Readiness For Evidence-based Practice Research Articles

Barriers and facilitators influencing EBP readiness: Building organizational and nurse capacity.

Organizational supported evidence-based practice (EBP) enables nurses to be change agents and impact patient outcomes. Globally, a multitude of barriers limits EBP implementation, evaluation, and dissemination, which include time constraints, staff, resource access, education, technology, and fiscal support. These barriers and other disenfranchising elements hinder nurses' ability to actualize EBP and change practice within their workplace. This study describes the EBP readiness, barriers, and facilitators reported by inpatient registered nurses (RNs) employed in a nationwide healthcare system before COVID-19. The study employed a cross-sectional descriptive survey design using the 2005 Nursing EBP Survey for RN EBP readiness. The setting included 14 hospitals in Southern California. The survey was deployed in November 2016 and closed after 23 weeks. Descriptive statistics analyzed demographics and EBP scores, with inferential statistics for associations between demographics and EBP scores. ANOVA examined differences between EBP scores, service lines, years of employment, and education level. A content approach synthesized open-ended barrier and facilitator questions into seven specific themes. Seven hundred and twenty-four nurses completed the survey. Overall, the scores of inpatient RNs were highest scores for Practice Climate, suggesting the health system fosters a climate conducive to EBP. Scores were lowest for Data Collection and Implementation. Qualitative themes were: (1) Everyone Involved in EBP Implementation, (2) Fear and Resistance to Change, (3) Protected Release Time, (4) Knowing EBP Culture Outside of Current Organization, (5) Organizational Communication and Education, (6) Management and Leadership Support, and (7) Pragmatic Solutions to Facilitate EBP. Fear and Resistance to Change cut across all themes. Nurses at all organizational levels from the C-suite to the bedside can create strategies to determine essential EBP readiness components, including EBP mentors to guide knowledge uptake activities. Pragmatic solutions for EBP capacity require frontline nurse feedback, commitment, and partnership with nursing leaders.

Organizational culture and readiness for evidence-based practice in the Kingdom of Saudi Arabia: A pre-experimental study.

This study aims to establish postgraduate students' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces in the Kingdom of Saudi Arabia. Nurse shortages and a reliance on a transient nurse workforce have long been a challenge in the Kingdom of Saudi Arabia. Developing a home-grown nurse workforce, a key objective of the Government of Saudi Arabia, can help to address this. Evidence-based practice offers a mechanism to address this. Evidence-based practice implementation is heavily reliant on the prevailing organizational culture. Establishing the organizational culture and readiness for evidence-based practice is crucial for sustainable evidence-based practice implementation. A pre-experimental pilot study collected data from the same participants at three different points. As part of this, a questionnaire measuring organizational culture and readiness for evidence-based practice was administered twice. Descriptive, inferential and correlational statistics were employed to analyse the data. Results demonstrated improved participant perceptions of the organizational culture and readiness for evidence-based practice of their workplaces between the first (M= 76.58, SD= 19.2) and second (M= 92.10, SD= 23.68) data collection points, indicating moderate movement towards a culture of evidence-based practice. Strengths, challenges and opportunities for improvement were identified. This study established participants' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces, affording insight into context-specific strategies to embed evidence-based practice in health care organizations. Assessing an organization's culture and readiness for evidence-based practice (EBP) can afford insight on the strengths, challenges and opportunities that exist to equip nurse managers to advance evidence-based practice at individual, professional and organizational levels. This study demonstrated the importance of promoting an environment conducive to EBPand putting in place the necessary resources to support evidence-based practice implementation. Nurse managers can play a central role in this.

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."

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.

Evidence-Based Practice Culture and Mentorship Predict EBP Implementation, Nurse Job Satisfaction, and Intent to Stay: Support for the ARCC© Model.

The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.

Improving nurses\u2019 readiness for evidence-based practice in critical care units: results of an information literacy training program

BackgroundOne of the most important prerequisites for nurses’ readiness to implement Evidence-Based Practice (EBP) is to improve their information literacy skills. This study aimed to evaluate the impact of a training program on nurses’ information literacy skills for EBP in critical care units.MethodsIn this interventional study, 60 nurses working in critical care units of hospitals affiliated to Kerman University of Medical Sciences were randomly assigned into the intervention or control groups. The intervention group was provided with information literacy training in three eight-hour sessions over 3 weeks. Data were collected using demographic and information literacy skills for EBP questionnaires before and 1 month after the intervention.ResultsAt baseline, the intervention and control groups were similar in terms of demographic characteristics and information literacy skills for EBP. The training program significantly improved all dimensions of information literacy skills of the nurses in the intervention group, including the use of different information resources (3.43 ± 0.48, p < 0.001), information searching skills and the use of different search features (3.85 ± 0.67, p < 0.001), knowledge about search operators (3.74 ± 0.14, p < 0.001), and selection of more appropriate search statement (x2 = 50.63, p = 0.001) compared with the control group.ConclusionsNurses can learn EBP skills and apply research findings in their nursing practice in order to provide high-quality, safe nursing care in clinical settings. Practical workshops and regular training courses are effective interventional strategies to equip nurses with information literacy skills so that they can apply these skills to their future nursing practice.

Readiness and leadership in evidence-based practice and knowledge management: A cross-sectional survey of nurses’ perceptions

Although research on evidence-based practice (EBP) has been available for several decades, EBP has not been implemented successfully by nursing management. Evidence-based practice is a key area of knowledge management (KM), and EBP and KM are subject to similar challenges. However, there has only been limited research on KM and EBP within the context of nursing. The aim of this study was to describe and explain nurses’ perceptions of their own readiness for EBP, and their perceptions of the managerial and organizational support for enhancing competency and EBP. The study design was a cross-sectional survey carried out in accordance with STROBE. Data were collected from 125 nurses using two international instruments and one instrument developed for this study. The data were then analyzed using descriptive and multivariate statistics. Less than half of the nurses reported that their practices were often evidence-based, and only a third had often searched for evidence. The nurses perceived the weakest areas of management leadership to be arranging resources, solving problems and encouraging discussion in the context of EBP, and anticipation of nurses’ competency needs, ensuring competency and intervening when competency was inadequate in the context of KM. The results emphasize the need to develop nurse training, management leadership and an operational environment conducive to KM and EBP. Managers should take a more visible role in mentoring nurses for EBP and in identifying the developmental needs of nurses’ competencies.

Individual and organizational factors associated with evidence-based practice among physical and occupational therapy recent graduates: A cross-sectional national study.

Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate-level entry education to address graduates' readiness for evidence-based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence-based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence-based activities among graduates of professional OT and PT master's programs. A cross-sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence-based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis. 257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence-based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence-based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12). Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence-based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence-based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence-based professionals.

Physiotherapists\u2019 perceptions of challenges facing evidence-based practice and the importance of environmental empowerment in fall prevention in the municipality \u2013 a qualitative study

BackgroundFalls in older adults are an increasingly important public-health concern. Despite abundant research, fall rates have not been reduced, because implementation of evidence-based fall-prevention measures has been slow and limited. This study aims to explore physiotherapists’ perceptions on external factors, such as public policy, organisation and leadership, regarding the relation between knowledge translation and the three elements of evidence-based practice (EBP) to effectively address barriers and facilitate the uptake of EBP in fall prevention.MethodsWe conducted semi-structured interviews with 18 physiotherapists (men = 7; women = 11) working with fall prevention in the primary healthcare system. The physiotherapists ranged in age from 27 to 60 years (median 36 years) and had worked as a physiotherapist from 1 to 36 years (median 7 years). Data are analysed using thematic analysis.ResultsThe analysis revealed one main theme and four sub-themes. The main theme was ‘Environmental empowerment enhances physiotherapists’ capabilities for using EBP’. A resourceful work environment facilitates EBP, having access to information about research-based knowledge, supportive leadership, enough human resources and opportunities to learn and grow at work. The four sub-themes were as follows: 1) ‘Tension between attributes of research-based knowledge and organisational routines and practices’; 2) ‘Evidence must be informed by policymakers—What works?’; 3) ‘Empowering culture and work environment—A steppingstone to EBP’ and 4) ‘Organisation readiness for EBP, managerial and clinical relations’. Success in environmental empowerment depends on the leader’s role in creating preconditions at the workplace that may lead to important positive personal and organisational outcomes for EBP. Two-way communication and transfer-of-information are also key factors in the development of positive work engagement when using EBP.ConclusionThe findings of this study outline tension between policy, leadership, organisational facilitators and EBP. Leadership is influenced by policy with ripple effects for the organisation and clinicians. Organisational facilitators form structural empowerment, which is the foundation for creating an EBP environment.Trial registration2018/2227/REC south-east C. Registered 19 December 2018, Norwegian Ethics Committee for Medical and Health Research Ethics.

Development and Psychometric Testing of the Implementation Self-efficacy for EBP (ISE4EBP) Scale

There is inadequate research about nurses' confidence in implementation strategies that foster the application and sustainability of evidence-based practice (EBP). Guided by Bandura's self-efficacy theory, we propose that self-efficacy (confidence) in EBP implementation strategies can accelerate the uptake of evidence into practice to improve health care quality. The purpose of this study was to develop and test the psychometric properties of the Implementation Self-efficacy for EBP (ISE4EBP) scale as a measure for evaluating self-efficacy in using EBP implementation strategies. In a sample of 65 registered nurses, the 29-item ISE4EBP scale demonstrated adequate content validity (via content validity index), internal consistency reliability (Cronbach's alpha = 0.987), and construct validity indicated by associations with organizational readiness for EBP. Clinicians may use the ISE4EBP scale to identify areas for building implementation confidence to accelerate the uptake of evidence to improve quality care.

Evaluation of readiness of evidence-based practice for the prevention and management of deep vein thrombosis after spinal orthopedic surgery

Objective To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence. Methods A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA). Results The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness (P<0.05). Conclusion In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence. Key words: Evidence application; Readiness for evidence-based practice; Evidence-based nursing

A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Practice.

Implementation and sustainability of a culture of evidence-based practice (EBP) require a systematic approach. A baseline assessment of the organizational context can inform implementation efforts. To examine organizational hospital context and provider characteristics associated with EBP readiness and to describe EBP context across hospitals. A nonexperimental descriptive correlational design was used to conduct a web-based survey of direct-care registered nurses (N=701) and nurse managers (N=94) across a large Midwestern multisite healthcare system using the Alberta Context Tool (ACT). Many significant relationships existed among nurse characteristics and ACT domains, including age (lower age had higher Leadership, Evaluation, and Formal Interactions), education (graduate education had lower Social Capital than a bachelor's or associate degree), role (direct-care nurses had lower Culture than managers and lower Social Capital), and work status (full-time employees had lower Evaluation and Social Capital). EBP context across type of hospitals is similar, with marginal differences in Social Capital and Organizational Slack (higher in critical access hospitals). Assessing organizational context to support EBP is the first step in developing and enhancing a sustainable culture of inquiry. The ACT has been tested across countries, settings, and healthcare disciplines to measure perception of readiness of the practice environment toward EBP. Optimal organizational context is essential to support EBP and sustain the use of evidence in professional nursing practice. Nursing leaders can use baseline assessment information to identify strengths and opportunities to enhance EBP implementation. Enhancing organizational context across nurse characteristics (e.g., age, role, and work status) to acknowledge nurses' contributions, balance nurses' personal and work life, enhance connectedness, and support work culture is beneficial. Fostering development of Social Capital in nurses is needed to influence EBP readiness. A systematic and standardized approach to foster EBP across health systems is key to successful implementation.

Hospital nurses’ perception of evidence-based practice: A descriptive-analytical study

Background &amp; Aim: Evidence-based practice refers to the use of the best research evidence, personal knowledge and clinical expertise, and patients’ values and preferences for the provision of healthcare services. This study aimed to evaluate hospital nurses’ perception of evidence-based practice.&#x0D; Materials &amp; Methods: This descriptive-analytical study was conducted in 2015 on 374 nurses randomly recruited from five teaching hospitals in Ardabil and Khalkhal, Iran. Data were collected using the Evidence-Based Practice Questionnaire and analyzed through the SPSS software (v.13.0).&#x0D; Results: The total mean scores of nurses’ perception of evidence-based practice and its practice, attitude, and knowledge/skills domains were 107.40±18.76, 4.66±1.34, 3.63±1.48, and 4.63±1.03, respectively. The mean scores of these domains had significant correlations with each other (P&lt;0.05).&#x0D; Conclusion: Nurses’ perception of evidence-based practice is at moderate level and hence, they have moderate readiness for evidence-based practice. Coherent policies, educational strategies, and environmental improvements are needed to improve nurses’ perception of evidence-based practice.

Evidence based practice readiness: A concept analysis.

To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover.

Evidence-Based Practice and U.S. Healthcare Outcomes: Findings From a National Survey With Nursing Professional Development Practitioners.

Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners' EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities.

Students\u2019 attitudes and perceptions of teaching and assessment of evidence-based practice in an occupational therapy professional Master\u2019s curriculum: a mixed methods study

BackgroundMost health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students’ attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students’ perceptions towards the teaching and assessment of evidence-based practice within a professional master’s curriculum and their self-efficacy for evidence-based practice.MethodsThe study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings.ResultsAll student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous education had less favourable perceptions. Students’ self-efficacy for evidence-based practice was significantly higher across cohorts. Four main themes emerged from the focus group data: (a) Having mixed feelings about the value of evidence-based practice (b) Barriers to the application of evidence-based practice; (c) Opposing worlds and (d) Vital and imperfect role of the curriculum.ConclusionThis study provides important data to support the design and revision of evidence-based practice curricula within professional rehabilitation programs.

Readiness for and predictors of evidence base practice in Greek healthcare settings

BackgroundImplementation of evidence-based practice (EBP) remains limited in healthcare settings and knowledge of predictors of healthcare professionals' EBP activities is lacking. AimDescribe nurses' readiness for EBP and identify related predictors in Greek healthcare settings we conducted a survey. ResultsNurses scored high in the EBP readiness scale reflecting significant positive readiness toward EBP and consistently reported favourable attitudes toward and beliefs about EBP. However, half of them were unsure about their ability to engage in EBP despite the fact that they valued research-based practice as important. EBP specific domains including the “EBP-attitude”, the “EBP-knowledge”, the “Informational needs” and the “Workplace culture” and nurses' demographics as well, were found to be strong predictors of EBP readiness among Greek nurses. ConclusionAs nurses are now more aware of and open to the idea of EBP, diverse strategies and well-designed interventions to facilitate the desired change to practice are needed.

Building Strong Clinicians: Education Strategies to Promote Interest and Readiness for Evidence-Based Practice

The challenges of including evidence-based practice (EBP) and evidence-based treatments (EBTs) in social work education continue to be discussed in the literature. As the behavioral health system moves toward greater practitioner accountability and expanded implementation of EBTs, it becomes increasingly important to prepare students for this type of practice. A successful provider-developed curriculum, designed to prepare students for extensive EBT job opportunities in Connecticut, was disseminated to local graduate schools through a faculty fellowship. This article discusses provider and faculty perspectives about course design elements that contributed to its effectiveness, as well as how the course was subsequently adapted to online learning for Master of Social Work (MSW) students, with evidence of positive impact on clinician development.

Nurses' Evidence-Based Practice Beliefs and the Role of Evidence-Based Practice Mentors at University Hospitals in Finland.

Although systematic implementation of evidence-based practice (EBP) is essential to effectively improve patient outcomes, quality, and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' readiness for EBP, including nurses' EBP beliefs and lack of EBP mentors. Favorable EBP beliefs are foundational to Registered Nurses' (RNs) use and integration of best evidence into clinical decision making, whereas EBP mentors are in a key role for strengthening RNs' beliefs in the value of EBP and confidence in their ability to implement EBP. Although nurses' EBP beliefs and role of BP mentors have been widely studied in countries leading the EBP movement, less is known about them in the non-English-speaking world. To determine RNs EBP beliefs and the role of EBP mentors at Finnish university hospitals and to explore the associations between RNs' EBP beliefs and sociodemographic factors. A cross-sectional descriptive survey was conducted in November-December 2014 at every university hospital in Finland with a convenience sample (n = 943) of practicing RNs. The data were collected via an electronic survey, and analyzed using descriptive and inferential statistics. RNs reported low levels of EBP beliefs in the degree to which they believed that clinical nursing practice and their own practice were based on evidence. EBP mentors worked in many professional nursing roles. Several significant differences were found between RN's EBP beliefs and sociodemographic variables. Although RNs were familiar with and believed in the value of EBP in improving care quality and patient outcomes, their ratings were low about the degree to which they believed that clinical nursing practice and their own practice were based on evidence, indicating a modest level of individual EBP readiness among Finnish RNs required for integrating best evidence into clinical care delivery.

Knowledge and Competency of Nursing Faculty Regarding Evidence-Based Practice.

The Institute of Medicine recommended that 90% of clinical decisions should be evidenced based by 2020. Both the IOM and the American Association of Critical-Care Nurses identified evidenced-based practice (EBP) as a core competency for practice. EBP can reduce costs, improve patient outcomes, and ensure optimal nursing interventions. Because nursing faculty may have deficits in knowledge, attitudes, and competencies to teach EBP, few nursing students conduct EBP reviews. The purpose of this project was to develop EBP educational resources to increase nursing faculty knowledge and competency of EBP in a southeastern college with both a multicultural faculty and student body. A pre- and postsurvey design using Stevens' ACE Star Model of Knowledge Transformation and Evidence Based Practice Readiness Inventory (ACE-ERI) determined the effectiveness of the educational intervention. Results indicated that faculty's self-confidence about their competency in EBP increased significantly from presurvey to postsurvey, t(17) = -2.04, p = .028, but there was no significant change from pretest to posttest, t(17) = -0.576, p =.572, for the EBP knowledge component of ACE-ERI. The results of the study suggest that educational programs for RN-to-BSN faculty are vital in increasing participant's readiness for EBP. J Contin Educ Nurs. 2016;47(9):409-419.