Evidence-based Practice Implementation Scale Research Articles

Individual and social system factors influencing evidence-based practices among nurses in general hospitals: A cross-sectional multi-institutional study.

To investigate evidence-based practices and examine the influence of individual and social system factors on evidence-based practices among nurses in general hospitals. Evidence-based practice is essential for improving healthcare quality. However, a challenge for nursing worldwide is nurses' limited use of evidence-based practices. It is crucial to determine the individual and social system factors affecting nurses' use of evidence-based practices. This study employs a multi-institutional cross-sectional design. With a multistage random sampling method, 336 registered nurses were recruited from 17 general hospitals in the Republic of the Union of Myanmar. Data were collected through a seven-part questionnaire, including the Evidence-Based Practice Implementation Scale and individual and social system factors. Data were analyzed using descriptive statistics and multiple linear regression. Nurses in general hospitals perceived low levels of evidence-based practices. Individual factors, such as perceived barriers (p < .001), knowledge (p < .001) and attitudes (p = .001), were related to EBP as well as social system factors, including the work environment (p < .001) which influence nurses' practice, explaining 34% variance among nurses. Nurses perceived the work environment as the most influencing factor related to evidence-based practices. Individual characteristics, including perceived knowledge, attitudes and barriers, were critical factors in performing evidence-based practices in Myanmar. Nurse administrators and policymakers can develop strategies and interventions for improving knowledge, attitudes and work environment towards evidence-based practice. Minimizing the barriers to evidence-based practice will promote evidence-based practices in Myanmar general hospitals. In addressing the individual and social system factors influencing the evidence-based practices of nurses, this study contributes to enhancing healthcare quality and outcomes. This study adhered to the STROBE checklist. There was no patient or public contribution.

Implementation of Evidence-Based Practice and Burnout Among Occupational Therapists: The Role of Self-Efficacy.

Implementing evidence-based practice (EBP) is essential for ensuring optimal quality care and obtaining positive outcome in treatment. Occupational therapists generally hold positive attitudes toward EBP; however, EBP is not always fully implemented. To explore the mediating role of self-efficacy on the relationship between implementing EBP and burnout among occupational therapists. A cross sectional study. Data were collected through social media and WhatsApp groups using an online survey accessible through Qualtrics, a secured web-based data collection system; responses were anonymous. The final sample consisted of 261 female Israeli occupational therapists (ages 24-65 yr, with 1-40 yr of clinical experience). The following questionnaires assessed EBP implementation, burnout, and self-efficacy, respectively: the EBP Implementation Scale, the Maslach Burnout Inventory, and the Occupational Therapy Self-Efficacy Questionnaire. Demographic data were also collected. EBP implementation was low (0-43 points out of a maximum 72 points), moderate levels of burnout and high levels of self-efficacy were reported. Significant associations with medium effect sizes were found between EBP implementation and burnout: the higher the levels of EBP implementation, the lower the levels of burnout frequency and intensity. Moreover, self-efficacy mediated these relationships. EBP implementation was related to elevated self-efficacy, which, in turn, was associated with lower burnout. EBP implementation may serve as an important tool to limit burnout among occupational therapists by fostering their trust in their ability to handle clinical challenges. Further research is needed. Plain-Language Summary: This study explored implementing evidence-based practice (EBP) and its relationships to burnout and work-related self-efficacy among occupational therapists. The study found that self-efficacy mediated the relationships between implementing EBP and burnout. Implementing EBP was associated with higher self-efficacy, which, in turn, was associated with lower burnout among occupational therapists.

Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study

BackgroundEvidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.MethodsOne hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman’s test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis.ResultsThere were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0).ConclusionsEBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

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.

Identification of the Gap between Research and Practice in Surgical Care

Background: The process of applying Evidence-Based Practice (EBP) in the clinic has been slow in various departments and disciplines. In particular, according to studies, EBP use in the operating room is much less common than in medical wards.Aim: We aimed to evaluate the use of evidence-based practice in surgical care and identify barriers to its use among operating room and anesthesia nurses.Methods:We conducted a cross-sectional descriptive study using online survey tools on 251 operating room and anesthesia nurses from Mazandaran teaching hospitals who responded to the survey request (response rate 78%) on January 2021. EBP Implementation Scale (EBPI-Scale) and EBP BARRIERS Scale were used to assess the extent of evidence-based performance and barriers, respectively. Information on sociological and occupational characteristics of respondents was also collected.Results: The average use of evidence-based performance was 27.73 ± 8.73 (range: 0-72). The results showed that about 50% of participants had never used EBP in the past eight weeks. The EBP application showed an inverse relationship with age (p<0.01, r=-0.30) and work experience (p<0.01, r =-0.20). Education has a significant effect on the process of evidence-based performance (p<0.01). There was a positive correlation between EBP barrier scale and EBP utilization scale (P<0.01, r=0.34). The major barrier for the use of EBP were lack of authority to change patient care procedures.Implications for Practice: The results of this study can be used along with evidence-based information to plan the organization's strategy to increase the use of EBP into daily practice.

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.

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 Factors Associated With Nurses' Perceptions of Decisional Involvement.

The purpose of this study was to evaluate nurses' perceptions of decisional involvement (DI). Decisional involvement is a measure or gauge of nurses' perceived shared leadership. There has been limited research examining factors associated with actual and preferred DI. A descriptive, observational study design was used. A total of 189 RNs completed the Decisional Involvement Scale and Evidence-Based Practice Implementation Scale. Nurses' preferred DI (DI-P) and actual DI (DI-A) were analyzed, and DI total and subscale scores were compared based on nurses' demographic and clinical practice characteristics. The DI-A and DI-P total scores were significantly different, including subscales for DI-A compared with DI-P score. Dissonance scores by subscale were highest for recruitment, governance, and support. Unit-based council (UBC) participants had significantly higher actual DI, compared with non-UBC participants. Nurses' perceptions of implementing evidence-based practice (EBP) was not significantly different by low versus high EBP implementation; nor were the scores significantly correlated with their DI-A or DI-P scores. Findings indicate nurses' perceptions of DI-A and DI-P. This study provided further examination of the differences and interrelationships between DI and nurses' demographic and clinical practice characteristics. Dissonance DI scores provide opportunities for targeting interventions to engage nurses in shared leadership.

A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: Development, implementation, and preliminary outcomes

Improving outcomes and quality of care through evidence-based practice (EBP) is a priority globally. But most nurses have insufficient competence in EBP. How to conduct Educational interventions to enhance clinical nurses' EBP competencies and critical thinking disposition (CTD) requires more evidence. One hundred eleven clinical nurses from a Chinese four-campus hospital were enrolled in our EBP education program. The Johns Hopkins Nursing Evidence-Based Practice Model was used to develop and guide the educational and practical sessions. Multi-dimensional learning strategies —including online self-learning, on-site lectures, workshops, and social media-facilitated group discussions—were used to facilitate the implementation of the education sessions. After education, nurses embedded evidence into practice. The Chinese versions of the EBP Believe scale (EBPB), EBP Implementation scale (EBPI), and the Simplified Chinese Version of the Critical Thinking Disposition Inventory (CTDI-SCV) were applied to assess the relevant competencies among clinical nurses before and after the education program. Clinical nurses' EBPB, EBPI, and CTDI-SCV scores improved. But only EBPB and EBP skills and attitudes were enhanced with a statistical difference (t = −2.980, −4.141, and −2.695, with all p < 0.01). There was a small positive association between EBPB and CTDI-SCV (r = 0.396, p < 0.01). Fifteen EBP programs were successfully accomplished.

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.

Effect of Educational Program regarding Evidence Based Practice on Beliefs and Implementation among Clinical Instructors.

Background: Evidence-based practice (EBP) is a systematic approach to improving the quality of nursing practice.Aim: The current study aims to investigate the effect of educational program regarding evidence based practice on beliefs and implementation among Clinical instructors. Design: A quasi-experimental research was utilized. Setting: The study was carried out at Faculty of Nursing, Minia University. Subjects: convenient sample of all available (78) clinical instructors who were working in a six Departments in Faculty of Nursing at Minia University at the time of conducting the study. Tools: Two tools were used; the Evidence-Based Practice Beliefs (EBPB) Scale, and the EBP implementation (EBPI) scale. Results: showed that total mean scores of clinical instructors' evidence-based practice implementation was increased post program than pre-program and follow up session was increased than pre and post program and total mean scores of clinical instructors' evidence-based practice beliefs was increased post program than pre-program and follow up session was increased than pre and post program with highly statistically significance differences which P – value .0001 respectively. Conclusion: Findings of the research demonstrated that education can affect the clinical instructor’s belief and implementation to use EBP. Recommendations: Repetition of the educational program in other nursing Faculties needs to be done on the use and implementation of EBP.

Evidence-Based Practice and Associated Factors Among Health Care Providers Working in Public Hospitals in Northwest Ethiopia During 2017

Background: Despite the fact that evidence-based practice (EBP) is believed to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia is not evidence-based. Understanding the extent of and barriers to EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia.Objective: This study aimed to assess reported level of EBP and associated factors among health care providers working in public hospitals in northwest Ethiopia.Methods: A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire that was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP Implementation Scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation.Results: The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β = –0.10; P < 0.05); having been trained as a bachelor's degree-level nurse (β = 3.45; P < 0.001) or a bachelor's degree-level midwife (β = 2.96; P < 0.001), a general practitioner (β = 7.86; P < 0.001), or a specialist physician (β = 15.04; P < 0.001) rather than a diploma-level nurse; working in a pediatrics ward (β = –1.74; P < 0.05); and reporting as barriers either a lack of clarity on the importance of EBP (β = –0.93; P < 0.05) or a lack of orientation sessions on new health priorities (β = –0.91; P < 0.05).Conclusions: Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)

Validation of the SYdney Shared and Evidence-based decision-Making test (SYStEM) among healthcare professionals

PurposeWhilst competence in evidence-based practice (EBP) is a critical skill for healthcare professionals, there is a gap in the literature in the assessment of EBP. Current frameworks in Evidence-Based Practice education cite a five-step process (Ask, Acquire, Appraise, Integrate and Evaluate) yet many existing measures of competence focus on the first three, relying on self-report and cognitive testing, falling short of assessing skills. The Fresno Test has been validated for assessing the first three steps and the “Assessing Communication about Patient Preferences” tool is reliable in capturing the quality of information given by physicians in integrating evidence. The Evidence-Based Practice Implementation Scale is useful for the ‘evaluate’ step in the EBP process. We adapted components from all three of these tools to create the SYdney Shared and Evidence-based decision-Making test (SYStEM) in order to measure EBP and Shared Decision Making (SDM) competencies in the context of patient care. The aims of this study were to examine the internal structure, criterion and consequential validity of the SYStEM. MethodData were available from 37 healthcare practitioners who completed the SYStEM online. We conducted a confirmatory factor analysis to determine the theoretical structure and a modified Angoff method to determine a minimum competence level for newly graduated health professionals. ResultsThe final 10-item SYStEM consisted of two subscales: ‘EBP knowledge’ and ‘SDM skills’ demonstrating good construct validity and reliability (α > 0.74). The factorial validity of SYStEM was shown by all items loading significantly on their expected factors and a good fit to the data. Although the benchmark for passing the SYStEM was low, only 13/37 practitioners (35%) reached the minimum standard for EBP competence. DiscussionThis study provides preliminary evidence for the validity the SYStEM tool for measuring EBP competence amongst health graduates. Further large-scale validation of SYStEM is required.

The impact of a small-group educational intervention for allied health professionals to enhance evidence-based practice: mixed methods evaluation

BackgroundHealthcare professionals are recommended to use evidence-based practice (EBP) principles to update and improve clinical practice. Well-designed educational initiatives, together with practice and feedback opportunities can improve individuals’ EBP knowledge, skills and attitudes.MethodsA concurrent mixed methods assessment was designed to evaluate the effectiveness and feasibility of four monthly workshops on allied health professionals’ knowledge, skills, self-efficacy and behaviour. In between workshops, professionals were encouraged to practice and integrate EBP learnings with colleagues in their workplace.Participants completed three pre and post intervention assessments: Evidence-based Practice Confidence Scale; adapted Fresno test; and an adapted EBP Implementation Scale. A purpose designed satisfaction questionnaire was completed immediately after the educational intervention and follow up focus groups were conducted after 3 months.Mean change in assessment data was quantitatively assessed and comments from the clinician satisfaction questionnaire and focus groups were thematically analysed and interpreted together with quantitative data using the Classification Rubric for EBP Assessment tools in Education (CREATE).ResultsSixteen allied health professionals participated in the EBP workshops and completed all baseline and post intervention assessments. Seven clinicians participated in follow up focus groups. All clinicians reported a positive reaction to the learning experience, preferring short monthly workshops to a full day session. They self-reported improvements in self-efficacy (mean change 15 p < 0.001) and implementing EBP behaviours (mean change 7, p < 0.001) from pre- to post-intervention. Although the positive change in EBP knowledge measured by the adapted Fresno test was not statistically significant (mean change 10, p = 0.21), clinicians described examples of improved knowledge and skills across all five key steps of EBP during the focus groups. A further, post hoc analysis of individual questions in the two self-reported scales indicated consistent improvement across key EBP knowledge and skills.ConclusionsA tailored small group EBP education intervention can enhance AHPs’ self-efficacy to develop answerable questions, search the literature, critically appraise, apply and evaluate research evidence. Through practicing these behaviours and sharing new learning with their peers, allied health professionals can enhance their capability and motivation to use research evidence to potentially improve clinical practice.

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.