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Saturday, November 3, 2007

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This presentation is part of : EBP Applications
Evidence-Based Practice in Rural Hospitals
Robin Purdy Newhouse, RN, PhD, Nursing Administration, The Johns Hopkins Hospital/University School of Nursing, Baltimore, MD, USA
Learning Objective #1: Describe the rural hospital evidence-based practice scale.
Learning Objective #2: Discuss the major problems encountered by rural hospitals in fostering evidence-based practice.

Objective: 1) Test the psychometric properties of an evidence-based practice scale; and 2) Describe problems encountered by nurse executives in fostering evidence-based practice in rural hospitals.  

 

Design:  Rural hospital nurse executives completed a mail or phone survey using the Rural Hospital Nurse Executive Survey (NES). The NES consists of 104 continuous and categorical items which were developed based on qualitative research with acceptable estimates of reliability and validity. The evidence-based practice scale consists of seven items with four point response format. 

Population:  A national sample of 276 rural hospital nurse executives completed the survey with a response rate of 40 % (276/688) representing 183 rural and 93 critical access hospitals.

 

Findings:  Cronbach’s alpha for the evidence-based practice scale was acceptable (α =.85).  Nurse executives perceived that a big or moderate problem in enabling evidence based practice is related to their multiple roles or “wearing many hats” (89%), the lack of time (75%), the availability of an expert (71%), the availability of mentors (68%), the education of staff (66%), the availability of an educator (66%), and the lack of familiarity with evidence-based practice (61%). Controlling for hospital type, the total evidence-based practice scale explains 41% of the variance in the nurse executive’s perception of the extent of the problem in enabling evidence-based practice in their hospital. 

 

Conclusion:  The evidence-based practice scale demonstrates acceptable levels of reliability and convergent validity. Enabling evidence-based practice is a frequent and significant problem for rural hospital nurse executives.  Implication:  Professional nursing practice requires an evidence-enhanced environment.  Novel strategies are needed to assist nurse executives to foster evidence-based nursing practice in rural hospitals. Collaborative efforts between academic and clinical settings should be cultivated to make available the needed expertise and mentorship.