Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers |
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| Authors: | Shaheen Majid Schubert Foo Brendan Luyt Xue Zhang Yin-Leng Theng Yun-Ke Chang Intan A Mokhtar |
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| Institution: | Associate Professor ;Professor ;Assistant Professor ;Doctoral Student ;Associate Professor ;Assistant Professor, Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore 637718 ;Assistant Professor, Department of Policy and Leadership Studies, National Institute of Education, Singapore 637616 |
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| Abstract: | 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 training, 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.Highlights- Nurses in Singapore, as in other countries, support the idea of evidence-based practice (EBP) but have limited skills in the area of literature searching and understanding evidence, which limits their use of evidence-based practice.
- Only a small number of nurses were able to pick an appropriate search strategy for a given topic, indicating a lack of basic literature searching skills.
- Sufficient literature searching knowledge is essential to retrieve current, relevant, and accurate evidence. However, a majority of nurses do not know how to properly use Boolean and proximity operators, indexing, truncation, or limits.
Implications- Librarians need to be part of providing ongoing training for clinical nurses in searching the evidence, especially in hospitals promoting EBP or seeking Magnet status.
- Training is needed for clinical nurses to be able to achieve the use of EBP, and librarians can support this goal by teaching the search strategies portion of an EBP skills course.
- This study''s instrument could be used by librarians as a needs assessment tool to measure their own clinical nurses'' information literacy skills, if justification is needed locally.
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