For this project, Bandura's Social Learning Theory (SLT) was utilized (Bandura, 1997). Cherry (2014) stated that Bandura's SLT maintains the ideas of learning ensuing from conditioning, reinforcement, and punishment while proposing that learning can be achieved by witnessing the actions of other individuals. The three core concepts of the SLT are: (a) Observation can be used by people to affect learning, (b) Intrinsic reinforcement (pride, satisfaction, etc) can support and influence learning, and (c) Behaviors does not consistently change as a result of learning (Cherry, 2014).
Methods: This study originally aspired to perform a randomized national survey of registered nurse self-efficacy and knowledge for EBP using a descriptive correlation survey design. Initially, a power analysis determined 740 subjects were needed for this study. Barriers related to achieving the adequate randomized sample size compelled a modification of the original research plan from stratified random sampling to convenience sampling methods to answer the study questions/hypotheses.
The demographic data sheet was used to accumulate information regarding the participants' age, gender, characteristics of the general work place, years of functioning as a registered nurse, and educational levels. A second tool entitled "Nursing Evidence-based Practice Survey" was used which had 29 questions (5-point Likert-type scale) associated with five areas - organizational culture, unit culture, knowledge and skills, time, and attitude. The 5-factor tool has an established Cronbach's alpha coefficient level of 0.84. The principal focus for this study was on the organizational culture, unit culture, and knowledge and skills factors predominantly. This instrument identified the capacities of the participant concerning the application of evidence in nursing practice, decisions making on the strength of the evidence along with clinical considerations and patient/family preferences. The third tool used was entitled "Evidence-Based Nursing Practice Self-Efficacy Scale", which had 17 questions, asked the participant to assess their proportion of confidence in performing the designated EBP activity. The scale for the percentages was 0 to 100. A designation of 0% was associated to no confidence while a designated percentage of 100 was simultaneous to the individual having absolute confidence in undertaking the activity for the support of nursing practice. The Cronbach’s alpha coefficient level for this tool ranges from 0.95 to 0.98. Permission to use both tools was obtained from the Department of Nursing Services and Patient Care from the University of Iowa Hospitals and Clinics.
Each of the tools was delivery via the online platform - Qualtrics. A cover letter describing the project was provided within the online platform. The completion of the tools was viewed as consent to participate in the study. The project was reviewed and approved by the university IRB. No personal identification was included in the actual survey. The risks to participants related to this project was minimal in nature
Results: The study resulted in 343 surveys using the convenience sampling method. Two hundred forty-seven surveys were usable within the data analysis process. The data reflected that 89% of the participants were female while the largest age group was 30 to 39 years of age. Fifty-three percent of the surveys were submitted by individuals holding a bachelor’s degree in nursing. The years employed as an RN ranged from 1 to over 31 years with 33% of the respondents documenting that they had worked five years or less. The analysis indicated a moderate association and statistically significant association between evidence-based practice knowledge and skills and self-efficacy (Pearson Correlation .537; Significance .000). Individuals working in Magnet facilities did disclose that evidence-based practice knowledge and skills were utilized within the provision of health care. Multiple individual questions within the survey were found to be significant related to age, highest educational degree, and type of acute care setting. The data is being carefully reviewed to determine the interconnections between these questions and the different demographic data components.
Conclusion: According to Melnyk and her colleagues (2018), attention must be directed toward ensuring that the nursing professionals gain a firm foundation in EBP knowledge and skills associated with EBP competencies. This presentation will provide an overview of the process used for this research project along with the results obtained from the data analysis. Following the discussion of the process, recommendations and suggestions will be provided as EBP is moved forward to the next level of engagement.