Mentoring as a Strategy for Enhancing EBP in Clinical Practice

Saturday, 28 October 2017

Ngozi C. Eke, MSN
Lubbock Christian University, Lubbock, TX, USA

Aims and Purpose. The purpose of this review is to examine the scientific literature reporting the effectiveness of mentoring as a tool for enhancing nursing attitudes and acceptance of evidence based practice in nursing clinical practice.

Background. Evidence based practice (EBP) has been embraced by the nursing profession as a means of optimizing patient care (Ploeg, et. al., 2010). Evidence-based practice (EBP) in healthcare is known as the highest standard for patient care. Evidence based practice combines scientific knowledge, clinical expertise and patient choice (IOM, 2011; IOM, 2016). The call to evidence-based practice (EBP) is evolving. Nurses from varying practices, specialties and levels of research experience, have the opportunity to reflect on advances in leading best practices. With the increase emphasis on the use of EBP, faculty and clinicians are investigating the use of multifaceted means of enhancing the use of EBP in the clinical areas of nursing care delivery (Brooke & Mallion, 2016; Abdullah, et. al., 2016). Evidence suggests mentoring may increase EBP uptake; however, there is limited understanding of whether mentoring could be used as a tool for enhancing nursing attitudes and acceptance of EBP in clinical practice.

Design. This study used an integrative review research (IRR) approach.

Methods. An in depth electronic search in Health Source: nursing/Academic Edition, MEDLINE Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL) with full Text, Academic Search Complete and Cochrane Library databases, using the search terms: mentoring, nursing, and evidence based practice, from 2003 – 2016 was conducted. Twenty-two articles were initially identified. Fourteen studies met the inclusion criteria: peer reviewed in nursing, and a quantitative or qualitative research study design. Eight articles were excluded based on article design (concept paper), non-peer reviewed journals, and year of publication or lacking documentation of research procedures. A final sample of 13 articles met study criteria. Two systematic review articles were observed to be level one evidence, and were evaluated using the PRISMA Guidelines (Abdullah, et. al., 2014; Scala, et. al., 2016). Four articles; mixed methods and quasi experimental, were level two evidence (Farokhzadian, et. al., 2015; Ploeg, et. al., 2010; Soukup, & McCleish, 2008; Wallen, et. al., 2010). Five articles; explorative qualitative, quantitative, non-experimental, were level three evidence (Brooke & Mallion, 2016; Majid, et. al. 2011; Mariano, et. al., 2009; Hauck, et. al., 2013; Oh,et. al., 2010); two, ethnographic design, non-experimental descriptive design, were level four evidence: (Dupin, et. al., 2014; Granger, et. al., 2012). Data were extracted and synthesized.

Results. Personal, institutional/organizational and leadership/administration issues may play a role in EBP mentoring. Subthemes which gave clues to the effectiveness of mentoring in evidence based practice were: administrative support, staff perception, staff motivation and engagement, and availability of adequate training opportunities. Findings from the quantitative studies indicate barriers to full adoption and implementation of EBP include: difficulty accessing and reading the enormous body of literature published in healthcare, difficulty in understanding statistical analysis and research terms, insufficient time, and lack of authority for implementing EBP (Brooke, & Mallion, 2016; Oh, et. al., 2015).

Synthesis of the qualitative studies suggest nurses do not fully desire to engage in implementation of EBP (Abdullah, et. al., 2016; Brooke, & Mallion, 2016; Wallen, et. al., 2010). However, studies suggest participating in a structured EBP mentorship program has positive effects on organizational/institutional culture and readiness for EBP, and nurses’ perception, motivation and engagement for implementation of EBP (Ploeg, et. al., 2010; Farokhzadian, et. al., 2015; Granger, et. al., 2012).

Conclusion. Personal perception of evidence based research was identified to affect motivation and engagement. Adequate support from organizations administration and training utilizing a mentor was identified to be a positive influence in full adoption and implementation of EBP.

Relevance to Clinical Practice. Leadership in hospitals and teaching hospitals should consider developing mentoring programs as a tool for engaging nurses at all levels of career ladder. Integration of EBP into a clinical practicum is a strategy to increasing confidence and skill on EBP and decrease barriers to research utilization in student nurses. Credibility should be given to nurses’ participating in EBP experience and opportunity to effect changes increases staff satisfaction and overall patient safety and outcome.