Implementation of evidence-based practice and associated factors among nurses and midwives working in Amhara Region government hospitals: a cross-sectional study

Exploring academic and clinical nurses' perspectives on evidence-based nursing course for undergraduates from perspectives of academic-practice partnerships: a qualitative study

AIM

To explore nurses' perceptions of evidence-based nursing courses for undergraduates through academic-practice partnerships.

DESIGN

A deductive thematic analysis based on the practice-academic logic model.

METHODS

Fifteen academic and clinical nurses were interviewed between November and December 2023, either online or through face-to-face meetings. Each interview lasted 20-30 min. The interview outline was constructed based on the practice-academic partnership logic model, which was followed during the process of recorded, analyzed, and checked.

RESULTS

Themes identified include inputs (e.g., stakeholder commitment), activities (e.g., communication), outputs (e.g., nursing projects), and outcomes (e.g., improved competence). These themes highlight the various aspects and outcomes of academic-practice partnerships in evidence-based nursing courses.

CONCLUSION

Effective academic-practice partnerships are crucial for developing evidence-based nursing courses, leading to positive educational and professional outcomes.

IMPACT

Nurses' perceptions provide valuable guidelines for developing effective evidence-based nursing courses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public users participated in this study.

Development of an evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships: A Delphi study

AIM

To develop an evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships.

BACKGROUND

Academic-practice partnerships could play a crucial role in bridging theory-practice gap in evidence-based nursing education. However, there is a lack of evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships.

DESIGN

A Delphi study.

METHODS

The Delphi study was conducted by literature analysis, qualitative interview and Delphi expert consultation to develop this course framework. 15 and 12 experts were involved in round one and round two of Delphi expert consultation, respectively. The consensus threshold of two-round Delphi expert consultation was described by expert's positive coefficient (≥ 50 %), positive coefficient (≥ 70 %), expert authority coefficient (≥ 0.7), coefficient of variation (<0.25) and full score frequency (>20 %).

RESULTS

The final course framework includes learning objectives (17 items); teaching chapters of theoretical classes (five items); teaching contents (30 items), methods (12 items) and class hours (9 items) of theoretical classes; and the responsibilities of academic teachers (11 items) and clinical teachers (11 items) in practical classes.

CONCLUSION

The course framework developed by this study could provide guidance for evidence-based nursing education of undergraduate nursing students. The effectiveness of this course framework should be verified through further experimental studies in the future.

Uptake of evidence-based practice and its predictors among nurses in Ethiopia: a systematic review and meta-analysis

Background: While evidence-based practice has demonstrated its capacity to enhance healthcare quality and bolster clinical outcomes, the translation of research into clinical practice encounters persistent challenges. In Ethiopia, there remains a dearth of comprehensive and nationally representative data concerning the extent of Evidence-based practice adoption among nurses. Thus, this systematic review and meta-analysis endeavors to assess the overall prevalence of Evidence-based practice implementation and delve into its determinants among Ethiopian nurses. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines. In order to identify pertinent studies, a search was conducted across PubMed, Scopus, Google Scholar, and EMBASE databases. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence. Cochrane's Q-test and I2 statistics were calculated to assess heterogeneity among studies. Funnel plots and Egger's test were utilized to evaluate publication bias. Pooled implementation rates and meta-regression analysis were carried out using STATA 17. Results: Of the total 1,590 retrieved articles, twelve studies including 4,933 nurses were included in the final analysis. The pooled prevalence of Evidence-based practice uptake among nurses in Ethiopia is 53% (95% CI: 46%-60%). Having knowledge about Evidence-based practice (AOR = 2.29; 95% CI: 1.90, 2.69; I2 = 70.95%), holding a favorable attitude towards Evidence-based practice (AOR = 2.56; 95% CI: 1.63, 3.49; I2 = 88.39%), occupying a head nurse position (AOR = 3.15; 95% CI: 1.85, 4.46; I2 = 87.42%), possessing effective communication skills (AOR = 4.99; 95% CI: 1.47, 8.51; I2 = 99.86%), and having access to Evidence-based practice guidelines (AOR = 1.90; 95% CI: 1.55, 2.24; I2 = 57.24%) were identified as predictors of the uptake of Evidence-based practice. Conclusion: Only half of Ethiopia's nurses exhibit a strong embrace of Evidence-Based Practice within clinical settings, underscoring the urgent necessity for coordinated endeavors to cultivate this essential practice. Possessing knowledge, effective communication skills, access to updated guidelines, maintaining a positive attitude towards Evidence-Based Practice, and holding a position as head nurse emerged as predictors of successful implementation of Evidence-Based Practice. Hence, policymakers must prioritize capacity-building initiatives, disseminate the latest EBP guidelines widely, and strengthen mentorship roles for head nurses. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CRD42023488943.

Pre-treatment assessment of chemotherapy for cancer patients: a multi-site evidence implementation project of 74 hospitals in China

BACKGROUND

Chemotherapy, whilst treating tumours, can also lead to numerous adverse reactions such as nausea and vomiting, fatigue and kidney toxicity, threatening the physical and mental health of patients. Simultaneously, misuse of chemotherapeutic drugs can seriously endanger patients' lives. Therefore, to maintain the safety of chemotherapy for cancer patients and to reduce the incidence of adverse reactions to chemotherapy, many guidelines state that a comprehensive assessment of the cancer patient should be conducted and documented before chemotherapy. This recommended procedure, however, has yet to be extensively embraced in Chinese hospitals. As such, this study aimed to standardise the content of pre-chemotherapy assessment for cancer patients in hospitals and to improve nurses' adherence to pre-chemotherapy assessment of cancer patients by conducting a national multi-site evidence implementation in China, hence protecting the safety of cancer patients undergoing chemotherapy and reducing the incidence of adverse reactions to chemotherapy in patients.

METHODS

The national multi-site evidence implementation project was launched by a JBI Centre of Excellence in China and conducted using the JBI approach to evidence implementation. A pre- and post-audit approach was used to evaluate the effectiveness of the project. This project had seven phases: training, planning, baseline audit, evidence implementation, two rounds of follow-up audits (3 and 9 months after evidence implementation, respectively) and sustainability assessment. A live online broadcast allowed all participating hospitals to come together to provide a summary and feedback on the implementation of the project.

RESULTS

Seventy-four hospitals from 32 cities in China participated in the project, four withdrew during the project's implementation, and 70 hospitals completed the project. The pre-and post-audit showed a significant improvement in the compliance rate of nurses performing pre-chemotherapy assessments for cancer patients. Patient satisfaction and chemotherapy safety were also improved through the project's implementation, and the participating nurses' enthusiasm and belief in implementing evidence into practice was increased.

CONCLUSION

The study demonstrated the feasibility of academic centres working with hospitals to promote the dissemination of evidence in clinical practice to accelerate knowledge translation. Further research is needed on the effectiveness of cross-regional and cross-organisational collaborations to facilitate evidence dissemination.

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.

Assessing evidence-based practice competencies of undergraduate nursing students using a developed multi-criteria decision-analysis model

AIM

The developed multi-criteria decision analysis model was used to identify the inter-influence relationships and key factors affecting the EBP competencies of UNSs, to assess the EBP competencies of UNSs and based on these results, to formulate an improvement strategy to enhance the EBP competencies of UNSs.

BACKGROUND

EBP is considered a core competency in international nursing practice. However, few studies have developed EBP evaluation models and applied them to assessing and improving the EBP competencies of UNSs.

DESIGN

This is a quantitative study with multi-criteria decision-analysis model.

METHODS

Firstly, the questionnaire was designed based on the characteristics of the DEMATEL and VIKOR-AS methods, which was completed by 17 nursing experts from a case hospital in Zhejiang Province, China. Subsequently, the DEMATEL method was used to analyze the inter-influence relationships among various criteria to determine their respective weights. Finally, the VIKOR method is utilized to integrate multiple criteria and their relative weights to assign comprehensive scores to each UNSs.

RESULTS

The use of the DEMATEL method reveals that "Knowledge (C1)", "Mastering the basic scientific research methods during the study of the undergraduate courses (C11)", "Being able to consult clinical experts appropriately when encountering problems in clinical practice (C23)" and "Understanding the importance of reading journals related to the nursing profession regularly (C34)" were critical influencing factors. "Skill (C2)," "Being able to explain the essential roles of the best research evidence in determining clinical practice (C15)," "Being able to apply the collected research evidence to the individual case in nursing care (C25)" and "Paying attention to using the evidence-based nursing practice concept to determine the best clinical practice (C35)" were the most influential factors. According to the VIKOR method, the performance of the UNSs in the case hospitals in terms of EBP competencies from highest to lowest was Student C, Student B and Student A. However, all of these students suffered from deficiencies at the knowledge level.

CONCLUSIONS

The application of the DEMATEL and VIKOR methods provides a systematic and comprehensive approach to the assessment of EBP competencies of UNSs. The lack of EBP competencies of UNSs in case hospitals is mainly reflected in knowledge level. To improve UNSs' EBP competencies, medical schools and hospital educators should propose short- and long-term strategies to improve knowledge.

Exploring Professional Practice Environments and Organisational Context Factors Affecting Nurses' Adoption of Evidence-Based Practice: A Scoping Review

This scoping review, conducted within the Joanna Briggs Institute (JBI) framework, analysed the recent literature (January 2018 to March 2023) addressing factors inherent to professional practice environments and organisational contexts influencing nurses' adoption of evidence-based practice (EBP). This review included studies involving nurses regardless of sector, practice setting, and scope of practice. A systematic search was undertaken across the PubMed, Web of Science, CINAHL, and MEDLINE databases, as well as the EThOS, OATD, and RCAAP platforms. The extracted textual elements underwent a content analysis, resulting in a coding structure established through an inductive approach that categorised information into main categories and subcategories linked by similarity and thematic affinity. Forty-one studies were included, revealing four main categories of factors impacting EBP adoption by nurses: (1) organisational dynamics, (2) management and leadership, (3) teamwork and communication, and (4) resources and infrastructure. The study's limitations acknowledge the subjective nature of categorisation, recognising potential variations based on individual perspectives despite adopting procedures to minimise the risk of bias. The results provide a substantial foundation for developing interventions to cultivate environments conducive to EBP adoption by nurses, thereby enhancing the integration of evidence into nurses' professional practice contexts. This review was prospectively registered on the Open Science Framework (registration no. osf.io/e86qz).

Evidence-Based Practice and Its Associated Factors among Health Professionals Working at Public Hospitals in Southwest Ethiopia

Introduction

"Evidence-based practice" (EBP) is the process of incorporating clinical expertise and taking patient values and preferences into consideration when making clinical decisions. It is used to describe the provision of high-quality patient care.

Objective

This study is aimed at assessing evidence-based practice and associated factors among health professionals working at public hospitals in Illu Aba Bora and Buno Bedele Zones, Oromia Region, Southwest Ethiopia, in 2022.

Methods

An institution-based cross-sectional study design was conducted from May 8 to June 20 at public hospitals in Illu Aba Bora and Buno Bedele Zones, Oromia Region, Southwest Ethiopia. A total of 423 health professionals were included, using proportional allocation and simple random sampling. The data were collected using a self-administered questionnaire. Data was entered using EpiData version 4.6, and the collected data was cleared, arranged, coded, and then analyzed using Statistical Package for the Social Sciences version 26. Descriptive statistics and bivariable and multivariable analyses of logistic regression with AOR (95% CI) were performed at p < 0.05.

Result

The study revealed that 36.2% of health professionals had good evidence-based practice. The factors found to be significantly associated with good EBP include having training in EBP (AOR = 5.43; 95% CI: 4.323, 9.532), good knowledge (AOR = 1.91; 95% CI: 1.065, 3.541), a favorable attitude (AOR = 1.91; 95% CI: 1.884, 2.342), and work experience greater than 5 years (AOR = 1.58; 95% CI: 1.482, 2.437).

Conclusion

The evidence-based practice of health professionals was poor. Evidence-based practice should included in the curriculum, and also planned trainings need to be delivered to all health professionals, inorder to enhancing their knowledge as well as their attitudes by motivating them to increase evidence-based practice.

Determinants of evidence-based practice among health care professionals in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Evidence-based practice (EBP) is the art of using up-to-date information for clinical decision-making. Healthcare professionals at all levels are expected to use the latest research evidence for quality care. In Ethiopia inclusive and nationally representative summarized evidence regarding the level of EBP among health professionals is scarce. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of EBP utilization and its determinants among Ethiopian health professionals.

METHOD

A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Google Scholar, and African Online Journal databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Factors associated with EBP were identified using STATA v. 14.

RESULT

Overall, 846 articles were retrieved and finally 23 articles were included in this review. The pooled prevalence of good EBP among health professionals was 52.60% (95%CI; 48.15%-57.05%). Knowledge about EBP (AOR = 2.38, 95% CI: (2.08-2.72)), attitude (AOR = 2.09, 95% CI: (1.67-2.60)), educational status (AOR = 3.12, 95% CI: (2.18-4.47)), work experience (AOR = 2.59, 95% CI: (1.48-4.22)), EBP training (AOR = 2.26, 95% CI: (1.87-2.74)), presence of standard guideline (AOR = 1.94, 95% CI: (1.51-2.50)), internet access (AOR = 1.80, 95% CI: (1.47-2.20)), presence of enough time (AOR = 2.01, 95% CI: (1.56-2.60)) and marital status (AOR = 1.73, 95% CI: (1.32-2.28)) were determinants of EBP.

CONCLUSION

Around half of health professionals in Ethiopia have good EBP utilization which was low. Knowledge, attitude, educational status, work experience, EBP training, presence of standard guidelines, internet access, presence of enough time, and single marital status were positively associated with EBP. Therefore future interventions should focus on increasing their knowledge and changing their attitude through providing training and addressing organizational barriers like availing standard guidelines, accessing the internet, and minimizing professionals' workload that enables them to critically appraise and integrate the latest evidence for clinical decision-making to improve the quality of care.

How Teaching and Internship Influence the Evidence-Based Practice Approach of Nursing Students: A Longitudinal Study

AIM

The study aimed to analyze students' approach to evidence-based practice and evaluate the effect of teaching (based on lessons in statistics, epidemiology, evidence-based nursing, bioengineering, English language) and internship experiences on the attitude of nursing students to evidence-based practice.

METHOD

In 2019,one hundred nineteen second-year nursing students from an Italian university were involved in a pre-post longitudinal study. The Italian version of the Student-Evidence Based Practice Questionnaire was administered to nursing student in four moments of one academic year.

RESULTS

The Student-Evidence Based Practice Questionnaire showed different mean scores based on the four moments of the survey with a significant increase after the experience of planning clinical cases with an online simulation system. In particular, the aptitude subscale does not have significant improvements in the various phases of the study. Conversely, the support of the clinical tutor affects student performance. The didactic module on evidence-based nursing develops the ability to assess the quality of the information found and its sharing. Basic English proficiency is not significantly correlated.

CONCLUSION

To develop evidence-based practice knowledge, aptitude, and skills in nursing students, it is necessary to strengthen the learning opportunities both in classroom lessons and in simulation and internship experiences.