The Concept of Facilitation in the Implementation of Evidence-based Practice: Development of an Instrument to Measure Facilitation

Sunday, 17 November 2013: 3:25 PM

Susan J Brown, BSN, MSN, PhD
Nursing, The James Cancer Hospital at the Ohio State University, Columbus, OH

Learning Objective 1: Describe the role of facilitation in the implementation of EBP

Learning Objective 2: Interpret the psychometrics of the Facilitation Assessment Index (FAI)

In 2001 the Institute of Medicine identified a significant gap between what is known about how we should care for patients and the care that they actually receive. This identified gap renewed interest in the study of evidence-based practice (EBP). Significant numbers of research studies have evaluated barriers to EBP, yet questions still arise as to why evidence is not routinely incorporated into practice. The Promoting Action on Research Implementation in Health Services (PARiHS) framework  purports that successful implementation of EBP is a function of the strength of the evidence to be implemented, the quality of the context into which it is implemented, and appropriate facilitation. There currently are levels of evidence and measures of context that can be adopted but no measures of appropriate facilitation. The purpose of this research was to develop an instrument to measure facilitation.

This methodological study was conducted to determine the psychometric properties of an investigator-developed instrument to define and measure the concept of facilitation. The instrument was distributed to a sample of 1025 Registered Nurses in an Academic Medical Center. The response rate was 28%. The majorities of respondents were in a staff nurse role, over the age of 35 and had at least a Bachelor’s degree.

The Facilitation Assessment Index (FAI) demonstrated adequate psychometrics. Factor analysis delineated four subscales entitled Support, Leadership, Respect and Autonomy. The overall reliability of the scale was .931 and the range of reliability of the subscales was .853- .931. The test-retest correlation for the total scale was .852 (p< .001).  Correlations for the subscales ranged from .610-.851 (p< .01).

Relationships between demographic variables and facilitation were evaluated. Both the unit and job title variables demonstrated relationships with scale scores, although group sizes were not equal. Future research is needed to strengthen the psychometric properties of the FAI.