Adopting Evidence-Based Practice in Clinical Decision Making: Nurses' Perceptions, Knowledge, and Barriers (EC)

By Majid, Shaheen; Foo, Schubert et al. | Journal of the Medical Library Association, July 2011 | Go to article overview

Adopting Evidence-Based Practice in Clinical Decision Making: Nurses' Perceptions, Knowledge, and Barriers (EC)


Majid, Shaheen, Foo, Schubert, Luyt, Brendan, Zhang, Xue, Theng, Yin-Leng, Chang, Yun-Ke, Mokhtar, Intan A., Journal of the Medical Library Association


Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated.

Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%.

Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP trairting, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators.

Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses.

INTRODUCTION

Medical and health care is one of the most dynamic human disciplines, and large amounts of money are spent annually on high-quality and sophisticated research, resulting in an exponential growth in health care literature. Regularly, new and more effective medicines, medical devices, and procedures are invented. One major objective behind all these efforts is to help doctors, nurses, and medical technicians provide the best possible care and treatment to patients. In addition to using traditional and wellestablished procedures and practices, health care practitioners are adopting innovative interventions that are based on best practices as well as solid research-based evidence. Evidence-based practice (EBP) is one such technique and is quickly gaining popularity due to its potential to effectively handle clinical issues and provide better patient care.

Historically, care of the patient was influenced by the experiences and opinions of those involved in providing treatment [I]. EBP marks a shift among health care professionals from a traditional emphasis on authoritative opinions to an emphasis on data extracted from prior research and studies [2, 3]. A meta-analysis done by Heater et al. demonstrated that nursing practice based on evidence improves patient care, as compared to traditional practices [4]. Moreover, as nurses are increasingly more involved in clinical decision making, it is becoming important for them to utilize the best evidence to make effective and justifiable decisions [5].

CHALLENGES AND BARRIERS TO ADOPTING EVIDENCE-BASED PRACTICE (EBP)

A number of studies investigating nurses' perceptions show that nurses generally view EBP positively and consider it important to better patient care [6]. Nevertheless, it is a fact that the pace of accepting and implementing EBP is rather slow [7]. Several previous studies have tried to investigate possible barriers to adopting EBP. One barrier that some studies revealed was the enormous amount of health care literature, published in a variety of sources, which makes it almost impossible for individual medical professionals to keep up to date. …

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