Evidence-based practice is defined as the proper, explicit, and conscientious use of the most recent and best evidence in making decisions about individual patient treatment. Furthermore, it entails combining individual therapeutic experience with the finest external clinical data available from systematic research. In this example, clinical expertise refers to the clinician's combined experience, clinical abilities, and education. It consists of three parts: the best available scientific findings, clinical judgment and competence, and client preferences and values (Warren, McLaughlin, Bardsley, Eich, Esche, Kropkowski, & Risch, 2016). It is also defined as an approach that helps in solving problems in the delivery of healthcare and combines clinician’s expertise, the best evidence available and the preferences and values of the patient.
What was purposed in the study (purpose, research questions, and hypotheses)?
This study aimed at evaluating both the strengths and the opportunities that are in the implementation of the Evidence-based nursing practice. It was undertaken across a different 9-hospital system that is in the mid-Atlantic region. Also, it was to describe the beliefs, perceptions, and attitudes of the registered nurses about the preparedness and implementation of EBP in a multihospital healthcare system.
Moreover, the study was purposed to examine the differences by professional characteristics which involved the age, work experience, education, and certification. Again, there was an examination of differences by demographics which included the hospitals that are magnet versus those that are non-magnet (Warren et al, 2016). Finally, there was an analysis of the extent to which clinical nurses and nursing leadership differed in their implementation behaviors, beliefs, and perceptions of the organizational preparedness for the EBP.
How was the sample obtained?
The survey was carried out with a convenience sample of 6800 nurses whose employer was a mid-Atlantic healthcare system. It was conducted from May 2012-July 2012.
What inclusion or exclusion criteria were used?
There were three hospitals in the District of Columbia and other seven in Maryland. The primary, urgent, acute, and subacute care medical research and education are the Healthcare Systems comprehensive services that were included. In Washington DC, two out of the three hospitals are for acute care and research while the third is a specialty for rehabilitation. Magnet-designated hospitals are two and are located in Washington DC and Maryland each (Warren et al, 2016). The hospitals whose sizes range from 100-1000 hospital beds are located in rural, urban and suburban settings.
Who from the sample participated or contributed data (demographic or clinical profile, and dropout rate)?
There was the inclusion of registered nurses working part-time, full-time and per diem in the patient care, supportive services, and clinical leadership. Moreover, 1608 registered nurses produced a survey that could be used. There is consistency in the distribution of those who responded based on geographic location. Further, there was a 34% respondent from the two Washington DC hospitals. These two hospitals employ 42% of the registered nurses working in the nine hospitals hence the response was expected. Also, 36% of the respondents were workers in the two Magnet designated facilities (Warren et al,2016).
What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?
The sample was obtained by the use of three questionnaires; the Organization Cultural and Readiness for System-Wide Integration of EBP Scale, The Evidence-Based Practice Beliefs Scale, and the Evidence-Based Practice Implementation Scale. The three surveys helped in data collection.
Was an intervention tested?
No, there was no testing of any interference in the research.
How was the sample size determined?
The qualified registered nurses were given information about the survey through specific hospital-wide and multiple hospital-wide communication methods. These methods of communicating the information included advertisements in newsletters, announcements, through fliers, and through e-mails (Warren et al, 2016). In the process, there were five notifications through e-mail that informed the staff about the survey. In inclusion, there was an initial e-mail, three other e-mails as reminders, and a final one that communicated about the deadline extension of the investigation. Notably, it was conducted between the dates of May 2012 and July 2012. Moreover, it involved a convenience sample of a total of 6800 nurses whose employer was a mid-Atlantic healthcare system.
What are the main findings?
In the results, 41% of the registered nurses individually believed and agreed they had the knowledge to contrivance EBP sufficiently to make practice changes. However, 44% were confident that they were able to implement EBP. Another 48% of the same were positive they could apply it in a time efficient way. Further, 49% were in a position of getting the resources necessary to help implement EBP. In the survey, more than one-third of those who responded were from two of the Magnet designated hospital system. These Magnet registered nurses believed that their hospital organization was ready for implementation of EBP.
However, a bigger percentage (64%) suggested that their organizational hospitals were not ready for the implementation. Besides, there was the inability of human resource to facilitate EBP practice. Also, the survey depicted that although the younger RNs claimed they had less experience in the implementation, they had more positive beliefs towards EBP. Finally, the RNs in both in support roles and leadership had more positive views on the EBP.
Is the research published in a source that required peer review?
Yes, the study is both in books and website where it can be examined by a peer.
Was the design that was used appropriately to the research question?
Yes, the use of three different but related questionnaires was suitable for an all-around research.
Was the research question answered by the data obtained and the analysis conducted?
Yes, the aim was to describe the beliefs, attitudes, and perceptions about the readiness and implementation of EBP in the multihospital healthcare system.
Were the measuring instruments reliable and valid?
Yes, the instruments are rated at 0.85 which is ignorable.
Were important extraneous variables and bias controlled?
Not Clear
Was the study free of external variables introduced by how, when, and where the study was done?
Yes, there was a significant variable among the RNs responses based on where the hospital was.
Conclusion
It is vivid regarding the study that the registered nurses in the Magnet-designated hospitals held positive beliefs about the readiness of their hospital organizational for implementation of the EBP. However, this is a disadvantage because there are several countries where Magnet-designated hospitals are not available yet. Besides, it can take a lot of time for the Magnet-designated hospitals to expand all over the world. Also, the study shows that the implementation of the EBP faces setbacks liken knowledge deficit. Besides, there is a lack of human resources like Advanced Practice Registered Nurses to facilitate the implementation (Warren et al, 2016). Due to the presence of Magnet-designated hospitals in the USA, I think the research would not have much difference if it were based in the country.
There is also insufficient doctoral prepared nurses' scientists and the health science librarians. Again, there are no fiscal resources which may help in the provision of EBP knowledge to the nurses. Hence the ability to implement the EBP is meager. Notwithstanding, the study demonstrates that the younger nurses with less experience showed positive reactions towards EBP, however, their ability to apply the EBP only increases with the number of years in practice. Also, those with the knowledge about the EBP are likely to be current nurses as opposed to seasoned nurses since it is in the curriculum now.
In summary, in as much as the implementation of EBP can improve the quality care and patient safety, reduce inconsistencies, and contain cost, it demands a lot of time and workload. In fact, it best works in the multihospital healthcare system, unlike only hospitals which are the most in number. The nurses and clinicians, in general, should equip themselves with knowledge and have the courage to put it to work. The research should be translated into practice to help in the quick implementation of the EBP. Lastly, the more experienced nurses should act as role models to their junior to help in rapid integration of EBP. The nurses should assist in framing the practice questions and in the application of the evidence.
References
Warren, J., McLaughlin, M., Bardsley, J., Eich, J., Esche, C., Kropkowski, L., & Risch, S. (2016). The Strengths and Challenges of Implementing EBP in Healthcare Systems. Worldviews On Evidence-Based Nursing, 13(1), 15-24. doi:10.1111/wvn.12149
