An Exploration of Contextual Factors Impacting Nurses Implementation of Evidence: Readiness, Beliefs, Skills and Needs

Sunday, 17 November 2013: 3:25 PM

Lisa English Long, MSN, RN1
Tracy Brewer, DNP, RNC2
Lucinda Brown, MSN3
Mary Beth Kaylor, PhD, RN2
Donna Miles Curry, PhD, RN, PCNS-BC4
Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN5
(1)College of Nursing, The Ohio State University, Columbus, OH
(2)College of Nursing and Health, Wright State University, Dayton, OH
(3)Children's Medical Center, Dayton, OH
(4)College of Nursing & Health, Wright State University, Dayton, OH
(5)Nursing, East Texas Baptist University, TX

Learning Objective 1: The learner will be able to identify strategies for conducting an EBP needs assessment.

Learning Objective 2: The learner will be able to describe the importance of developing systems to support evidence-based practice within organizations.

Theoretical Base.  The need to understand systems, infrastructure and context are imperative when developing a culture based on evidence. Improving outcomes through the implementation of evidence-based practice (EBP), achieving nursing excellence and building a foundation for exemplary professional practice can be achieved through identification of an organization’s culture of EBP.  The Promoting Action on Research in Health Services (PARIHS) framework (Rycroft-Malone, 2004) and the Advancing Research through Close Collaboration (ARCC) Model (Melnyk & Fineout-Overholt, 2011) served as the basis for a needs assessment.

Purpose of research.  The purpose of this study was to conduct a needs assessment that explored the relationship between contextual factors (readiness, beliefs, skills and needs) and nurses’ ability to translate and implement research.

Design and Methods.  The study, conducted in a mid-west pediatric institution, used a descriptive correlational design.  To understand the relationship between contextual factors and nurses’ ability to translate and implement research the Evidence-based Practice Beliefs Scale, Evidence-based Practice Implementation Scale and Organizational Culture and Readiness for System Wide Implementation of Evidence-based Practice Survey (Melnyk & Fineout-Overholt, 2011) were used for electronic data collection. 

Analysis and Results.  Descriptive and correlational statistics were used to describe results and identify associations among variables. Positive relationships were reported between EBP beliefs, extent of education (p=.013), and organizational EBP culture (p=.000).   Exposure to EBP through CE programs (p=.008) and shared governance activities (p=.000) were positively correlated with EBP implementation.  Engagement of nurses in EBP was positively correlated to a culture of EBP (p=.021).  Areas for further development focused on implementation of EBP.

Conclusion and Implications.  Potential benefits of nurse’s participation included implementation of results to improve the contextual environment.  Innovation through the development of EBP Mentors, resources, and educational programs can be achieved as nurses lead a shift to an organizational culture based on evidence.