scores increased from 13 (IQR: 7-33) to 20 (IQR: 13-31), and median OCRSIEP scores increased from 88 (IQR: 73-97) to 99 (IQR: 90-113). A 12-week Nurse Inquiry E-mentoring Program can leverage the small number of EBP mentors in an organization to improve EBPB. A program lasting longer in duration may also significantly improve EBPI and OCRSIEP scores. By utilizing technology and leveraging economies of scale, exponentially more nurses can be mentored to create and enhance an EBP culture.

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.

An exploration of the factors that impact on clinical practices of Nurses in applying evidence-based practice

While healthcare institutions around the world strive to adopt evidence-based practice (EBP) as the new standard in best practice, the nursing profession still faces multiple barriers and limitations in implementation. The aim of this paper is to present the analysis of EBP from the perspective of nurses working within two major South Australian hospitals, assessing their implementation and beliefs and exploring avenues for further research-based upon their feedback. A descriptive survey using the EBP beliefs (EBP-b) and the EBP implementation (EBP-I) scales were developed by Melnyk and Fineout-Overholt. Nurses scored high in the EBP belief scale reflecting significant positive readiness towards EBP. A positive correlation was observed between EBP beliefs and implementation, yet implementation rates were very low. More research is needed to explore the reasons why implementation rates are so low amongst practising nurses to understand and address the root of this problem. Based on the evidence it appears that more research is needed to explore the reasons why implementation rates are so low amongst practising nurses to understand and address the root of this problem.

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.

Evidence-Based Practice Beliefs, Implementation, and Organizational Culture and Readiness for EBP Among Nurses, Midwives, Educators, and Students in the Republic of Ireland.

Evidence-based practice (EBP) is an approach to health care that combines best available evidence, healthcare professionals' expertise, and patient preferences, yielding benefits for patients, healthcare professionals, and organizations. However, globally, EBP implementation remains inconsistent among nurses. Exploring this in an Irish context will establish a national baseline from which progress can be made on system-wide integration of EBP in nurse and midwife (i.e., clinician) practice, nursing/midwifery education, and the Irish healthcare system. To establish clinician, educator, and student's EBP beliefs, knowledge, and implementation, and the organizational culture of the clinical and educational settings within the Republic of Ireland. Using a descriptive study design, a national survey with demographic questions, uniquely focused EBP scales, and an open-ended question were administered to clinicians, nursing/midwifery educators, and students. Ethical review was obtained. Descriptive and inferential statistics were used to analyze the quantitative data. Clinicians, educators, and students reported positive beliefs about EBP (M=59.98, SD 8.68; M=87.72, SD = 10.91; M=55.18, SD = 10.29, respectively). Beliefs regarding their ability to implement EBP were lower overall. EBP implementation was low across all groups (clinicians: M=12.85, SD = 14; educators: M=31.09, SD = 16.54; students: M=16.59, SD = 12.11). Clinicians, educators, and students reported varying perceptions of organizational support and readiness for EBP (M=74.07, SD = 19.65; M=86.43, SD = 15.01; M=93.21, SD = 16.21, respectively). Across all measures, higher scores indicated higher beliefs, implementation, and organizational culture and readiness for EBP. Clinicians have a unique opportunity to facilitate system-wide integration of EBP. Furthermore, given the variable EBP knowledge, beliefs, and implementation, opportunities to enhance these attributes abound, particularly when supported by their organizations. This study established a contemporary baseline in Ireland from which to engage the identified strengths, challenges, and opportunities required to craft an organizational culture and environment that supports and advances an EBP approach to nursing and midwifery practice and education.

Perioperative Pain Management for Surgical Patients with Opioid Use Disorder: A Program Development Initiative

PurposeOver the last decade an increased number of individuals have been diagnosed with Opioid Use Disorder (OUD) and state-level regulatory pressure has mounted to develop the capability to provide opioid-free anesthesia (OFA) on clinical indication or at patient request. DesignA program initiative for OUD patients who require OFA was developed and implemented in two phases. MethodPhase I assessed the needs and knowledge of licensed nurse anesthetists in the state of Florida. Phase II recruited volunteers for a day-long event which involved both didactic and simulation training. Data collection for phase II included: demographics, knowledge, evidence-based practice belief scale (EBPBS), and evidence-based practice implementation scale (EBPIS) which measures the perceived ability to implement those beliefs. Phase II training was divided into three domains: Preoperative, Intraoperative and Postoperative with didactic and simulation experiences for each domain. FindingsThe phase II participants pre-simulation median total knowledge assessment score was 9 with median scores of 5 for questions 1 to 6 and 4 for questions 7 to 12. After participating in simulation, median knowledge assessment scores increased to 11, with median scores of 6 for questions 1 to 6 and 5 for questions 7 to 12. Before simulation training, median scores for the EBPBS and EBPIS were 66 (IQR 8) and 22 (IQR 24) respectively. After simulation, the median EBPBS score increased to 76 (IQR 7.5), a significant improvement from pre-simulation (P = .002). ConclusionThere is a lack of knowledge and training of anesthesia providers on how to manage the growing population of patients with OUD. This program initiative increased perceived ability to provide OFA care to patients with OUD presenting for surgery.