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

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• 作者：Hannele Saunders^a ; ^{hannele.saunders@uef.fi" class="auth_mail" title="E-mail the corresponding author} ; Katri Vehvilä ; inen-Julkunen^b ; ^{katri.vehvilainenjulkunen@uef.fi" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Evidence-based practice ; Nursing ; Knowledge ; Clinical competence ; Review literature
• 刊名：International Journal of Nursing Studies
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：56
• 期：Complete
• 页码：128-140
• 全文大小：506 K

文摘

To review factors related to nurses’ individual readiness for evidence-based practice and to determine the current state of nurses’ evidence-based practice competencies.

Design

An integrative review study.

Data sources

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.

Review methods

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.

Results

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.

Conclusions

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.