Learning Objective #1: understand the evidence-based nursing practice process

Learning Objective #2: describe strategies for the successful development and implementation of evidence-based practice guidelines in a mental health setting

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Promoting evidence-based practice is a strategic imperative in Singapore in response to the drive for quality and effectiveness. There is consistent acknowledgement in the literature that a simultaneous alignment of multiple strategies is more effective to promote and sustain evidence-based practice than single discrete strategies. This will involve developing a multifaceted program that not only promotes the utilization of evidence in practice, but aims to foster an environment in which it is widely appreciated, understood and positively nurtured.

A cross-sectional survey was conducted on 88 Registered Nurses randomly selected from the database of a mental health setting in Singapore to assess their perceptions and attitudes towards evidence-based practice. After which, a 20-hour, 3-month hands-on workshop on the development and implementation of evidence-based practice guidelines was conducted. A post-survey was conducted on the participants at the end of the workshop to assess changes in their knowledge, perceptions and attitudes towards evidence-based practice.

The results indicated that 45% of the 88 Registered Nurses did not participate in evidence-based activities in the last 12 months, 50% had minimal knowledge and skills about evidence-based practice, 21% had negative attitudes towards evidence-based practice and 41% had negative perception of barriers towards the implementation of evidence-based practice. Analyses of the post-workshop survey showed an approximate 20% positive change in the nurses' knowledge, perception and attitudes towards evidence-based practice.

The outcome of the educational workshop has been positive. The nurses, who have attended the workshop, are developing clinical practice guidelines that aim to standardise management of five critical clinical issues in the mental health setting. Roger's (1995) theory on the diffusion of innovations is being used to devise strategies to facilitate adoption and integration into clinical practice so that the desired outcomes can be achieved.