#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture


Autoři: Jae Yong Yoo aff001;  Jin Hee Kim aff001;  Jin Sun Kim aff001;  Hyun Lye Kim aff001;  Jung Suk Ki aff002
Působiště autorů: Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea aff001;  Department of Nursing, Chosun University Hospital, Gwangju, South Korea aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226742

Souhrn

Background

This study aimed to identify clinical nurses’ evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt’s Advancing Research & Clinical Practice through Close Collaboration model as the first step.

Methods

A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP.

Results

Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation.

Conclusions

Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.

Klíčová slova:

Critical care and emergency medicine – Decision making – Korea – Korean people – Nurses – Nursing administration – Nursing science – Questionnaires


Zdroje

1. Sackett DL, Rosenberg WM, Gray JM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312:71. doi: 10.1136/bmj.312.7023.71 8555924

2. Balakas K, Sparks L, Steurer L, Bryant T. An outcome of evidence-based practice education: Sustained clinical decision-making among bedside nurses. J Pediatr Nurs.2013;28(5):479–85. doi: 10.1016/j.pedn.2012.08.007 22999987

3. Melnyk BM, Gallagher‐Ford L, Long LE, Fineout‐Overholt E. The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews Evid Based Nurs. 2014;11(1):5–15. doi: 10.1111/wvn.12021 24447399

4. Spruce L. Back to basics: implementing evidence-based practice. AORN J. 2015;101(1):106–14. doi: 10.1016/j.aorn.2014.08.009 25537331

5. Wilson M, Sleutel M, Newcomb P, Behan D, Walsh J, Wells JN, et al. Empowering nurses with evidence‐based practice environments: Surveying Magnet®, Pathway to Excellence®, and non‐Magnet facilities in one healthcare system. Worldviews Evid Based Nurs. 2015;12(1):12–21. doi: 10.1111/wvn.12077 25598144

6. Kim SC, Ecoff L, Brown CE, Gallo AM, Stichler JF, Davidson JE. Benefits of a regional evidence‐based practice fellowship program: A test of the ARCC model. Worldviews Evid Based Nurs. 2017;14(2):90–8. doi: 10.1111/wvn.12199 28178389

7. Melnyk BM, Fineout‐Overholt E, Giggleman M, Choy K. A test of the ARCC© model improves implementation of evidence‐based practice, healthcare culture, and patient outcomes. Worldviews Evid Based Nurs. 2017;14(1):5–9. doi: 10.1111/wvn.12188 28002651

8. Melnyk E, Mazurek B. An urgent call to action for nurse leaders to establish sustainable evidence‐based practice cultures and implement evidence‐based interventions to improve healthcare quality. Worldviews Evid Based Nurs. 2016;13(1):3–5. doi: 10.1111/wvn.12150 26766404

9. Mackey A, Bassendowski S. The history of evidence-based practice in nursing education and practice. J Prof Nurs. 2017;33(1):51–5. doi: 10.1016/j.profnurs.2016.05.009 28131148

10. Melnyk BM. Culture eats strategy every time: What works in building and sustaining an evidence‐based practice culture in healthcare systems. Worldviews Evid Based Nurs. 2016;13(2):99–101. doi: 10.1111/wvn.12161 27062247

11. Pearson A, Weeks S, Stern C. Translation science and the JBI model of evidence-based healthcare. Philadelphia, PA: Lippincott Williams & Wilkins; 2011. Available from: https://nursing.lsuhsc.edu/JBI/docs/JBIBooks/JBI_Model.pdf

12. Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: A guide to best practice: Philadephia, PA, Wolters Kluwer/Lippincott Williams & Wilkins; 2011.

13. Institute of Medicine, Committee on Assuring the Health of the Public in the 21th Century. The future of the public’s health in the 21st century. Washington, DC: National Academies Press; 2003. Available from: https://www.nap.edu/download/10548

14. American Association of Colleges of Nursing (AACN). The essentials of baccalaureate education for professional nursing practice. Washington, DC: American Association of College of Nursing; 2008 Available from: https://www.aacnnursing.org/Portals/42/Publications/BaccEssentials08.pdf.

15. Schaffer MA, Sandau KE, Diedrick L. Evidence‐based practice models for organizational change: overview and practical applications. J Adv Nurs. 2013;69(5):1197–209. doi: 10.1111/j.1365-2648.2012.06122.x 22882410

16. Choe MA, Bang KS, Park YH, Kang HJ. Current status and direction for future development of evidence-based nursing in Korea. Perspect Nurs Sci. 2011;8(2):129–38.

17. Cho MS, Song MR, Cha SK. Nurses' perceptions regarding evidence-based practice facilitators in a tertiary hospital. J Korean Acad Fundam Nurs. 2011;18(3):300–9.

18. Cho YA, Gu MO, Jeong JS, Eun Y, Kim SM, Jung IS, et al. Current status of evidence-based nursing in general hospitals in Korea. Evid Nurs. 2013;1(1):16–24.

19. Lim KC, Park KO, Kwon JS, Jeong JS, Choe MA, Kim J, et al. Registered nurses' knowledge, attitudes, and practice about evidence-based practice at general hospitals in Korea. J Korean Clin Nurs Res. 2011;17(3):375–87.

20. Oh EG, Oh HJ, Lee YJ. Nurses′ research activities and barriers of research utilization. J Korean Acad Nurs. 2004;34(5):838–48. doi: 10.4040/jkan.2004.34.5.838 15502449

21. Oh EG, Yang YL, Yoo JY, Lim JY, Sung JH. Mixed method research investigating evidence-based practice self-efficacy, course needs, barriers, and facilitators: From the academic faculty and clinical nurse preceptors. J Korean Acad Nurs. 2016;46(4):501–13. doi: 10.4040/jkan.2016.46.4.501 27615040

22. Park HY, Jang KS. Structural model of evidence-based practice implementation among clinical nurses. J Korean Acad Nurs. 2016;46(5):697–709. doi: 10.4040/jkan.2016.46.5.697 27857013

23. Kim JS, Gu MO, Jo SY. Factors influencing evidence-based practice readiness for tertiary general hospital nurses. J Korea Acad Industr Coop Soc. 2013;14(6):2945–57. doi: 10.5762/KAIS.2013.14.6.2945

24. Melnyk BM, Fineout-Overholt E, Gallagher-Ford L, Stillwell SB. Evidence-based practice, step by step: sustaining evidence-based practice through organizational policies and an innovative model. Am J Nurs. 2011;111(9):57–60. doi: 10.1097/01.NAJ.0000405063.97774.0e 21865934

25. Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence‐based practice at an academic medical center. J Adv Nurs. 2009;65(2):371–81. doi: 10.1111/j.1365-2648.2008.04878.x 19040688

26. Kang Y, Yang IS. Evidence-based nursing practice and its correlates among Korean nurses. Appl Nurs Res. 2016;31:46–51. doi: 10.1016/j.apnr.2015.11.016 27397818

27. Fineout-Overholt E, Melnyk B. Organizational culture and readiness scale for system-wide integration of evidence-based practice. Gilbert, AZ: ARCC, LLC; 2006.

28. Hauck S, Winsett RP, Kuric J. Leadership facilitation strategies to establish evidence‐based practice in an acute care hospital. J Adv Nurs. 2013;69(3):664–74. doi: 10.1111/j.1365-2648.2012.06053.x 22697406

29. Wallen GR, Mitchell SA, Melnyk B, Fineout‐Overholt E, Miller‐Davis C, Yates J, et al. Implementing evidence‐based practice: effectiveness of a structured multifaceted mentorship programme. J Adv Nurs. 2010;66(12):2761–71. doi: 10.1111/j.1365-2648.2010.05442.x 20825512

30. Melnyk BM. The evidence‐based practice mentor: A promising strategy for implementing and sustaining EBP in healthcare systems. Worldviews Evid Based Nurs. 2007;4(3):123–5. doi: 10.1111/j.1741-6787.2007.00094.x 17850493

31. Choi M, Kim HS, Chung SK, Ahn MJ, Yoo JY, Park OS, et al. Evidence‐based practice for pain management for cancer patients in an acute care setting. Int J Nurs Pract. 2014;20(1):60–9. doi: 10.1111/ijn.12122 24118273

32. Chung SK, Ahn MJ, Yoo JY, Choi M, Hyang N, Woo SR, et al. Implementation of best practice for chemotherapy‐induced nausea and vomiting in an acute care setting. Int J Evid Based Health. 2011;9(1):32–8. doi: 10.1111/j.1744-1609.2010.00198.x 21332661

33. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. doi: 10.3758/bf03193146 17695343

34. Jang IS, Park MH. Knowledge management, beliefs, and competence on evidence-based practice, evidence-based decision making of nurses in general hospitals. Korean J Adult Nurs. 2016;28(1):83–94. doi: 10.7475/kjan.2016.28.1.83

35. Upton D, Upton P. Development of an evidence‐based practice questionnaire for nurses. J Adv Nurs. 2006;53(4):454–8. doi: 10.1111/j.1365-2648.2006.03739.x 16448488

36. Melnyk BM, Fineout‐Overholt E, Mays MZ. The evidence‐based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews Evid Based Nurs. 2008;5(4):208–16. doi: 10.1111/j.1741-6787.2008.00126.x 19076922

37. Melnyk BM, Gallagher‐Ford L, Zellefrow C, Tucker S, Thomas B, Sinnott LT, et al. The first U.S. study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews Evid Based Nurs. 2018;15(1):16–25. doi: 10.1111/wvn.12269 29278664

38. Cho MS, Cho YA, Song MR, Kim MK, Cha SK. Development of a program to facilitate evidence-based practice based on the transtheoretical model. Korean J Adult Nurs. 2013;25(2):136–47. doi: 10.7475/kjan.2013.25.2.136

39. Nam ARN, Lee EH, Park JO, Ki EJ, Nam SM, Park MM. Effects of an evidence-based practice (EBP) education program on EBP practice readiness and EBP decision making in clinical nurses. J Korean Acad Nurs Adm. 2017;23(3):239–48. doi: 10.11111/jkana.2017.23.3.239

40. Kim SK, Lee HH, Park GH, Kim HJ, Choi JH, Park KG, et al. Nurses’ evidence-based practice beliefs and competencies, and organizational supports. J Korean Clin Nurs Res. 2018;24(2):245–54. doi: 10.22650/JKCNR.2018.24.2.245

41. Williams B, Perillo S, Brown T. What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review. Nurse Educ Today. 2015;35(2):34–41. doi: 10.1016/j.nedt.2014.11.012 25482849

42. Aiken LH, Sloane DM, Clarke S, Poghosyan L, Cho E, You L, et al. Importance of work environments on hospital outcomes in nine countries. Int J Qual Health Care. 2011;23(4):357–64. doi: 10.1093/intqhc/mzr022 21561979

43. Kim SY, Kim EK, Lim HM, Lee MY, Park KO, Lee KA. Structural equation modeling on nursing productivity of nurses in Korea. J Korean Acad Nurs. 2013;43(1):20–9. doi: 10.4040/jkan.2013.43.1.20 23563065

44. Chung HJ, Ahn SH. Relationship between organizational culture and job satisfaction among Korean nurses: a meta-analysis. J Korean Acad Nurs Adm. 2019;25(3):157–66. doi: 10.11111/jkana.2019.25.3.157

45. Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. Am J Nurs. 2010;110(3):58–61. doi: 10.1097/01.NAJ.0000368959.11129.79 20179464

46. Yoo JY, Oh EG. Level of beliefs, knowledge and performance for evidence-based practice among nurses experienced in preceptor role. J Korean Acad Nurs Adm. 2012;18(2):202–12.


Článek vyšel v časopise

PLOS One


2019 Číslo 12
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#