Evaluation of a Web Course to Increase Evidence-Based Practice Knowledge Among Nurses

Effectiveness of an Evidence-Based Practice Training Program for Nurse Educators: A Cluster-Randomized Controlled Trial

BACKGROUND

Evidence-based practice (EBP) endeavors to integrate the best available evidence with clinical expertise and patient preference to enhance clinical outcomes. For nurses to effectively demonstrate EBP, the concepts of EBP should be systematically incorporated into the nursing curriculum, with nurse educators playing a pivotal role in execution. However, the effect of EBP training programs on nurse educators remains largely unexplored.

AIM

To evaluate the effectiveness of an EBP training program on the knowledge, attitude, practice, and competency of nurse educators.

METHODS

A pragmatic randomized controlled trial was conducted at a nursing education institution. Fifty-one nurse educators were cluster randomized into intervention and control groups. A 30-hour EBP training intervention was provided for nurse educators in the intervention group. The outcome variables were knowledge, attitude, practice, and competency regarding EBP. These outcomes were evaluated using the EBP knowledge and practice questionnaire, EBP attitude scale, and Fresno test. Data were collected at baseline, the end of 5 months, and the end of 10 months.

RESULTS

Fifty-one eligible participants were enrolled in the study. The intervention and control group had three clusters each with 27 and 24 participants, respectively. Participants in both groups were comparable for variables such as age, years of experience, and educational background (p > .05). Between groups, outcome variables were compared using mixed linear multi-level modeling. Nurse educators who received the EBP training program demonstrated significant differences in knowledge (p < .05), attitude (p < .05), practice (p < .05), and competency scores (p < .05), than that of the control group, indicating the intervention effectiveness.

LINKING EVIDENCE TO ACTION

EBP training programs are effective in improving the knowledge, attitude, practice, and competency of nurse educators.

Evidence-Based Practice Competency and Related Factors Among Nurses Working in Public Hospitals

This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses’ demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses’ age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.

Measures of evidence-informed decision-making competence attributes: a psychometric systematic review

Background

The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing.

Methods

The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings.

Results

A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6–25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach’s alphas ranging from 0.45–0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.

Conclusions

This review highlights a gap in the testing and use of competence attribute measures related to evidence-informed decision making in community-based and long-term care settings. Further development of measures is needed conceptually and psychometrically, as most measures assess only a single competence attribute, and lack assessment and evidence of reliability and sources of established validity evidence.

Registration

PROSPERO #CRD42018088754.

A Quasi-Experimental Study of a Basics of Evidence-Based Practice Educational Intervention for Health and Social Care Professionals

Education is one of the central interventions to promote evidence-based practice (EBP) in service organizations. An educational intervention to promote EBP among health and social care professionals was implemented in a Finnish hospital. The aim of this study was to explore the outcomes of an educational intervention, focusing on the basics of EBP for health and social care professionals, using a quasi-experimental study design. The data were collected with a questionnaire before, immediately after, and 6 months after the education (n = 48). The data were analyzed with descriptive statistics and nonparametric tests. Immediately after the education, an increase was found in the EBP knowledge of participants, in participants’ confidence in their own ability to conduct database searches and read scientific articles, and in the number of participants using databases at work. Six months after the education, improvements were still found between the first and the third measurement in the participants’ knowledge and confidence in their own ability to conduct database searches and read scientific articles. The number of those who had made an initiative about a research topic regarding the development of their own work had increased from the first to the third measurement. The educational intervention produced a statistically significant improvement on most of the areas evaluated. Significant improvements were often found even 6 months after the education was finished. However, the low completion rate and a quasi-experimental before and after design limit the conclusions that can be derived from this study.

E-learning: who uses it and what difference does it make?

BACKGROUND

CaseSearch 'My Learning' e-learning modules were designed to remind clinicians and practitioners about the role of evidence in practice and demonstrate how to find relevant evidence to make a difference in clinical care. This study aims to describe the role of the modules and their uptake, and determine whether the modules influenced the learners' palliative care practice and whether the modules were easy to use.

METHOD

Two sets of questions were designed to capture data to evaluate the modules.

FINDINGS

The modules supported the awareness and use of evidence by health professionals. The modules contribute to ongoing professional development for practitioners and can improve palliative care practice.

CONCLUSION

It is possible to collect meaningful data that contributes to understanding who uses e-learning resources and how useful healthcare professionals find them.

Perceptions of Rural Magnet Nurses' Comfort and Confidence With Evidence-Based Practice

BACKGROUND

Evidence-based practice (EBP) is essential for improving outcomes for patients and is an expected competency of nurses. However, current practice finds varying levels of comfort and confidence among nurses regarding EBP implementation.

METHOD

A descriptive study using an online survey was conducted to assess the perceptions of nurses at a rural midwestern Magnet^® hospital on their comfort and confidence regarding EBP and compare the results to the nurses' level of education and years of experience.

RESULTS

Although nurses agreed that EBP is important for patient care, nurses with a baccalaureate degree or higher reported increased comfort and confidence with EBP implementation. However, nurses with more years of experience, regardless of education level, reported increased comfort and confidence with EBP, although that finding did not reach significance levels.

CONCLUSION

Creating a culture of EBP is the responsibility of every organization. Administrators and educators must continue to assess the comfort and confidence levels of nurses who work directly at the bedside and provide continuing education and hands-on opportunities to increase nurses' comfort and confidence with implementing EBP. [J Contin Educ Nurs. 2019;50(11):495-500.].

Undergraduate student nurses' knowledge of evidence-based practice: A short online survey

BACKGROUND

Various approaches and frameworks have been designed and tested to increase the uptake of research findings into practice. One approach is to base healthcare providers' practices on the best available research evidence rather than on expired policy or tradition. For which knowledge of evidence-based practice (EBP) principles is a prerequisite.

OBJECTIVE

The purpose of the current inquiry is to evaluate Jordanian nursing students' knowledge of EBP.

DESIGN

This study was an on-line cross-sectional survey.

SETTINGS

We targeted students in two universities in the north and one in the capital city of Amman.

PARTICIPANTS

The target population was Jordanian student nurses, and the sample consisted of 316 from the nursing schools within three government universities.

METHODS

The EBP knowledge test was used to collect data from students. It was adapted from the EBP Knowledge, Attitudes, Access & Confidence Evaluation. Ethical approval was obtained from the principal investigator's university before the questionnaire was uploaded on to the free online survey website. The link to the survey was established and shared on Facebook.

RESULTS

Just over half of the participating students were male (51.9%) and the average age was 21.6 years (SD 2.7). The mean total knowledge score as measured by the EBP knowledge test was low at 1.9 (SD 1.4) out of 10.

CONCLUSIONS

An evaluation of EBP-related content in nursing schools' curricula is needed in order to design and test the effectiveness of implementing an EBP course in improving knowledge and skills. Critical appraisal and evidence synthesis skills should be honed as they are seen to be very weak, with much room for improvement. Meanwhile, research courses could be the mainstay for a nursing faculty to introduce the EBP approach for undergraduate nurses.

Evaluating Evidence-Based Practice Knowledge and Beliefs Through the e-Learning EBP Academy

BACKGROUND

This research examined evidence-based practice (EBP) knowledge and beliefs before and after a 3-month e-learning program was implemented to build EBP capacity at a large children's hospital.

METHOD

Ten clinicians completed the development, implementation, and evaluation of the e-learning education, comprising phase one. Revision and participation by 41 clinicians followed in phase two. Participants in both phases completed the EBP Beliefs and Implementation Scales preintervention, postintervention, and 6 months after postintervention.

RESULTS

EBP beliefs and implementation increased immediately and 6 months after postintervention, with statistically significant increases in both phases. Participants in both phases applied knowledge by completing mentor-supported EBP projects.

CONCLUSION

Although EBP beliefs and implementation scores increased and e-learning provided flexibility for clinician participation, challenges arose, resulting in lower-than-expected completion. Subsequent revisions resulted in hybrid education, integrating classroom and e-learning with project mentoring. This funded e-learning research contributes knowledge to the growing specialty of professional development. J Contin Educ Nurs. 2017;48(7):304-311.