Evidence-based Practice Movement Research Articles

Knowledge, skills, attitudes, beliefs, and implementation of evidence‐based practice among nurses in low‐ and middle‐income countries: A scoping review

AbstractBackgroundOver the past three decades, research studies on nurses' engagement in evidence‐based practice (EBP) have been widely reported, particularly in high‐income countries, with studies from these countries dominating literature reviews. As low‐ and middle‐income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP.AimsThe aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs.MethodsThe JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full‐text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis.ResultsFifty‐three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal.Linking Evidence to ActionStudies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Nurses’ Perception on Evidence Based Practice in Tertiary Hospital of Nepal: A Quantitative Cross-sectional Study

Background: The evidence-based practice movement has spread globally, prompting calls for evidence-based policymaking and public health. Health care being the dynamic discipline with research, is, intended to improve practice through evidence-based novel approaches. As evidence based practice (EBP) among nurses is essential for improving the quality of care, fewer pieces of evidence are available in Nepal. This study aimed to assess the perception of evidence-based practice among nurses of a tertiary hospital in Nepal. Methods: We conducted a quantitative cross-sectional study among the 100 nurses of Bir Hospital in Kathmandu. The self-administered questionnaires were applied using the survey instrument by Upton and Upton. A purposive sampling technique was employed. We calculated the mean score to assess the nurses’ perceptions in the three sub-scales of knowledge, attitude, and use of evidence-based practice. Bivariate analysis was performed to examine the relationship between subscales. Results: The majority (89.0%) of nurses did not receive training on evidence-based practices. The mean score of knowledge on EBP was 4.47±1.11, the mean score of attitude on EBP was 4.45±1.06, and the mean score of EBP use was 4.18±1.42. EBP knowledge, attitude, and use were not significantly associated with the selected demographic variables (age, work experience, EBP training and marital status). Conclusion: Nurses’ perceptions of evidence-based practice were moderate. The implementation of EBP use needs to be strengthened among the nurses. Nurses need to be more involved in the implementation of EBP. To incorporate evidence in practice, nurses require training and support from high authorities.

A compendium of evidence-based practice instruments for nursing education, practice and research.

Evidence-based practice (EBP) is a cornerstone for safe, high-quality care. Implementation science recognizes that many factors influence the successful use of EBP, from attitudes and beliefs, self-efficacy, and knowledge and skills to contextual factors related to unit and organizational culture. This integrative review aimed to identify valid and reliable instruments measuring critical EBP domains with nursing professionals. A systematic search of the literature was conducted. CINAHL, PubMed, EMBASE, Cochrane, and Joanna Briggs were searched to identify original research publications testing the reliability and validity of EBP nursing instruments. Of 347 records, 48 studies representing 50 instruments were identified as having undergone psychometric testing, thus meeting the inclusion criteria. Most instruments were validated in English-speaking countries. Content validity, construct validity, and internal consistency standards were met for 70%, 62%, and 94% of instruments, respectively. Limited testing was found for other types of validity, test-retest reliability, acceptability, feasibility, or responsivity and sensitivity, thus representing gaps in psychometric validation. Less than 20% of instruments have been translated to other languages limiting their use to advance EBP worldwide. Eighty-two percent of instruments met minimal psychometric standards and are sound for education, practice, and research. Expanding psychometric testing and utilizing validated EBP instruments will further the EBP movement to improve global population health.

Telos of Special Education for Students with Severe Disabilities

ABSTRACT We overview several key issues of the past, present, and near future of special education for students with severe disabilities. We contextualize the Telos of special education by briefly remarking on its historical roots in the United States, then delve into several issues we believe are critical for advancing toward better outcomes for students with severe disabilities, including the increasingly alarming shortage of special education teachers and short-sighted responses to address it. We also discuss issues related to curricular decisions, and the apparent tension between access to general education (i.e. academic) curriculum and teaching other life altering repertoires for students with severe disabilities. Attention also is given to the evidence-based practices movement in special education, including the apparent rigidity of intervention protocols and slow advances toward clarifying for whom and under what conditions an intervention is effective. Our intention is to generate discussion about and interest in areas where consensus among stakeholders appears feasible such that policy and law can be influenced in ways that advance toward realizing the Telos of special education for students with severe disabilities.

Den mätande socialtjänsten

The measuring social service organization – the use of individual-based systematic follow-up of interventions For the past two decades, national policy in Sweden has repeatedly argued that social services should follow the principles of evidence-based practice (EBP) and that intervention effects should be informed by research. Conversely, there is a recurring critique against the “EBP movement” concerning a too narrow view of evidence and limited applicability in social services. Despite these differences, common perceptions advocate a need for local and systematic production of knowledge about the significance of interventions for service users. Individual-based systematic follow-ups (ISF) of interventions aggregated at group level could be a relatively undisputed path towards an increased knowledge base of social services. Therefore, the article examines and problematizes different dimensions of how ISF is practiced and how results come into use in social services. The research was conducted within social service units providing non-institutional treatment for children, young people, and families in two Swedish municipalities. Both have several years of experience using the ISF models LOKE (Local Evidence) and FIT (Feedback-Informed Treatment) respectively. The empirical material consists of 8 observations, 45 documents, and 21 interviews with family therapists, heads of units and departments, executive directors, and development officers. The findings reveal a wide range of types of use of ISF, which both overlap and presuppose each other and where the use differs depending on the user’s organizational level and role. Although the results are rarely used for development purposes in distinct ways, it is noted that the ISF models and their results play important roles within the organizations, for example strategic, legitimacy-enhancing and conceptual perspective-giving, which also affect work within the units.

The Future of INCOG (Is Now).

The Future of INCOG (Is Now).

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: a scoping review protocol.

The objective of this scoping review is to identify and map the evidence reporting the knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries. Evidence-based practice aims to improve health care quality, safety, and health system efficiency. Numerous research studies have explored nurses' engagement in evidence-based practice in high-income countries. Developing nations have recently joined the evidence-based practice movement, and primary research about nurses' engagement with it are emerging. The scoping review will include primary studies (quantitative, qualitative, and mixed methods) and gray literature addressing knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses. Participants will include registered nurses working in low- and middle-income countries. Studies conducted in all health care settings, including acute and community settings, in low- and middle-income countries will be included. We will search MEDLINE, Embase, CINAHL, Scopus, ERIC, JBI Evidence-based Practice Database, Cochrane Library, LILACS, and AIM. Gray literature will be sourced from ProQuest Dissertations and Theses Global and Google Scholar for primary studies. Studies published in the English language will be included, with no limit on publication date. Titles, abstracts, and full-text articles will be assessed against the inclusion criteria by 2 independent reviewers. The extracted data will be analyzed quantitatively using frequencies and counts. Textual data from qualitative studies will be analyzed using descriptive content analysis. Results of the data analysis will be presented using graphs, tables, and a narrative format. Open Science Framework ( https://osf.io/hau5y ).

How and Why Context Matters: A Personal Reflection Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis".

This commentary acknowledges that the evidence-based practice (EBP) movement did not automatically or initially understand the impact of context on successful implementation (SI). The subsequent work of research teams, such as the PARIHS (Promoting Action on Research in Health Services) team, and the Ottawa team led by Squires, have contributed to the ongoing refinement of the concept. However, still under discussion is whether having a more comprehensive set of contextual attributes will necessarily lead to more implementation success. Just as the strength of the evidence does not automatically lead to implementation success, so having a comprehensive understanding of contextual factors will not necessarily improve implementation uptake.

Nursing Theory Makes a Practice Turn in the 21st Century

The author assumes that practice became prominent in nursing theory in the first two decades of the 21st century. The end of the last century saw a burgeoning of literature on what is known as grand theories, their implementation, and evaluation. The era of healthcare quality research began when the Institute of Medicine issued a report on building a safer health system. At this time, the 21st-century literature in nursing took a distinct turn toward practice, influencing nursing theory. The movement to individualize care acted to further this influence. The nurse and patient relationship is the source of data for knowledge development. Established research approaches such as grounded theory and new approaches such as story theory were being used to create nursing theory from practice. Grand theory work moved to the development of instruments to measure the effects of theory in practice, such as that of Watson and Roy. The middle-range theories were developed and seen as closer to and easier to use in practice. The evidence-based practice movement also contributed to the role of theory in practice. These knowledge developments led to nurses having expanded roles in nursing.

EVIDENCE-BASED PRACTICE TEACHING INTEGRATION IN COLLEGE NURSING STUDIES: HISTORICAL AND LEGAL ASPECTS

To better understand and analyze the education of evidence-based practice, it is necessary to review the context and premises of the formation of evidence-based practice itself. The beginning of the evidence-based practice movement in the teaching of health professionals’ dates back to 1910 and looking at the health care system; first, there was evidence-based medicine. In 1990, Sackett's initiative at McMaster University in Canada, it was decided to change the term "evidence-based medicine" to "evidence-based practice" (Mackey Bassendowski, 2017; Thom Eaves, 2015). In nursing, the beginning of evidence-based practice is linked to the reforms of nursing science and practice by the first nursing researcher, Florence Nightingale, from 1854 to 1910, although the term of “evidence-based practice” was not yet known at the time. The professional training of nurses as one of the leading health professionals is related to health policy and the development of nursing science. The European Qualifications Framework (EHEA) defines the expected learning outcomes for professionals with a bachelor's degree, including the skills to find, evaluate, reflect, and apply scientific information in practice (Bologna Working Group, 2005). Despite international and national recommendations, it is difficult for many higher education institutions to refine the steps of teaching evidence-based practice in nursing study programs. These difficulties are revealed by the ambiguity in the definition of the concept of evidence-based practice (Horntvedt et al. 2018).The problematic question is: What is the basis for integrating evidence-based practice training into college nursing study programs?The study is based on the scientific literature review.

From the Ivory Tower to the Treatment Trenches: Bridging the Gap between Research and Practice.

The evidence-based practice (EBP) movement in social work has challenged the traditionally insular relationship between research and practice, demonstrating a critical need for more reciprocity. Despite a proclaimed commitment to EBP in social work, an implementation gap persists (Bellamy, Bledsoe, & Traube, 2006). This commentary identifies factors that have contributed to the gap between research and practice and proposes solutions to bridge this divide. EBP originated in the field of medicine and emphasizes the systematic use of research in the decision-making process of patient care (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). EBP tasks researchers with conducting and synthesizing treatment research to develop best practices and clinicians with identifying and implementing appropriate EBPs and evaluating client response in a systematic manner. Clinicians can implement the EBP approach in a four-step process: (1) formulating a question, (2) appraising relevant literature, (3) applying data to the clinical context, and (4) evaluating outcome-based measures of the novel intervention (Edmond, Megivern, Williams, Rochman, & Howard, 2006).

Exploring readiness for implementing best practices: A mixed methods study.

Evidence-based practice (EBP) can improve health care in underprivileged countries. Bolivia's EBP movement is nascent and the factors contributing to better implementation in nursing are unknown. To explore Bolivian nurses' readiness to engage in EBP while highlighting the facilitators and barriers for pursuing EBP. The study used a sequential explanatory mixed methods study. First, general trends were disclosed via a survey of 170 nurses in La Paz, Bolivia, holding at least a baccalaureate regarding their perceived beliefs about EBP. The survey identified facilitators and barriers for implementing EBP in acute and ambulatory settings. Second, qualitative data was gathered via a focus group of nine nurses with the purpose of enhancing the survey results. The survey results showed that nurses believe that engaging in EBP can improve their clinical practice. However, the nurses' research behaviors were found to be infrequent. Lack of support from the nurses' clinics and hospitals and from non-nursing professionals were identified as barriers for engaging in EBP. The qualitative results revealed underlying limitations to nurses' clinical practice, including "feeling undervalued". There is a dearth of EBP knowledge among Bolivian nurses stemming from a lack of preparation in EBP environments, including EBP training opportunities. This situation affects nurses' professional dimensions of relational work, power, and collaboration. Collaborative research among educators, professional nursing societies, and local and international organizations could provide initiatives for implementing EBP, based on local health profiles.

A Review of Treatment Decision-Making Models and Factors in Mental Health Practice

Treatment decision making has been influenced by the evidence-based practice movement, which encourages practitioners to make decisions based upon current research evidence, practice wisdom and ethics, and client values or preferences. This article offers a review of the treatment decision-making literature to identify decision-making drivers based on characteristics of the therapist and client. The narrative review includes surveys, case studies, and naturalistic studies of factors and processes involved in treatment decision making for mental health treatment. Naturalistic studies of decision-making factors reveal client problem formulation and motivation have a significant impact on treatment decision making. Implications for the conceptualization of evidence-based practice in social work and future directions for research in decision making are discussed.

What are the Key Characteristics of a 'Good' Psychotherapy? Calling for Ethical Patient Involvement.

ObjectiveThe evidence-based practice movement clearly defines the relevant components of a good treatment. In the present article, we elaborate on how the active involvement of patients within psychotherapy can and should be increased in order to respect ethical considerations. Our arguments complement the requirements of evidence-based practice, and are independent of the actual psychotherapeutic treatment approach being used.MethodTheoretical and ethical analysis.ResultsIn order to respect patient autonomy, psychotherapy needs to be transparent and honest when it comes to disclosing the relevant factors for promoting therapeutic change. It has been argued that ethical informed consent needs to include empirically supported patient information. In this paper we go one step further: we outline that fully respecting ethical considerations in psychotherapeutic treatment necessarily calls for acknowledging and strengthening the active role of patients in the course of psychotherapy. Accordingly, patients need not only to be informed openly and transparently about the planned treatment, the treatment rationale, and the expected prognosis of improvement in the course of psychotherapy, but they also need to be actively involved in the decision-making process and during the entire process of psychotherapeutic treatment.ConclusionsOur arguments support the tendency that can be observed in health care in recent years towards more active patient involvement across different health-care domains, but also in clinical research. This article offers an ethical perspective on the question what defines a ‘good psychotherapy', which, hopefully, will help to leave behind some of the ongoing psychotherapy debates and move the field forward.

Collaboration, critique, diversity

Collaboration, critique, diversity

Autism Spectrum Disorder Interventions in Mainland China: a Systematic Review

Research on effective interventions for autism spectrum disorder (ASD) has historically been focused on Western populations and little is known in China. This literature review sought to determine the current state of ASD intervention research in mainland China, with respect to the evidence-based practice (EBP) movement in the treatment of ASD. A methodical search process of refereed articles yielded 33 studies from 2003 through August 2018 meeting the selection criteria for inclusion and analysis. The majority of articles (76%) used either a true EBP or an idiosyncratic behavior intervention package (IBIP) including at least one EBP to treat ASD. The total number of articles, and the number of articles testing IBIPs, has risen sharply in the past few years. Of studies testing true EBPs, the most popular EBP (n = 3) was parent-implemented intervention. All studies, regardless of the type of intervention, only included children or young adolescents. Although more definitive conclusions cannot be drawn without a meta-analysis of the literature, parent-implemented intervention of established interventions for ASD appears to be a promising route for mainland China until resources are more sufficient throughout the country, as these can be both evidence-based and culturally competent. Future research should include a meta-analysis of interventions for ASD in mainland China, as well as more rigorous testing of true EBPs and IBIPs that truly meet the needs of autistic individuals in China.

Research awareness among children's nurses: An integrative review.

Developing nursing research skills, awareness and research utilisation are important for improving healthcare outcomes and are key to ensuring the full understanding and knowledge base necessary for optimal delivery of care. Nevertheless, little is known about research awareness in children's nurses. To address this issue, an integrative literature review was conducted for studies published between January 2007 and January 2017 to obtain up-to-date evidence about the extent of research awareness and utilisation among children's nurses. Using PubMed, Cochrane Library, ILISI and CINAHL databases, 21 studies related to children's nurses' research awareness were included in the final review, which was later developed and structured in keeping with PRISMA checklist and guidelines. The studies isolated show that nurses' knowledge about and utilisation of research vary and that there are many existent barriers to and facilitators of evidence-based practice in the paediatric setting. Some studies report that introducing a cultural and/or change in clinical practice change to improve research utilisation can have positive impacts on healthcare outcomes and the quality of nursing care of children. It is recommended that structured approaches to improving research utilisation be considered and additional research is needed to explore the benefits of these approaches. Despite more than three decades of the evidence-based practice movement within nursing, barriers still exist among children's nurses in the use of research in practice. If the use of research to improve the delivery of children's nursing care is to become a reality, then nurses' research awareness needs to improve to underpin care delivery with optimal evidence in a cohesive informed manner.

Pedagogical Considerations for Educators Teaching an EBP Curriculum. A Guide for Educators Delivering a Bachelor of Health Science(Naturopathy) in Australia

The effective translation of research findings into clinical practice is a significant challenge to the evidence-based practice movement. In response, implementation science (IS) – the study and application of methods to facilitate the integration of research findings and evidence into healthcare policy and practice – has emerged over recent years.While IS has been developed for a wide range of health care settings and disciplines, there has been a paucity of critical discourse on the role of IS in complementary medicine (CM) practice – an area of health care that has gained increasing popularity across many countries and in addition, introduces a number of unique and significant challenges with regards to IS and research translation. In addressing this significant knowledge gap, this paper identifies a number of core features and considerations instrumental in progressing the examination and application of IS to CM-related practice and clinical decision-making.IS (and its scientific study/practice) is a contemporary scholarly field that cannot be dismissed by those invested in ensuring that CM research is, and remains, practice-, practitioner- and patient-relevant.

The sexist algorithm.

Algorithmic risk assessment tools are informed by scientific research concerning which factors are predictive of recidivism and thus support the evidence-based practice movement in criminal justice. Automated assessments of individualized risk (low, medium, high) permit officials to make more effective management decisions. Computer-generated algorithms appear to be objective and neutral. But are these algorithms actually fair? The focus herein is on gender equity. Studies confirm that women typically have far lower recidivism rates than men. This differential raises the question of how well algorithmic outcomes fare in terms of predictive parity by gender. This essay reports original research using a large dataset of offenders who were scored on the popular risk assessment tool COMPAS. Findings indicate that COMPAS performs reasonably well at discriminating between recidivists and non-recidivists for men and women. Nonetheless, COMPAS algorithmic outcomes systemically overclassify women in higher risk groupings. Multiple measures of algorithmic equity and predictive accuracy are provided to support the conclusion that this algorithm is sexist.

The Medicalization of Nursing: The Loss of a Discipline's Unique Identity

The authors propose that the evolution of the role development for generalist and advanced practice nursing is increasingly at odds with the contemporary scholarship of the discipline and ultimately betrays the unique identity and autonomy of the nursing profession. The development of the evidence-based practice movement in medicine and nursing is explored as the predominant theoretical framework guiding nursing practice. Professional challenges and recommendations to reclaim the unique nature of nursing are discussed with attention to the implications for the educator, clinician, and scholar.