Perceived Knowledge, Attitudes, and Implementation of Evidence-Based Practice Among Jordanian Nurses in Critical Care Units

Knowledge, attitudes, practice, and perceived barriers toward evidence-based practice among Palestinian nurses in intensive care units

BACKGROUND

Evidence-based practice (EBP) implementation can improve healthcare safety and patient outcomes. The significant challenge for intensive care nurses is providing safe and evidence-based care to patients with complex illnesses who are at high risk of complications and death. This study aimed to assess the knowledge, attitudes, and practice of EBP, and the perceived barriers to EBP implementation among nurses in intensive care units (ICUs) in the North West Bank hospitals.

METHODS

A cross-sectional descriptive correlational design was employed, with 154 registered nurses from governmental and private ICU hospitals in the North West Bank of Palestine participating. Data were collected using a self-reported questionnaire from December 2022 to July 2023.

RESULTS

The findings revealed that the attitudes mean was (M = 5.1 SD ± 1.1), followed by knowledge (M = 4.8, SD ± 1.4), and practice (M = 4.6, SD ± 1.2). The main barriers to EBP were insufficient time to find research reports (M = 3.5, SD ± 1.0) and inadequate time at work to implement changes in own practice (M = 3.4, SD ± 0.8). A correlation was found between knowledge, attitudes, and practice of EBP with Levels of education (t = 2.68, p < 0.01; t = 2.98, p < 0.01; t = 4.83, p < 0.01, respectively), attending EBP courses (t = 4.30, p < 0.01; t = 20.0, p < 0.01; t = 4.30, p < 0.01, respectively), and age (r = 0.159, p < 0.05; r = 0.234, p < 0.01; r = 0.289 p < 0.01, respectively). In contrast, the experience was associated with the practice of EBP (t = 1.77, p < 0.05).

CONCLUSION

The intensive care nurses had positive knowledge, attitudes, and practice of EBP, while attitudes were more favorable than knowledge and practice. Thus, the findings can assist policymakers and hospital administration in developing appropriate interventions and strategies, such as effective continuing education and developing and implementing a hospital-wide EBP culture to improve nurses' knowledge and practice of EBP.

Evaluation of an evidence-based practice education workshop focused on critical appraisal for advanced practice nurses: A before-after intervention study

BACKGROUND

Regarding the evidence-based practice (EBP) process, nurses tend to perceive that critical appraisal of research articles is challenging. Though critical appraisal in EBP has been a frequent topic in medical education, implementing and disseminating existing EBP education for nurses are challenging in countries with limited EBP educational resources. This study aimed to evaluate changes in practice, attitude, knowledge and skills of EBP before and after an EBP workshop focused on critical appraisal among advanced practice nurses.

METHODS

This study was a before and after educational intervention study. The workshops were provided in small groups in 2017 and 2018. The targeted nurses were certified nurse specialists (CNSs) who provide patient care and are certified as advanced practice nurses. The workshop was designed to include at least one CNS in each group. The Japanese version of the Evidence-based Practice Questionnaire, with four subscales-practice, attitude, and knowledge and skills of research and practice-was evaluated four times: baseline, immediately after the workshop, and 3 and 6 months after the workshop. At the end of the workshop, the participants wrote their learning objectives and plans for improving their critical appraisal of EBP. A self-reflection questionnaire was distributed 3 months after the workshop, and a qualitative descriptive analysis was used.

RESULTS

Eleven CNSs participated in this study. Only the score of the knowledge and skills of research showed a statistically significant change. Many participants did not perform critical appraisal of research articles after the workshop. The facilitators were to have a role in integrating research evidence into practice and the barriers to being too busy, personnel transfers, and insufficient conditions.

CONCLUSIONS

Self-efficacy for critical appraisal in EBP might increase through the EBP education workshop. Even nurses interested in EBP require ongoing learning opportunities and organizational support for EBP activities.

TRIAL REGISTRATION

This study was retrospectively registered with University hospital Medical Information Network Clinical Trial Registry (UMINCTR) on 09/14/2018 (Registration Number. UMIN000034146).

The Effect of Perceptions of Evidence-Based Practice on Endotracheal Cuff Pressure Management in Critical Care Nurses: A Correlational Cross-Sectional Multicentre Study

AIMS

This correlational cross-sectional multicentre study aims to achieve two objectives. Firstly, to assess nurses' knowledge and practice of endotracheal cuff pressure management. Secondly, to examine the relationship between endotracheal cuff pressure management knowledge and evidence-based practice leadership and work environment.

DESIGN

A correlational cross-sectional multicentre study design.

METHODS

This study was conducted among 144 intensive care nurses in Turkey. Data collection included descriptive characteristics and cuff pressure management of nurses, the Evidence-Based Practice Leadership Scale and Evidence-Based Practice Work Environment Scale. Descriptive statistics, chi-square test, Pearson correlation and receiver operating characteristics analysis were conducted. A STROBE checklist was the reporting guide for this study.

RESULTS

The success status of nurses in terms of knowledge related to cuff pressure was found significantly different according to the type of intensive care unit working in and the status of receiving training on evidence-based practice. A positive, strong relationship was found between nurses' mean scores on the Evidence-Based Practice Leadership Scale and the Work Environment Scale. There was a very weak positive correlation between the mean scores of the Evidence-Based Practice Leadership Scale and the cuff pressure management.

CONCLUSION

Adherence by nurses to current evidence-based practice for cuff pressure monitoring is essential for safe patient care and improved quality of care. It is recommended to provide both a supportive working environment and training programmes for intensive care nurses to perform cuff pressure management in line with evidence-based practice.

RELEVANCE TO CLINICAL PRACTICE

Providing educational programs, an appropriate clinical environment, support from health managers and access to appropriate tools are important considerations in increasing the knowledge and skills of intensive care nurses to effectively monitor and manage cuff pressure.

REPORTING METHOD

Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Factors Related to Evidence-Based Practices Among Mental Health Nurses in Thailand: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES

Despite the robustness of evidence-based practice in increasing efficiency in nursing care and improving patient safety, using evidence in practice is still rare in mental health nursing. This correlational descriptive research aimed to explore the factors and examine the relationship between attitudes, knowledge/skills, organizational culture, mentorship, and demographic factors to evidence-based practices among mental health nurses working in psychiatric hospitals in Thailand.

METHODS

The sample consisted of 255 nurses working in psychiatric hospitals under the Thai Department of Mental Health, located in service units across the country's four regions. The data collection tools included (1) a demographic questionnaire, (2) the Evidence-Based Practice Questionnaire: EBPQ, (3) Organizational Culture & Readiness for System-wide Integration of Evidence-Based Practice: OCRSIEP, and (4) the Evidence-Based Practice Mentorship Scale. Descriptive statistics and Spearman's correlation coefficient were used for data analysis.

RESULTS

The findings revealed that the factors positively correlated with evidence-based practice among mental health nurses in Thailand were attitude with a mean score of 4.90 (r = 0.39, p-value < 0.001), knowledge/skills with a mean score of 4.69 (r = 0.61, p-value < 0.001), organizational culture with a mean score of 3.94 (r = 0.26, p-value < 0.001), and mentorship with a mean score of 2.77 (r = 0.16, p-value = 0.011). Demographic factors such as educational level (r = 0.21, p-value < 0.001) and work experience in psychiatric and mental health nursing (r = 0.14, p-value = 0.031) were also positively correlated.

CONCLUSIONS

This research revealed that EBP knowledge and skills are the most significant factors related to evidence-based practice among Thai mental health nurses. Therefore, EBP knowledge and skills should be enhanced in the curriculum during the nursing study and through continuing education once nurses graduate. Organizational culture and mentorship also need to be promoted to strengthen the use of EBP in Thailand.

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

BACKGROUND

Over 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.

AIMS

The 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.

METHODS

The 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.

RESULTS

Fifty-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 ACTION

Studies 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.

Assessing perceptions of nursing knowledge, attitudes, and practices in diabetes management within Chinese healthcare settings

Background

Effective management of diabetes mellitus (DM) involves comprehensive knowledge, attitudes, and practices (KAP) by nurses, which is essential for optimal patient care and aiding patients in their self-management of the condition.

Method

This survey evaluates nurses' self-assessed knowledge, attitudes, and practices (KAP) related to diabetes management, focusing on their perceptions of personnel expertise and care approaches. Using a stratified sampling method, the survey was disseminated across various online platforms from January 2023 to February 2024 within China, including WeChat and Sina Weibo. We employed binary logistic regression and Chi-square tests to explore the statistical correlates of KAP related to DM.

Results

A total of 4,011 nurses participated, revealing significant perceived knowledge deficiencies in specialized DM management areas, with only 34% (n = 1,360) proficient in current pharmacological treatments. Attitudinal assessments showed that 54% (n = 2,155) recognized the importance of cultural competence in dietary counseling. Practices were strong in routine glucose monitoring (96%, n = 3,851) but weaker in psychological support (68%, n = 2,736). Regression analysis indicated significant effects of experience on KAP, where nurses with 1-5 years of experience were more likely to show better knowledge (OR = 1.09; p = 0.08), and those with advanced degrees demonstrated higher competence (OR = 1.52; p = 0.028). Marital status influenced attitudes, with single nurses more likely to exhibit positive attitudes (OR = 0.49; p < 0.001), and work environment impacted knowledge, with hospital-based nurses more knowledgeable (OR = 1.15; p = 0.14). Additionally, gender differences emerged, with male nurses showing greater knowledge (OR = 1.65; p = 0.03) and better practices in diabetes care (OR = 1.47; p = 0.04).

Conclusion

The study underscores the critical need for targeted educational programs and policy interventions to enhance nursing competencies in DM management. While the study provides valuable insights into nurses' perceptions of their competencies, future research should incorporate objective knowledge assessments to ensure a comprehensive understanding of their actual capabilities. Interestingly, the data also suggests a substantial opportunity to leverage technology and inter-professional collaboration to further enhance DM management efficacy among nurses, fostering an integrated care approach.

Evidence-based practice knowledge, attitude, practice and barriers as predictors of stay intent among Jordanian registered nurses: a cross-sectional study

AIM

This study aimed to identify factors influencing stay intent among Jordanian registered nurses, with a specific focus on the role of evidence-based practice (EBP) knowledge, attitudes, practices and barriers.

METHODS

A descriptive cross-sectional study of 311 nurses from 5 hospitals was conducted from January 2022 to June 2022. Participants completed data about stay intent and knowledge, attitude, practice and barriers of EBP. Data were analysed using SPSS program V.24.

FINDINGS

EBP attitudes, practices, knowledge and barriers significantly predicted stay intent, controlling for participants and workplace characteristics. Private hospitals (t=-4.681, Β=-0.287, p<0.001), having a library in the healthcare institution (t=-2.018, Β=-0.118, p<0.001) and adopter barriers (t=-1.940, Β=-0.105, p=0.05) were significantly associated with stay intent.

CONCLUSION

Our findings show that EBP influences Jordanian nurses' intent to stay. It highlights the importance of addressing EBP barriers, especially in private hospitals as well as library access issues, in enhancing nurse retention and healthcare outcomes in Jordan.

Development of an instrument to measure the competencies of health professionals in the process of evidence-based healthcare: A Delphi study

AIMS

To identify and reach consensus on dimensions and criteria of a competence assessment instrument for health professionals in relation to the process of evidence-based healthcare.

DESIGN

A two-round Delphi survey was carried out from April to June 2023.

METHODS

Consensus was sought from an expert panel on the instrument preliminarily established based on the JBI Model of Evidence-Based Healthcare and a rapid review of systematic reviews of relevant literature. The level of consensus was reflected by the concentration and coordination of experts' opinions and percentage of agreement. The instrument was revised significantly based on the combination of data analysis, the experts' comments and research group discussions.

RESULTS

Sixteen national and three international experts were involved in the first-round Delphi survey and 17 experts participated in the second-round survey. In both rounds, full consensus was reached on the four dimensions of the instrument, namely evidence-generation, evidence-synthesis, evidence-transfer and evidence-implementation. In round-one, the instrument was revised from 77 to 61 items. In round-two, the instrument was further revised to have 57 items under the four dimensions in the final version.

CONCLUSION

The Delphi survey achieved consensus on the instrument. The validity and reliability of the instrument needs to be tested in future research internationally.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Systematic assessment of nurses and other health professionals' competencies in different phases of evidence-based healthcare process based on this instrument provides implications for their professional development and multidisciplinary team collaboration in evidence-based practice and better care process and outcomes.

IMPACT

This study addresses a research gap of lacking an instrument to systematically assess interprofessional competencies in relation to the process of EBHC. The instrument covers the four phases of EBHC process with minimal criteria, highlighting essential aspects of ability to be developed. Identification of health professionals' level of competence in these aspects helps strengthen their capacity accordingly so as to promote virtuous EBHC ecosystem for the ending purpose of improving global healthcare outcomes.

REPORTING METHOD

This study was reported in line with the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies.

PATIENT AND PUBLIC CONTRIBUTION

No patient or public contribution.

Evidence-based practice attitudes, knowledge and skills of nursing students and nurses, a systematic review and meta-analysis

AIM/OBJECTIVE

This study aims to carry out a meta-analysis of attitudes, knowledge, and skills level of nursing students and nurses in EBP, providing a reference for optimizing EBP education strategies.

BACKGROUND

At present, no meta-analysis has been performed to quantitatively synthesize the attitudes, knowledge and skill levels of nursing students and nurses toward EBP. This makes it difficult to precisely identify the true level of EBP among nurses, implying that there is no evidence to support the adoption of EBP teaching strategies approaches.

DESIGN

A total of 9 Chinese and English databases including CNKI, Wan fang, VIP, CBM, PubMed, Embase, Web of Science, Cochrane Library and CINAHL were used to search cross-sectional quantitative articles on EBP attitudes, knowledge and skills level of nurses and nursing students. The search time limit was from the inception of the database to September 2023.

METHODS

Two researchers independently screened the literature and extracted the data. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the quality of the included studies. Stata15.0 software was used for statistical analysis to summarize the scores of EBP attitude, knowledge and skills level of nursing students and nurses included in the study.

RESULTS

A total of 25 cross-sectional studies from 13 countries were included, involving 11363 nursing students and nurses. The meta-analysis results revealed that nursing students and nurses lacked evidence-based practical knowledge and skills, with pooled mean scores of 3.06 (95 % CI: 2.72, 3.39), 2.91 (95 % CI: 2.60, 3.22), 4.31 (95 % CI: 4.08, 4.54) and 4.45 (95 % CI: 4.20, 4.70). In contrast, nursing students and nurses revealed a positive attitude towards EBP, with pooled mean scores of 3.57 (95 % CI: 3.28, 3.86) and 5.11 (95 % CI: 4.80, 5.42). Subgroup analysis revealed that senior nursing students and nurses with master's degree or above had higher attitudes, knowledge and skills.

CONCLUSIONS

In summary, nursing students and nurses have a positive attitude towards EBP. However, they seem to lack the necessary knowledge and skills. Therefore, nursing educators should consider this as an opportunity to strengthen the teaching of their evidence-based practical knowledge and skills. This will lay a reference for developing nursing discipline.

Implementation of evidence-based clinical practice and its associated factors among health care workers at public hospitals in Sidama regional state, southern Ethiopia

BACKGROUND

Health disparities, inconsistent outcomes, and underwhelming health services continue to be problems for all nurses and doctors. Studies from a variety of nations have found that doctors and nurses have little familiarity with evidence-based practice. There is a knowledge vacuum about the degree of evidence-based nursing practice and its contributing factors in Ethiopia as well as the current study region.

OBJECTIVE

The study's objective was to evaluate how healthcare professionals working in government hospitals in the Sidama regional state of 2022 are implementing evidence-based clinical practice and to identify associated factors.

METHODS

From October 1 to December 30/2022, a cross-sectional institution-based study with a mix of quantitative and qualitative methods was carried out. A total of 422 healthcare workers were randomly selected to participate in the current study from 6 randomly selected public hospitals in the region. This study included 25 key informant interviews. The Friedman test and Funk's BARRIER scale were adapted into a semi-structured questionnaire quantitative. Multivariable logistic regression was used to assess the significance of the association between the dependent and independent variables. A pretest was conducted on 22 healthcare workers from Shashmane Hospital.

RESULT

This study found that more than half, 51.7%, of the participants had a total implementation of evidence-based practice score below the mean score (40.4). only Access to the internet [having smart phone] (Adjusted Odds Ratio (AOR) = 3.03: 95% Confidence Interval (CI): (1.75-5.26))., favorable Attitude toward EBP of participants. (Adjusted Odds Ratio (AOR) = 1.84Confidence Interval (1.12-2.70)), inadequate Self-efficacy of Evidence-based practice skills (Adjusted Odds Ratio (AOR) = 0.29 Confidence interval = 0.19-0.46), and Knowledge of evidence-based practice (Adjusted Odds Ratio (AOR) = 0.45 Confidence interval = 0.30-0.77)were factors significantly associated with EBP implementation.

CONCLUSION

More than half of the participants,51.7%, do not implement evidence-based practice in the care of their clients, which is unacceptable. The use of EBP has been significantly associated with access to the internet (having a smartphone), participants' positive attitudes toward it, their level of skill efficacy in finding and accessing it, and their knowledge of it. Therefore, stakeholders ought to think about addressing these obstacles to the adoption of EBP.

Nurses' experiences and perspectives regarding evidence-based practice implementation in healthcare context: A qualitative study

AIM

To explore nurses' experiences and perspectives about evidence-based practice (EBP) implementation in the healthcare context.

DESIGN

A qualitative descriptive study design using focus group discussions (FGDs).

METHOD

Sixty-four nurses who purposefully selected and worked at various healthcare organizations in Bisha Governorate, Saudi Arabia, were included. Eight FGDs were used to obtain data using open-ended questions. The collected data underwent inductive qualitative content analysis.

RESULTS

Two main categories were extracted: experiences and perspectives towards EBP. The experiences category emerged into four sub-categories: familiarity with concepts and benefits, steps, dissemination sources of EBP and sources of EBP knowledge, while perspectives towards the EBP category included four sub-categories: application of EBP in clinical practice, barriers, facilitators and EBP application methods. The participants experienced being in a non-supportive and non-encouraging atmosphere which results from a lack of organizational commitment to EBP implementation and illuminates the complexities involved in the integration process.

CONCLUSION

The nurses' experience with EBP indicated that there was limited support for the implementation of this approach. Furthermore, they experienced varying barriers to EBP implementation. They viewed EBP as a complex technique as they lacked knowledge and skills related to the formulation of research questions, and retrieving, applying and disseminating of EBP in clinical practice decision-making. That is due to barriers pertinent to the individual, organizational and patient factors. The key to successfully implementing an EBP in nursing practice is to promote professional development, comprehensive and continuous training, a culture of change, organizational support and motivation.

CLINICAL RELEVANCE

Through the construction and provision of ongoing educational interventions and mentoring programmes about EBP, healthcare organizations and nursing leadership may develop a comprehensive strategy to encourage staff nurses' participation in the EBP process. This is to enhance nurses' experiences and perspectives towards the EBP approach and overcome the barriers to effective implementation.

NO PATIENT OR PUBLIC CONTRIBUTION TO THIS STUDY

Patients or the general public were not involved in the design, analysis or interpretation of the data in this study.

Development and validation of the novel nursing activities in the care of extracorporeal membrane oxygenation-supported patients scale

BACKGROUND

Nurses are members of multidisciplinary teams providing care to extracorporeal membrane oxygenation-supported patients (ECMO-SP). There are no valid and reliable measurements available to assess nursing activities in the care of ECMO-SP.

AIM

To develop and evaluate psychometric properties of a new 27-item nursing activities in the care of ECMO-SP scale.

STUDY DESIGN

A convenience sample was recruited of 76 registered nurses (mean age 41.3 ± 8.7; 71% female) in Israel. The nurses participated in an online survey with software Qualtrics, between March and June 2022. Content and construct validity, as well as internal consistency of the scale were evaluated. The participants also completed the perceived knowledge and skills in the treatment of ECMO-SP scale. The correlations between nursing activities in the care of ECMO-SP and ECMO knowledge were examined using Pearson's correlation.

RESULTS

Exploratory factor analysis extracted four factors, and seven items were excluded from the 27-item scale making it a 20-item scale in its final form. Internal consistency was acceptable for the total scale (α = 0.84) and the four subscales: Factor 1: Nursing care of ECMO-SP not related to the ECMO device (α = 0.90), Factor 2: Activities on ECMO device in emergency (α = 0.82), Factor 3: ECMO device calibrating and monitoring (α = 0.72), and Factor 4: Medication and blood administration through ECMO device (α = 0.73). When examined in confirmatory factor analysis, the 20-item scale yielded acceptable fit indices. A positive correlation was found between perceived ECMO knowledge and all four factors of the nursing activities in the Care of ECMO-SP scale.

CONCLUSIONS

The 20-item scale examining nursing activities in the care of ECMO-SP is ready for use for clinical, educational, and research purposes.

RELEVANCE TO CLINICAL PRACTICE

Because there are still no standards for nursing care of ECMO-SP and no agreed quality indicators, this novel scale may help in building such standards and quality indicators.

Towards digital readiness of evidence-based practice in a regional cancer center using role-based business process and data modeling

Introduction

Evidence-based practice is a problem-based solving approach to clinical practice that encourages nurses providing personalized patient care while utilizing the necessary scientific evidence for a better understanding of risks and benefits of diagnostic tests and treatments. Digital transformation of an organization begins with attaining an acceptable digital readiness level. One approach entails specifying and modeling their processes and the respective data models.

Objectives

In Jordan, at King Hussein Cancer Center-an international and regional accredited cancer care hospital-their nursing practice requires obtaining a standardized specification of evidence-based practice processes and their respective conceptual data model that is currently not specified for digital readiness.

Methods

The design science research methodology was adopted to deliver two increments. The first was concerned with the design, development, and demonstration of eight evidence-based practice processes specified using BPMN. The second was related to the design and development, demonstration, and evaluation of a respective derived data model of the case study. Both increments involved interviews with domain experts for elicitation and validation.

Results

Eight evidence-based practice process models were identified and specified using BPMN along with their associated data models, where one representative process model was utilized in this research to demonstrate the effectiveness of process and data modeling towards digital readiness of evidence-based practice in regional cancer center.

Conclusions

Both deliverables enabled the evidence-based practice management to attain common understanding to identify inefficiencies, redundancies, and areas for improvement that can be addressed through digital solutions. Evidence -based practice BPMN process models were considered as a road map to follow up a project implementation and a rich visualization to perform data analytics to identify evidence-based practice trends, patterns, and insights that can inform strategic data-driven decisions. Both deliverables were concluded necessary for developing respective information systems in the journey towards digital transformation.

Factors related to the knowledge and skills of evidence-based practice among nurses worldwide: A scoping review

BACKGROUND

Promoting evidence-based practice (EBP) among nurses may be a valuable component of improving health care. However, a comprehensive analysis of the factors associated with the knowledge and skill EBP in nurses has not been performed to date. This is essential for facilitating the acquisition of relevant knowledge and skills to effectively implement EBP.

AIMS

The aim of the study was to determine the factors related to the knowledge and skills of EBP among nurses.

METHODS

We searched various literature databases up to October 25, 2021, for relevant studies that investigated the factors associated with the knowledge and skills of EBP in nurses. The authors, year of study, country, study design, study subject information, instruments used for the assessment EBP knowledge and skills, use of multivariable analysis, and factors significantly associated with the knowledge and skills of EBP among nurses were extracted from each eligible study and collated to identify commonly reported factors.

RESULTS

We identified 47 eligible studies conducted in a wide range of countries. Nine articles applied multivariable analyses, and 38 articles did not perform any multivariable analyses. The factors related to the knowledge and skill levels of EBP among nurses were classified into two categories: personal and work-environment factors. In the nine articles that conducted multivariable analysis, personal factors, which included educational level, participation in EBP education, and experience conducting research, and work-environment factors, such as resources and organizational support for EBP, were related to the knowledge and skills of EBP among nurses.

LINKING EVIDENCE TO ACTION

Our review highlighted educational level, participation in EBP education, experience conducting research, and resources and organizational support for EBP as important factors that are associated with the knowledge and skills of EBP in nurses worldwide. Focusing on these factors may help improve nurses' understanding of EBP and facilitate the implementation of EBP.

Instruments for assessing healthcare professionals' knowledge and skills of evidence-based practice: A scoping review

OBJECTIVE

The aim of this scoping review was to describe the instruments used to assess the knowledge and skills of evidence-based practice (EBP) in healthcare settings.

METHODS

A scoping review was undertaken. Three electronic databases (CINAHL, PubMed and Cochrane) were searched in January 2022. The search phrases consisted of the following terms: healthcare professionals, EBP, competence and instrument and their synonyms, keywords and MeSH terms. The database search was run without any limitations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to support reporting.

RESULTS

Ultimately, 39 studies were included; most of them (35) were cross-sectional studies. The studies were conducted in 17 countries. A total of 17 evidence-based knowledge and skills instruments were identified. The Upton and Upton instrument was used in 19 studies. Twelve self-reported instruments were used only once. The psychometric properties of the instruments varied. The reliability was typically reported with Cronbach's alpha coefficient. The content of the EBP knowledge/skills instruments consists of five main categories: EBP, evaluation of current practice, preparation for the implementation of EBP, implementation of evidence and active participation in the development of EBP.

CONCLUSION

Almost all instruments are self-assessment instruments. Validated knowledge tests should be further developed. The instruments emphasise the preparation for the implementation of EBP. Further research is needed to develop instruments for healthcare professionals to assess the knowledge and skills of the implementation of evidence.

Sociodemographic and Work-Related Variables Affecting Knowledge of, Attitudes toward, and Skills in EBNP of Nurses According to an EBPPQ

(1) This study examines sociodemographic and work-related variables to determine their impact on the knowledge of, attitudes toward, and skills in Evidence-Based Nursing Practice (EBNP). (2) The study included 830 nurses from four voivodships in Poland, Dolnośląskie, Łódzkie, Podlaskie, and Zachodniopomorskie and was conducted by the diagnostic survey method, using the questionnaire technique. The following research tools were applied in the study: an Evidence-Based Practice Profile Questionnaire (EBPPQ) and a survey questionnaire developed by the authors, containing questions on sociodemographic data and work-related variables. (3) Sociodemographic variables with an impact on the knowledge of, attitudes toward, and skills in EBNP include age, marital status, and educational background. Older nurses find it problematic to apply EBNP, and their level of relevant knowledge and skills is lower; whereas, those with university education possess the best EBNP-related skills, and they are also more eager to expand them and apply them in their work. The work-related variables with an impact on the knowledge of, attitudes toward, and skills in EBNP among nurses include work experience, which has a negative effect on applying EBNP and the skills associated with it. The type of school from which the nurses graduated and the nursing specialisation training also have a strong impact on expanding nurses’ competence in EBNP.

Effectiveness of Digital Flipped Learning Evidence-Based Practice on Nurses' Knowledge, Attitude, and Practice: A Quasi-Experimental Trial

Background: Evidence-based care has become critical in raising the quality of medical facilities. The implementation of evidence-based practice helps medical practitioners make better clinical decisions. Objective: The objective of this study was to investigate whether the innovative flipped teaching model could be as effective as the conventional teaching model in terms of knowledge, attitude, and practice and to confirm the continuous effect. Design: A quasi-experimental design using the flipped and conventional learning groups concurrently with repeat measurements was used. Setting: The setting was a 475-bed regional teaching hospital in Taiwan, from March to July 2020. Participants: The study included 114 licensed nurses who had worked longer than three months, with 57 participants each in two groups. Methods: The participants were assigned to two groups using a block randomization method. All participants completed questionnaires related to knowledge, attitude, and practice of EBP at four-time points: pre-test (T0) and immediately after intervention (T1), at month 1 (T2), and at month 3 (T3). Analysis of repeated generalized estimating equations was used. Results: The flipped and conventional learning groups had significant differences in knowledge, attitude, and practice at the T0 and T1 (p < 0.05). The flipped group was higher than the conventional group at T3 in the knowledge score (p = 0.001) and lower than the conventional group at T2 in the attitude score (p = 0.010). There were no significant differences between the two groups’ practice scores at different time points. There were no significantly different score changes for knowledge, attitude, and practice (p > 0.05). The interaction term only at T3 vs. T0 in the knowledge score was slightly different (p = 0.049) in primary outcome. Conclusion: The intervention methods of both groups were effective. Flipped learning is more flexible and has more time for discussion, which nurses favor. Under the policy promoted in the hospital, EBP combined with the nursing advancement system was standardized, and conventional learning also improved the learning effect.