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.