The state of readiness for evidence-based practice among nurses: An integrative review.

To review factors related to nurses' individual readiness for evidence-based practice and to determine the current state of nurses' evidence-based practice competencies. An integrative review study. Thirty-seven (37) primary research studies on nurses' readiness for evidence-based practice, of which 30 were descriptive cross-sectional surveys, 5 were pretest-posttest studies, and one study each was an experimental pilot study and a descriptive qualitative study. Included studies were published from the beginning of 2004 through end of January 2015. The integrative review study used thematic synthesis, in which the quantitative studies were analyzed deductively and the qualitative studies inductively. Outcomes related to nurses' readiness for evidence-based practice were grouped according to the four main themes that emerged from the thematic synthesis: (1) nurses' familiarity with evidence-based practice (EBP); (2) nurses' attitudes toward and beliefs about evidence-based practice; (3) nurses' evidence-based practice knowledge and skills; and (4) nurses' use of research in practice. Methodological quality of the included studies was evaluated with Joanna Briggs Institute critical appraisal tools. Although nurses were familiar with, had positive attitudes toward, and believed in the value of EBP in improving care quality and patient outcomes, they perceived their own evidence-based practice knowledge and skills insufficient for employing evidence-based practice, and did not use best evidence in practice. The vast majority (81%) of included studies were descriptive cross-sectional surveys, 84% used a non-probability sampling method, sample sizes were small, and response rates low. Most included studies were of modest quality. More robust, theoretically-based and psychometrically sound nursing research studies are needed to test and evaluate the effectiveness of interventions designed to advance nurses' evidence-based practice competencies, especially teaching them how to integrate evidence-based practice into clinical decision-making. All efforts should be focused on systematically using knowledge transformation strategies shown to be effective in rigorous studies, to translate best evidence into practice-friendly, readily usable forms that are easily accessible to nurses to integrate into their clinical practice.

Saunders H ，Vehviläinen-Julkunen K 《-》

Readiness for and predictors of evidence-based practice of acute-care nurses: a cross-sectional postal survey.

Nurses' adoption of evidence-based practice (EBP) remains limited although most nurses are familiar with EBP and belief in its value for patient care. Efforts to accelerate nurses' EBP activities have met with limited success. Knowledge of predictors of nurses' EBP activities is lacking. To describe nurses' readiness for EBP as measured by their information needs, skills in using electronic bibliographical databases (EBDs) and awareness of available EBP-needed resources; EBP beliefs and frequency of EBP activities, and identify predictors of EBP activities and beliefs. This was a cross-sectional survey, distributed to a homogeneous, consecutive sample of 546 acute-care nurses. Response rate was 64.3%; responses from direct-care nurses (n = 298) and administrators (n = 45) were analysed. Descriptive statistics were used to describe readiness for EBP, frequency of certain EBP activities and EBP beliefs. Logistic regression analyses were performed to identify predictors of EBP activities and multiple regression analysis to identify predictors of EBP beliefs. The nurses generally seldom participated in the EBP activities studied, in spite of familiarity with and positive beliefs towards EBP. Evidence-based practice beliefs predicted all three activities studied. Skills in using EBDs predicted information-seeking and evaluating research. Awareness of available EBP-needed resources predicted information-seeking, role predicted evaluating research, while familiarity with EBP predicted using research in practice. Six predictors explained nearly 40% of the variance in EBP beliefs. Nurses' EBP activities must be facilitated and accelerated. The findings provide empirical support to the primacy of EBP beliefs in nurses' engagement in EBP and of the complexity of EBP. While the identified predictors of EBP activities and beliefs are susceptible to change, diverse strategies are needed to influence each one. Strategies should focus on influencing EBP beliefs, that is, by increasing skills in using EBDs, discussion about EBP in the clinical environment and familiarity with EBP.

Thorsteinsson HS ，Sveinsdóttir H 《-》

Determining registered nurses' readiness for evidence-based practice.

Thiel L ，Ghosh Y 《-》

Effectiveness of an education intervention to strengthen nurses' readiness for evidence-based practice: A single-blind randomized controlled study.

Nurses' lack of readiness for evidence-based practice slows down the uptake, adoption, and implementation of evidence-based practice which is of international concern as it impedes attainment of the highest quality of care and best patient outcomes. There is limited evidence about the most effective approaches to strengthen nurses' readiness for evidence-based practice. To evaluate the effectiveness of an Advanced Practice Nurse-delivered education program to strengthen nurses' readiness for evidence-based practice at a university hospital. A single-blind randomized controlled trial with repeated measures design, with measures completed during spring and fall 2015, before the education program (T0), within 1week after (T1), 8weeks after (T2), and 4months after completion of education interventions (T3). One large university hospital system in Finland, consisting of 15 acute care hospitals. The required sample size, calculated by a priori power analysis and including a 20% estimated attrition rate, called for 85 nurse participants to be recruited. Nurses working in different professional nursing roles and care settings were randomly allocated into two groups: intervention (evidence-based practice education, N=43) and control (research utilization education, N=34). The nurse participants received live 4-h education sessions on the basic principles of evidence-based practice (intervention group) and on the principles of research utilization (control group). The intervention group also received a web-based interactive evidence-based practice education module with a booster mentoring intervention. Readiness for evidence-based practice data, previous experience with evidence-based practice, and participant demographics were collected using the Stevens' EBP Readiness Inventory. Nurses' confidence in employing evidence-based practice and actual evidence-based practice knowledge were lower at T0, compared with the post-education scores, specifically at T1. The improvement in the confidence or actual evidence-based practice knowledge levels did not differ between the intervention and control groups. Confidence in employing evidence-based practice was directly correlated with level of education and inversely correlated with age. Actual evidence-based practice knowledge was lowest among nurses who had no previous knowledge or experience of evidence-based practice. Both the evidence-based practice and research utilization education interventions improved nurses' confidence in employing evidence-based practice and actual evidence-based practice knowledge, strengthening their evidence-based practice readiness at least in the short-term. Most of the variation in the confidence in employing evidence-based practice and actual evidence-based practice knowledge levels was due to background factors, such as primary role and education level, which emphasize differences in educational needs between nurses with diverse backgrounds.

Saunders H ，Vehviläinen-Julkunen K ，Stevens KR 《-》

Icelandic nurses' beliefs, skills, and resources associated with evidence-based practice and related factors: a national survey.

Evidence-based practice (EBP) is essential to the improvement of patient outcomes and the quality of care. Nurses' use of evidence in practice, however, remains limited. Assessing nurses' readiness for EBP where it is not as prominent as in countries leading EBP research was of particular interest. To determine Icelandic registered nurses' (RNs') ability to provide care based on evidence as measured by their beliefs, perception of skills, and access to resources associated with EBP. A descriptive survey was used in which a random sample of 540 Icelandic RNs completed the translated and modified version of the Information Literacy for Evidence-Based Nursing Practice and the translated EBP Beliefs Scale. Descriptive statistics, correlations, chi-square tests, t tests and one-way ANOVAs were used to analyze the data. Participants strongly believed in the value of EBP for patient care, but were less confident regarding their own knowledge and skills needed for EBP. Most (82%) of the respondents (i.e., RNs) turned to peers when in need of information, rather than peer-reviewed resources. Although over half of the RNs (54%) had received instructions in the use of electronic databases, only a third indicated success in using them. They considered "lack of search skills" as the primary barrier to use of research in practice. Using research findings in practice was associated with positive EBP beliefs, familiarity with EBP and other EBP-related activities. Clinical RNs were found to be at a disadvantage when it came to access to EBP-related resources and participated less frequently in EBP-related activities other than using research in practice. Icelandic RNs' beliefs regarding EBP are similar to those of RNs in other countries. Their access to EBP resources is generally good, but they lack the skills and knowledge needed for EBP. Strategies aimed at changing the organizational and practice context need to be developed.

Thorsteinsson HS 《-》