Italian EBP Implementation Scales: A Psychometric Validation Study.

Although evidence-based practice provides the best diagnosis and treatment decisions for patients, there is no relevant theoretical basis for designing an evidence-based practice curriculum for medical students. Also, no study has been conducted to investigate the attitude and behaviour of evidence-based practice among resident doctors in China. Therefore, this study aims to identify the beliefs and implementation of evidence-based practice among registered resident doctors in Lianyungang First People's Hospital. A descriptive cross-sectional design was used to recruit 257 participants conveniently. Beliefs about the evidence-based practice was evaluated using the Evidence-Based Practice Beliefs scale. In addition, the implementation of Evidence-Based Practice was evaluated using the Evidence-Based Practice Implementation scale. Participants' rate of evidence-based practice was 71.60%. Cronbach's alpha was more than 0.90 for each scale. Participants who had learned about evidence-based medicine gave significantly higher scores on the Evidence-Based Practice Beliefs scale and Evidence-Based Practice Implementation scale than those who did not. This study demonstrates that resident doctors develop a positive attitude towards evidence-based practice but exercise it to a lesser extent. Integrating the theory course of evidence-based medicine at the undergraduate level with the practice course at the standardized training stage is crucial to improving their practice, aiming to enhance that patients receive the best available care based on high-quality evidence.

BackgroundHaving a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses.The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation.MethodWe carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used.ResultsIn total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r = 0.59, p = 0.001).There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r = 0.38, p < .0001). Participants who had learned about evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups.ConclusionThis study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between beliefs about evidence-based practice and implementation of evidence-based practice. Beliefs related to knowledge appear to have the greatest effect on implementation of evidence-based practice. Having knowledge and taking part in evidence-based practice working groups seem important.

BackgroundUsing evidence-based practice (EBP) is one of the core skills that students should have acquired by the end of their Bachelor of Science in Nursing (BSN). However, little is known about how their beliefs about EBP and their frequency of implementation relate to multi-component educational programmes on this topic. This study aims to investigate the impact of a multi-component educational programme on nursing students’ beliefs about EBP and their frequency of implementation at the School of Health Sciences, HES-SO Valais.MethodsThis quantitative, pre–post-design study compared undergraduate nursing students’ beliefs about EBP and their frequency of implementation before and after completing a multi-component educational programme on EBP. The programme included integrative workshops based on the steps of EBP held during their clinical internships throughout their three-year curriculum. The study occurred between September 2017 and June 2020: the start and end of their studies. The programme’s impact was measured using Melnyk et al.’s self-reported EBP Beliefs and Implementation Scales. Descriptive, comparative, correlational and regression statistics were computed to evaluate nurses’ responses and scores.ResultsNinety-five eligible first-year undergraduate nursing students were invited to participate in this EBP study and 81 completed the pre- and post-test questionnaires. Mean EBP scores improved significantly versus baseline on both the Beliefs (49.1 vs. 53.3; p < 0.001) and Implementation (1.7 vs. 9.0; p < 0.001) scales. Cronbach alphas for the EBP Beliefs scale were 0.799 pre-test (95% CI: 0.729, 0.858) and 0.869 post-test (95% CI: 0.823, 0.907). Cronbach’s alphas for the EBP Implementation scale were 0.804 pre-test (95% CI: 0.736, 0.861) and 0.939 post-test (95% CI: 0.918, 0.957). There were significant correlations between EBP Beliefs and Implementation scores (p < 0.001). Linear regression analysis showed that the programme’s theory-based component contributed significantly more than clinical internships to raising EBP Beliefs and Implementation scores.ConclusionsThe multi-component educational programme on EBP improved undergraduate nursing students’ EBP Beliefs and Implementation scores. Future research should investigate means of optimally integrating EBP into undergraduate nursing curricula and explore nursing students’ intentions to implement EBP in clinical practice.

The research-to-practice gap often occurs when evidence-based practice (EBP) is inadequately implemented into clinical practice. Nurses are critical to bridging the gap in EBP implementation (EBPI) and identifying effective strategies to promote its use in practice; however, they need a supportive work environment to develop the necessary research capacity/culture (RCC). The purpose of this study was to examine relationships between nurses' perceptions of individual RCC and EBPI, team RCC and EBPI, and health care organization RCC and EBPI, adjusting for educational background, health care organization setting, and health care organization type. Survey data were collected from 175 nurses across the United States using a prospective cross-sectional study design. The Research Capacity in Context (RCC) tool and EBPI scale were used to measure nurses' perception of RCC and nurses' EBPI, respectively. Simple linear regression was used to assess the relationship between organizational, team, and individual RCC and EBPI. Multiple linear regression was used to adjust for pertinent participant demographics. The results of this study indicated that organization (R2 = 0.033, p = 0.016), team (R2 = 0.064, p < 0.001), and individual (R2 = 0.155, p < 0.001) RCC were significantly associated with nurse EBPI. Moreover, findings remained significant after adjusting for educational background, health care organization setting, and type. The regression model suggested that education significantly predicted EBPI (R2 = 0.142, p < 0.001). These results emphasize the importance of building RCC in health care organizations, as it can be an effective strategy to increase nurses' EBPI, which has been shown to impact patient outcomes directly. Future research should identify strategies to assist organizations and leadership in building RCC among nurses.

Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe. The purpose of this study was to describe: (a) the EBP beliefs and level of EBP implementation by chief nurse executives (CNEs), (b) CNEs' perception of their hospitals' EBP organizational culture, (c) CNEs' top priorities, (d) amount of budget invested in EBP, and (e) hospital performance metrics. A descriptive survey was conducted. Two-hundred-seventy-six CNEs across the United States participated in the survey. Valid and reliable measures included the EBP Beliefs scale, the EBP Implementation scale, and the Organizational Culture and Readiness scale for EBP. The Centers for Medicare and Medicaid Services Core Measures and the National Database of Nursing Quality Indicators (NDNQI) were also collected. Data from this survey revealed that implementation of EBP in the practices of CNEs and their hospitals is relatively low. More than one-third of the hospitals are not meeting NDNQI performance metrics and almost one-third of the hospitals are above national core measures benchmarks, such as falls and pressure ulcers. Although CNEs believe that EBP results in high-quality care, it is ranked as a low priority with little budget allocation. These findings provide a plausible explanation for shortcomings in key hospital performance metrics. To achieve higher healthcare quality and safety along with decreased costs, CNEs and hospital administrators need to invest in providing resources and an evidence-based culture so that clinicians can routinely implement EBP as the foundation of care.

Background: Evidence-based practice has been considered as a key for healthcare quality measure. As a result of its influence on nurses’ knowledge and practice, evidence-based practice has gained prominence in the nursing profession. Therefore, evidence-based practice is increasingly acknowledged as a critical component of improving the quality of healthcare and nursing care services, as well as achieving patient care excellence. The study aimed to explore nurses’ knowledge and attitudes toward implementing evidence-based practice. Research design: A cross-sectional research design was used to answer the study question. Sample: A convenient sampling of 100 nurses from staff nurses. Setting: The study was applied at Minia University Hospitals. Tools of data collection: Two tools were used, 1st tool was personal and professional data the second part was nurses’ knowledge related to implementation of evidence-based nursing practice, and 2nd tool: was the evidence-based practice attitude scale. Results: The study revealed that (34.5%) of nurses had satisfactory knowledge, while (37.9%) of nurses had a negative attitude toward evidence-based nursing practice implementation.Conclusion: There a positive correlation between nurses’ knowledge and attitude toward evidence-based nursing practice implementation. This study provides a foundation for the adoption of measures to encourage the use of EBP by nurses in different healthcare settings in Egypt, as well as a baseline assessment for upcoming reviews. Recommendations: Carefully crafted evidence-based programs, properly equipped facilities with state-of-the-art informatics tools.

To develop a clinical scenario-based educational program incorporating five evidence-based practice (EBP) steps and evaluate its effects on EBP knowledge and skills and EBP implementation among hospital nurses. This study employed a randomized controlled trial design. Eighty-seven registered nurses were recruited from 22 hospitals across Japan and randomly assigned to either the Intervention group (n = 44) or the Control group (n = 43). The Intervention group received a clinical scenario-based education program incorporating the five EBP steps, utilizing the Prevention of Delirium in Elderly Hospitalized Patients scenario. EBP knowledge and skills and EBP implementation were measured at baseline (T1), immediately post-intervention (T2), and 2 months later (T3). Linear mixed models were used to assess the between-group differences in EBP knowledge and skills, as well as EBP implementation. No significant differences were found between groups at T1 in EBP knowledge and skills (25.4 [22.6-28.1] vs. 27.9 [25.0-30.7], p = .219) and implementation scores (14.8 [12.7-16.9] vs. 15.0 [12.8-17.3], p = .882). At T2 and T3, the Intervention group had significantly higher knowledge and skills (T2: 33.8 [31.4-36.3] vs. 27.6 [25.1-30.2], p = .001; T3: 36.8 [34.3-39.3] vs. 27.2 [24.7-29.7], p < .001) and higher implementation scores at T3 (21.5 [19.5-23.5] vs. 14.5 [12.5-16.5], p < .001). A clinical scenario-based educational program incorporating the five steps of EBP effectively enhanced EBP knowledge and skills as well as promoted EBP implementation among hospital nurses. Trial registration number UMIN000053457 (1/27/2024).

Emergency care clinicians are expected to use the latest research evidence in practice. However, emergency nurses do not always consistently implement evidence-based practice (EBP). An educational intervention on EBP was implemented to promote emergency nurses' use of EBP, and the effectiveness of it was evaluated. This study aimed to evaluate the effectiveness of an EBP educational intervention on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The study also examined learners' satisfaction with the EBP educational intervention. A randomized controlled trial with parallel groups with evaluations before the education, immediately after it, and 6 and 12months after the education was conducted at four emergency departments in two university hospitals. The experimental group (N=40) received EBP education while the control group (N=40) completed self-directed EBP education. The primary outcomes were emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior, while the secondary outcome was satisfaction with the EBP education. Thirty-five participants of an experimental and 29 participants of a control group completed the study. There were no statistically significant (p<.05) improvements and differences between groups in EBP attitude, self-efficacy, or behavior immediately after the EBP education. At the 6-month measurement point, the experimental group showed significantly better EBP attitudes, behavior, knowledge, and self-efficacy than the control group. At the 12-month measurement point, the improvements began to decrease. The groups also differed significantly in terms of participant satisfaction with how the teacher encouraged learners to ask clinical questions. The EBP educational intervention implemented in this study had a positive effect on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The effects of the education appeared the best 6months after the education. After this point, the results began to decrease and approached baseline levels. EBP educational interventions designed for emergency nurses should apply various teaching strategies to improve their EBP attitude, knowledge, self-efficacy, skills, behavior, and satisfaction with the education.

The implementation of evidence-based practices (EBPs) for autistic youth is a critical concern worldwide. Research examining factors facilitating the implementation of EBPs found that providers’ attitudes are an important factor. In this study, we evaluated cross-cultural differences in attitudes toward and use of EBPs. We tested socio-demographic factors as predictors of attitudes, and attitudes as predictors of EBPs use among mental health professionals working with autistic youth in Bangladesh and Germany. We used purposeful sampling. Two-hundred-ninety-two professionals who worked in a clinical setting responded to the survey and fulfilled the inclusion criteria (101 in Bangladesh, 191 in Germany). Participants were asked to respond to nine subscales of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), to indicate which of nine types of treatments they used, and to provide sociodemographic data. Measurement invariance across countries could be established for four subscales of the EBPAS-36. Comparative analyses of attitudes showed that professionals in both countries were open to using EBPs, but German practitioners were more likely to use EBPs when they appealed to them. By contrast, Bangladeshi professionals claimed to be more likely to adopt an EBP when required and to be more willing to learn EBPs to enhance job security. The relationship between caseload and attitudes varied between countries. A broader variety of EBPs was used in Germany. The findings highlight the importance of considering country-specific factors when implementing EBPs. Directions for conducting comparative studies on mental health professionals’ attitudes towards EBP including methodological considerations are discussed.

Introduction: Internationally, evidence-based practice (EBP) is recognized as a fundamental component of healthcare professional education.The World Health Organization has prioritized promoting EBP to enhance nurses' contributions, highlighting their role in delivering effective, safe, and evidence-based care, which necessitates translating research into practice (WHO, 2017).Additionally, EBP is acknowledged as a core competency for clinical nurses (Friedmann, 2016).Adopting the EBP model in healthcare systems leads to high-quality care, better patient outcomes, reduced healthcare costs, and decreased variability in care delivery at the organizational level.At the staffing level, EBP fosters staff empowerment, job satisfaction, informed decision-making, and improved nursing practice.The study aimed to determine the effectiveness of an Evidence-Based Practice educational program targeting clinical nurses by assessing their competencies in EBP.Research Methodology: A pre-experimental design, one-group pre-post test design was adopted to evaluate the effectiveness of the Evidence-Based Practice educational program.Clinical nurses were selected through simple random sampling.A baseline pretest was conducted using a demographic tool, the EBP Competencies Scale by Gallagher-Ford, and a post-test was conducted four weeks after the EBP educational intervention. Results:The educational intervention's data analysis involved descriptive and inferential statistical methods.A normality check using the Shapiro LGVP;C-Wilk test revealed that the total pre-test and post-test scores for EBP among clinical nurses did not follow a normal distribution.Therefore, a non-parametric Wilcoxon signed-rank test was employed, indicating a significant increase in mean post-test EBP scores compared to pre-test scores (p < 0.05).The Wilcoxon signed-rank test showed a significant rise in mean post-test scores compared to pre-test scores (p < 0.05).Additionally, the chi-square test of independence revealed no significant association between demographic variables and the level of posttest EBP scores (p > 0.05).Discussion: This study aimed to evaluate the effectiveness of an Evidence-Based Practice (EBP) education program for clinical nurses, addressing methodological shortcomings by adopting a pre-experimental approach with immediate and longerterm evaluations.The program, comprising 16 hours of lectures and practical sessions over eight weeks, aimed to enhance EBP competencies.Results showed a 9.70% improvement in EBP competency.These findings aligned with previous research to demonstrate the efficacy of EBP educational interventions, and the study result showed that there was no significant association between any of the demographic variables with the level of post-test EBP score p> 0.05.Further research should explore the long-term effects of EBP interventions and broader strategies for integrating EBP across nursing curricula.Conclusion: Our study found that the EBP education program is very effective in improving Evidence-based practice competencies in clinical nurses.The EBP educational program at Al Khor Hospital, HMC, Qatar, aims to enhance the EBP competencies of clinical nurses.The study's findings will have significant implications across various aspects of nursing, including practice, administration, research, and education.By fostering a culture of EBP, the program aims to improve patient outcomes and advance the nursing profession in Qatar.

The implementation of evidence-based practices (EBPs) in community mental health settings for youths has consistently yielded weakened effects compared with controlled trials. There is a need to feasibly measure the quality of large-scale implementation efforts to inform improvement targets. This study used therapist-reported caregiver attendance in treatment sessions as a quality indicator in the community implementation of EBPs. Data were collected from therapists practicing in agencies contracted to provide publicly funded children's mental health services following a system-driven implementation of multiple EBPs. Community therapists (N=101) provided information about youth clients (N=267) and psychotherapy sessions (N=685). Multivariable binomial logistic regressions were conducted to examine associations between caregiver attendance and therapist factors (e.g., licensure status, education), youth factors (e.g., gender, age), and the type of EBP delivered. Caregiver attendance occurred in 42% of sessions. The following factors were associated with increased odds of caregiver attendance: younger client age, male sex of client, externalizing presenting problem, and delivery of an EBP that prescribes caregiver attendance at all sessions. Caregiver attendance at sessions targeting trauma or externalizing disorders appeared to explain the differences between boys and girls in levels of caregiver engagement. Overall, the patterns of actual caregiver attendance appeared consistent with empirically informed practice parameters for involvement of caregivers in treatment. Still, the rates of caregiver attendance in externalizing-focused sessions were suboptimal, and the gender difference in these rates-which clearly disfavored girls-suggests targeted areas for quality improvement. Potential reasons for these quality gaps are discussed.

BackgroundThis study aimed to identify clinical nurses’ evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt’s Advancing Research & Clinical Practice through Close Collaboration model as the first step.MethodsA descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP.ResultsOur findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation.ConclusionsBased on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.

The Advancing Research and Clinical practice through close Collaboration (ARCC© ) Model is a system-wide framework for implementing and sustaining evidence-based practice (EBP) in hospitals and healthcare systems. The model involves assessing organizational culture and readiness for EBP in addition to the development of a critical mass of EBP mentors who work with point-of-care clinicians to facilitate the implementation of evidence-based care. Determining how the various components of the ARCC© Model relate to one another is important for understanding how EBP culture and mentorship impact EBP implementation, nurses' job satisfaction, and intent to stay. The current study aimed to test a model that could explain the relationships and direct pathways among eight key variables in the ARCC© Model: (1) EBP culture, (2) mentorship, (3) knowledge, (4) beliefs, (5) competency, (6) implementation, (7) nurses' job satisfaction, and (8) intent to stay. Structural equation modeling was used to test relationships among the variables in the ARCC© Model with data obtained from an earlier cross-sectional descriptive study with 2,344 nurses from 19 hospitals and healthcare systems across the United States. The final structural equation model found that EBP culture and mentorship were key variables that positively impacted EBP knowledge, beliefs, competency, implementation, job satisfaction, and intent to stay among nurses. As described in the ARCC© Model, establishing a strong sustainable EBP culture along with a critical mass of EBP mentors is crucial for the development of EBP competency and consistent implementation of evidence-based care by nurses. A strong EBP culture along with EBP mentorship also can result in higher job satisfaction and intent to stay. Implementation of the ARCC© Model is a key strategy in assisting systems to reach health care's Quadruple Aim.

BackgroundThe implementation of evidence-based practice (EBP) in daily health care practice is strongly encouraged; it is widely recognized as a means to improve the quality and safety of health care for patients and reduce avoidable costs. Primary care nurses and physiotherapists face numerous challenges in trying to ensure that they deliver effective daily care. Broadly promoted educational interventions aim to increase the integration and implementation of EBP in their daily practice.ObjectiveThis systematic review will retrieve and evaluate publications examining the effectiveness of educational interventions to increase the integration and implementation of EBP among nurses, nurse practitioners, and physiotherapists active in primary care.MethodsWe will conduct a systematic review of published articles in relevant professional, scientific journals (from their start dates) and in the following electronic databases, from inception until October 31, 2020: Medline Ovid SP (from 1946), PubMed (NOT Medline[sb]; from 1996), Embase.com (from 1947), CINAHL Ebesco (from 1937), the Cochrane Central Register of Controlled Trials Wiley (from 1992), PsycINFO Ovid SP (from 1806), Web of Science Core collection (from 1900), PEDro (from 1999), the JBI Database of Systematic Reviews and Implementation Reports (from 1998), and the Trip Database (from 1997). We will use the predefined search terms of “evidence-based practice,” “nurses,” or “physiotherapists” and combinations with other terms, such as “educational interventions.” We will also conduct a hand search of the bibliographies of all the relevant articles and a search for unpublished studies using Google Scholar, the ProQuest Dissertations and Theses dissemination, Mednar, WorldCat, OpenGrey, and Grey Literature Report. We will consider publications in English, French, German, and Portuguese.ResultsThe electronic database searches were completed in October 2020. Retrieved articles are currently being screened, and the entire study is expected to be completed by March 2021.ConclusionsThis systematic review will provide specific knowledge about the effectiveness of educational interventions to increase the implementation and integration of EBP in the daily practice of nurses and physiotherapists providing primary care services. Its findings will inform us about the types and frequencies of the most successful educational interventions.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42017077309; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77309International Registered Report Identifier (IRRID)DERR1-10.2196/17621

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n=100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk etal. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n=100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by nurses in community healthcare settings in Valais. Further research is required to better understand their needs and expectations and to develop suitable strategies that will allow the integration of evidence-based practice into nurses' daily practice.