Methods: A descriptive, cross-sectional, on-line survey design was used. The study was approved by the OSU Institutional Review Board. The EBP Beliefs Scale, a valid and reliable instrument (alpha >.85 across various samples), was used to collect beliefs data from participants. Demographic characteristics and information about the participants’ organizations also was collected. All nurses who held a current membership in AMSN were recruited. Also, nurses who held certification from the Medical-Surgical Nursing Certification Board (MSNCB) were recruited to participate in the study. The on-line survey was created by the team members from OSU and AMSN and the data were collected via a link on the AMSN website to the OSU survey portal created for the study. No individual nurse was identifiable from the data obtained. Data were analyzed using SPSS v.25.
Findings: Approximately 1700 nurses from 49 states responded to the survey; 11 international AMSN members also responded. Not all nurses responded to each survey question. Most of the participants were Caucasian females in clinical staff nurse roles (47%). Most of the participants had completed a Bachelor of Science degree in nursing (BSN) and 25% had completed a Masters or Doctor of Nursing Practice (DNP) degree. The average age of the participants was 47 years and they had been nurses for an average of 18 years with 15 years as medical-surgical nurses. Most of the participants (80%) were certified as either medical surgical nurses (CMSRN) or care coordinators (CCCTM) through MSNCB. Approximately 42% of the participants indicated they worked in Magnet designated hospitals and another 41% said they worked in Pathway to Excellence hospitals. Only 6% worked in AMSN PRISM (Premier Recognition in the Specialty of Medical-Surgical Nursing) designated units. The nurses worked primarily in acute care community/ regional hospitals consisting of 100-500 beds.
Most of the participants (94%), said they believed EBP results in the best care for patients but only 75% said they were clear about the steps of EBP. Furthermore, 81% said they were sure they could implement EBP and 93% said they believed that critically appraising the evidence is an important step in the EBP process, but only 68% believed they could search for the evidence in a time efficient way and 62% said they could access the best resources to implement EBP. Regarding implementation of EBP, 64% of the participants said they knew how to implement EBP sufficiently to make practice changes and 61% said they believed they could implement EBP in a time efficient way but only 62% said they were sure about how to measure the outcomes of clinical care. However, 18% said they believed that EBP takes too much time and 25% believed EBP is difficult. Only 65% of the nurses believed they could overcome barriers in implementing EBP yet 75% of the respondents said they believed the care they deliver is evidence-based. Furthermore, only 45% of the participants believed that their EBP councils are effective in implementing EBP or that unit based councils contribute to EBP practice changes. But 80% of the nurses believed that sustaining a culture of EBP is important and that EBP reduces healthcare costs. Most of the participants (90%) believed that implementation of EBP enhances safety and reliability within healthcare yet only 54% strongly believed that nurse managers in their organizations implement EBP in their own practice. When asked about the biggest barriers to building and sustaining a culture of EBP, many participants cited lack of EBP skills, lack of resources such as librarians or library databases, lack of DNP or PhD EBP nurse champions, and nurse manager/senior nursing leader support.
Discussion/Conclusions: It should be noted that a limitation of this study is self-selection bias. It may be that nurses who were more knowledgeable about EBP chose to participate in this study. Because most of the nurses in this sample were educated at the BSN level or higher and certified, they may represent a more knowledgeable sector of the medical-surgical nursing population. Also, nurses who are members of national nursing specialty organizations may be more engaged in learning about and implementing EBP. However, in some respects the findings are consistent with other studies of nurses’ beliefs about EBP. For example, the barriers noted by participants such as lacks of resources and administrative support have repeatedly appeared in the literature. Therefore, there are opportunities for AMSN to assist their members in gaining EBP skills and the findings from this study will be used to plan educational activities for AMSN members. AMSN members also will be made aware of opportunities for learning EBP skills through organizations such as the Helene Fuld Institute for EBP. Additionally, as a national nursing organization, we can collaborate with our colleagues in the American Organization of Nurse Executives (AONE) to make them aware of continued findings that demonstrated lack of mid-level and senior administrative support for EBP activities.