Educational Intervention Effects on Nurses' Perceived Ability to Implement Evidence-Based Practice

Friday, 20 July 2018: 1:30 PM

Atalanta Wan, PhD, RN, CNS, CCRN, NE-BC
Professional Development Department, Contra Costa Regional Medical Center, Martinez, CA, USA


An effective evidence-based practice (EBP) educational intervention has not been identified in the clinical settings (Black, Balneaves, Garossino, Puyat, & Qian, 2015; Underhill, Roper, Siefest, Baucher, & Berry, 2015). Lack of effective EBP educational interventions may delay the promotion of EBP in nursing. Nurses’ negative attitudes toward EBP are correlated with lack of skills and knowledge about EBP (Kharmmarnia, Mahsa, Amani, Rezaeian, & Setoodehzadeh, 2015; Majid et al., 2011). Effective EBP educational training and strategies are needed to improve nurses’ knowledge and skills of EBP, their beliefs about and attitudes toward EBP, and their perceived ability to implement EBP (Melynk & Fineout-Overholt, 2008, 2015).


The first purpose of this study was to examine the effects of a face-to-face educational intervention on nurses’ knowledge of EBP, their beliefs about and attitudes toward EBP, and nurses’ perceived ability to implement EBP. The second purpose was to examine the correlations between nurses’ knowledge of, beliefs about, and attitudes toward EBP and their perception of their ability to implement EBP after implementation of the intervention


A quasi-experimental pretest/posttest random design was conducted. Participants were assigned to the experimental group or control group randomly. Instruments utilized in this study were the knowledge and attitudes subscales of the Evidence Based Practice Questionnaire, the Evidence Based Beliefs Scale, and the Evidence Based Practice Implementation Scale. Wilcoxon’s signed rank test was used for within subject and between subject data comparison to examine the effects of the EBP educational interventions. Multiple coefficient test was planned originally to examine the relationship between the variables. Because of small sample size, Pearson’s correlation coefficient test was employed instead to examine the bivariate relationships of the variables.

Sample and Procedure:

Purposive sampling was used to recruit nurses in a county hospital in California. Forty nurses voluntarily participated in the study from April 2016 to November 2016. One out of the 40 nurses resigned. The 39 participants were assigned randomly to the experimental and control groups. The intervention provided for the experimental group consisted of six-hour educational training and a one-and-half-hour workshop. Out of the 39 participants, ten nurses in the control group completed the survey and nine nurses in the experimental group showed up in the EBP course. Data were collected from the experimental group before the intervention, immediately and one month after the intervention. Among the ten nurses in the control group, one nurse completed the pretest survey only and the data from the participant was excluded from analysis. The nine nurses in the control group completed the pretest and posttest survey without taking any of the EBP educational courses. A web-based survey was used for data collection. A few participants completed the survey four weeks after the intervention. Data from this point were excluded for analysis.


Data analysis included descriptive statistics, Wilcoxon’s signed rank test, and Pearson’s correlation coefficient test. Within subject data analysis indicated that the EBP educational intervention significantly improved nurses’ beliefs about EBP, knowledge of EBP, and their perceived ability to implement EBP (p < .05). Pearson’s r test analysis indicated that there is no relationship between nurses’ knowledge of EBP, beliefs about and attitudes toward EBP, and their perceived ability to implement EBP (p > .05).


The study results could encourage nurse leaders to promote teaching EBP in clinical settings and remove barriers to the application of evidence into nursing practice. Education alone cannot improve nurses’ beliefs about EBP, their EBP knowledge and skills, attitudes toward EBP, and their perceived ability to implement EBP. Organizational culture and readiness for EBP and support from leadership have been identified to improve nurses’ beliefs about EBP and attitudes toward EBP (Melnyk & Fineout-Overholt, 2015; Stetler, Damschroder, Helfrich, & Hagedorn, 2011). Availability of EBP mentors, adequate infrastructure and resources are considered as successful strategies to promote nurses engage in implementing EBP in their daily practice (Melnyk et al., 2016).

In addition, the study served as a foundation for future studies on an educational intervention to help nurses adopt EBP. A quasi-experimental pretest and posttest research design with random assignment is a possible study design in education research in clinical settings (Cooper & Schindler, 2014; Cozby & Bates, 2014). One of the strengths of this study included a novel approach to using random assignment to examine the effects of an educational intervention on nurses’ perceived ability to implement EBP. Another strength of this study was the use of power analysis to calculate the necessary sample size for testing the difference of the effects of the intervention between the experimental group and the control group. However, the limitations of this study were a small sample size and purposive sampling. Future studies with a larger sample size and random sampling are highly recommended to obtain significant results for generalization.