Results – Phase One
The sample consisted of 179 nurses holding at least a baccalaureate degree. Each was
employed at least part-time and worked in the same institution at least two years. Most worked in hospital settings (n = 143) with the remaining in health centers (n = 36). Of the 179 nurses, five were male, and 174 were female (see Table 1 for demographic information).
EBP Beliefs. The summed EBPB scores ranged from 35 to 75, with a mean of 59.45 (SD = 6.50), indicating that nurses had positive beliefs about EBP. However, there is a wide score variation, from M = 2.64 (SD = 0.98) to M = 4.27 (SD = 0.60). The clinical care items (1,5, and 9), and items related to their EBP knowledge and their ability to implement it (4, 6, and 15) had high scores, while items regarding beliefs about EBP being difficult and time-consuming (11
and 13) had the lowest scores (Figure 1).
EBP Implementation Behaviors.The mean score for the EBPI scale was 22.4 (SD =
15.09), indicating that nurses implemented EBP behaviors less than three times in the previous eight weeks. Items associated with frequency of using evidence, collecting patient data, and collecting data and generating research questions (1, 3, and 5) received relatively high scores compared to items asking about accessing and assessing data from the Cochrane and National
Clearinghouse Guidelines data bases (items 12 and 13), which had the lowest scores (Figure 2).
EBP Barriers and Facilitators.The overall mean of the BARRIERS scale (M =
65.53, SD = 15.74) demonstrates that the nurses were more than moderately affected by barriers to utilizing the research in their practices. Specifically, “The Setting” characteristics subscale items scores were higher than the nurse characteristics, quality of research, and research information, all of which were identified as barriers to engage in EBP (Table 2). Conversely, the most distinctive facilitators were those with high scores on the EBPB scale (e.g., the clinical care items [1, 5, 9] and the nurses’ knowledge and ability to implement EBP items [4, 6,15]) (Figure 1), as well as high scores on the EBPI scale (items 1, 2, and 5, associated with using evidence, creating research questions, and collecting data from patients, respectively) (Figure 2).
Relationships among Nurses’ Characteristics and Perceived Barriers and Facilitators. Among the facilitators to engagement in EBP, the nurses’ respective levels of education were significantly associated with knowledge to improve patients’ care (EBPB: item 9) (F = [5,173] = 2.61,p = 0.026) (Figure 1). Respective education levels also had an effect on collecting data on patients’ problems (EBPI: item 5) (F = [5,169] = 2.30,p = 0.05). Nurses enrolled in a graduate program had a higher mean score in using evidence to change clinical practice (EBPI: item 1) (M = 2.22, SD = 1.315) compared with those who were not enrolled (M = 1.75, SD = 1.035); t (145) = -2.23, p = 0.027). Moreover, nurses with experience working in research (M = 4.31, SD = 0.655) had higher scores in the belief that EBP results in the best clinical care compared to those without such experience (M = 3.97, SD = 0.724), t(175) = -2.62, p= 0.010) (Figure 1). Among the barriers, the belief that EBP is difficult to implement (item 13) showed a significant correlation with education level (F = [5,170] = 2.40,p = 0.042). Regarding accessing the Cochrane database (item 12) showed a significant difference for the mean scores between those who were enrolled in a graduate program (M = 1.30, SD = 1.331) and those who were not (M = 0.74, SD = 1.081) t(145) = -2.57,p = 0.011) (Figure 2). No other characteristics demonstrated significant associations with the facilitators or barrier items on the EBPB and EBPI scales. Of the four BARRIERS scale factors (Table 2), factor 1, containing items associated with setting, was identified as the major barrier to implementing EBP. Overall, there was a positive correlation between Factor 1 and the EBPB total items score, r = 0.16, n = 178, p = 0.04.