Evidence-based Practice for Nurses

Critical care nurses' knowledge of, adherence to, and barriers toward institution-specific ventilator bundle

Background:Evidence-based practice (EBP) is a problem-solving approach to patient care based on the best available and valid evidence. It is accentuated to increase the quality of care and patient safety. EBP in clinical service is low in developing countries including Ethiopia. This study a

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Evidence-based practice among health professionals in hospitals of Northwest Ethiopia: a cross-sectional study.

Evidence-Based Medicine (EBM) is the process of systematically locating, searching, evaluating, and using contemporaneous research findings as the basis for clinical decision making. The systematic review showed that there is a considerable gap between what is known in the systematic research evidence and what happens in practice. Thus, the purpose of this study is to assess knowledge, attitude, practice and perceived barriers to EBM among physicians working in public hospitals in eastern Ethiopia. An institutional-based cross-sectional survey was conducted from April 1–June 8, 2017. Simple random sampling with proportional allocation was used. A total of 137 physicians was included in the survey. The data were collected by interview. Data were coded and entered to EpiData 3.1 then exported to and analyzed by using IBM SPSS statistics 21.0. Physicians were aware of and used HINARI (22.6%), Cochrane (29.8%) and PubMed/Medline (37.9%) EBM electronic databases. The majority, (88.7%) physicians have a good attitude to EBM but only (32.3%) integrate it into clinical practice. Ability to retrieving evidence, evaluating the outcomes of the EBM practice implemented and difficulty in understanding research reports were significantly associated factors. The attitude of the physicians towards EBM was virtuous, but knowledge of EBM and practice of integrating new evidence in healthcare service were really insufficient. Relatively, the EBM implementation is low when compared with many studies. To obviate this, the stakeholders need to have a strong commitment to design a strategy for promoting physicians in implementing EBM to their day to day clinical decision-making process.

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Evidence-based medicine among physicians working in selected public hospitals in eastern Ethiopia: a cross-sectional study

BACKGROUND Despite the fact that evidence-based practice (EBP) is believed to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia is not evidence-based. Understanding the extent of and barriers to EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia. OBJECTIVE This study aimed to assess reported level of EBP and associated factors among health care providers working in public hospitals in northwest Ethiopia. METHODS A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire that was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP Implementation Scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation. RESULTS The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β = -0.10; P < 0.05); having been trained as a bachelor's degree-level nurse (β = 3.45; P < 0.001) or a bachelor's degree-level midwife (β = 2.96; P < 0.001), a general practitioner (β = 7.86; P < 0.001), or a specialist physician (β = 15.04; P < 0.001) rather than a diploma-level nurse; working in a pediatrics ward (β = -1.74; P < 0.05); and reporting as barriers either a lack of clarity on the importance of EBP (β = -0.93; P < 0.05) or a lack of orientation sessions on new health priorities (β = -0.91; P < 0.05). CONCLUSIONS Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia. (Curr Ther Res Clin Exp. 2020; 81:XXX-XXX).

Evidence-Based Practice and Associated Factors Among Health Care Providers Working in Public Hospitals in Northwest Ethiopia During 2017.

Background: Historically, nurses have relied on expert’ opinions in clinical decision-making. However, these ways of practicing may not only be outdated but unsafe. Experienced-based knowledge may be associated with biased thinking that lead to errors. Objective: Assessment of nurses’ perceptions, level of use and barriers on Evidence Based Practice. Method: Two hundred ten nurses were assessed through self-administer questionnaires for quantitative and fifteen nurses were also involved in in-depth interview for qualitative. The quantitative data was analysis in SPSS version 21. The qualitative was analyzed through open code. Results: 90% and 73.8% have good perception and positive attitude respectively. Of the total 210 121(57.6%) of nurses were integrate EBP in their clinical practice. Only 19 (15.7%) use EBP in their clinical practice always. Knowledgeable (AOR 3.2 95%CI 1.5-7.0); skill, (AOR 2.4, 95%CI 1.1-5.4); free time (AOR 7.9, 95%CI 3.5-17.6); supportive nursing managers (AOR 5, 95%CI 1.7-14.5) have significant association with implementation of EBP. But, year of experience and perception have no association. Conclusion: Both individual and organizational factors are the predominant factors that hinder implementation of EBP. So, hospital managements and nursing leaders can easily overcome some of these barriers through arranging EBP training.

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S. Tsehay

Papers

Assessment of Nurses’ Perceptions and Barriers on Evidence Based Practice in Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia