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Nurses' Perceived Knowledge, Beliefs, Skills, and Needs Regarding Evidence-Based Practice: Implications for Accelerating the Paradigm Shift

Authors

  • Bernadette Mazurek Melnyk RN, PhD, CPNP/NPP, FAAN, FNAP,

  • Ellen Fineout-Overholt RN, PhD,

  • Nancy Fischbeck Feinstein RN-C, PhD,

  • Hong Li RN, PhD,

  • Leigh Small RN-CS, PhD, PNP,

  • Larry Wilcox RN, MS, NP-BC,

  • Rachel Kraus RN, MS, PNP


  • Bernadette Mazurek Melnyk, Associate Dean for Research and Professor, Director, Center for Research & Evidence-Based Practice and Pediatric Nurse Practitioner (PNP) & Dual PNP/Psychiatric Mental Health NP Programs, University of Rochester School of Nursing and School of Medicine & Dentistry, 601 Elmwood Avenue, Box SON, Rochester, NY 14642. Ellen Fineout-Overholt, Associate Director, Center for Research & Evidence-Based Practice. Nancy Fischbeck Feinstein, Assistant Professor of Clinical Nursing, University of Rochester School of Nursing. Hong Li, Assistant Professor of Nursing, University of Rochester School of Nursing. Leigh Small, Assistant Professor of Clinical Nursing, University of Rochester School of Nursing. Larry Wilcox, Doctoral Candidate, State University of New York at Buffalo. Rachel Kraus, PhD Student, University of Rochester School of Nursing.

Address correspondence to Bernadette Mazurek Melnyk, 601 Elmwood Avenue, Box SON, Rochester, NY 14642; Bernadette_Melnyk@urmc.rochester.edu

ABSTRACT

Background: The paradigm shift to evidence-based nursing practice in the United States has been slow. Although multiple barriers to evidence-based practice (EBP) have been identified through prior studies, there is a gap in the literature specifically identifying key variables (e.g., belief that EBP produces quality outcomes) that are correlated with the extent to which nurses engage in EBP.

Aim: The primary aims of this study were to (1) describe nurses' knowledge, beliefs, skills, and needs regarding EBP; (2) determine whether relationships exist among these variables; and (3) describe major barriers and facilitators to EBP.

Methods: A descriptive survey was conducted with a convenience sample of 160 nurses who were attending EBP conferences or workshops in four states located within the Eastern Region of the United States.

Results: Although participant beliefs about the benefit of EBP were high, knowledge of EBP was relatively low. Significant relationships were found between the extent to which the nurses' practice is evidence-based and (1) nurses' knowledge of EBP, (2) nurses' beliefs about the benefits of EBP, (3) having an EBP mentor, and (4) using the Cochrane Database of Systematic Reviews and the National Guideline Clearinghouse.

Conclusion and Implications: Health care systems need to implement interventions that not only increase nurses' EBP knowledge and skills, but also strengthen their beliefs about the benefit of evidence-based care. EBP mentors may be key in accelerating a more rapid shift toward evidence-based nursing practice. Theoretically driven randomized controlled trials are urgently needed to test the effectiveness of interventions on advancing evidence-based care.

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