Individual Potentials Related to Evidence-Based Nursing among Nurses in Teaching Hospitals Affiliated to Tabriz University of Medical Sciences, Tabriz, Iran

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.

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.

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.

Measures of evidence-informed decision-making competence attributes: a psychometric systematic review

Background

The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing.

Methods

The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings.

Results

A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6–25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach’s alphas ranging from 0.45–0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.

Conclusions

This review highlights a gap in the testing and use of competence attribute measures related to evidence-informed decision making in community-based and long-term care settings. Further development of measures is needed conceptually and psychometrically, as most measures assess only a single competence attribute, and lack assessment and evidence of reliability and sources of established validity evidence.

Registration

PROSPERO #CRD42018088754.