A multilevel-informed examination of factors associated with nurses’ implementation of evidence-based practice institutionalized by hospitals: a cross-sectional study
Keiko Ishii, Yukie TakemuraABSTRACT
Introduction:
The implementation of evidence-based practice (EBP) is influenced by multilevel factors; however, comprehensive evidence on the factors affecting nurses’ EBP implementation is lacking.
Aim:
This study aimed to examine the relationship between nurses’ EBP implementation and individual, process, organizational, and institutional factors.
Methods:
An anonymous survey was conducted among 1,741 nurses from 59 wards or departments in 12 hospitals in Japan. One specific EBP—defined as a practice informed by research evidence and institutionalized by the hospital—was selected per ward and displayed in the survey. The survey participants were required to report the extent to which they implemented that practice. Factors were then selected based on the Consolidated Framework for Implementation Research. Multiple regression analysis was conducted, with nurses’ EBP implementation as the dependent variable, while problem-solving behavior, EBP beliefs, ward-level learning, hospital nursing practice environment, and EBP type (incentivized or non-incentivized) were the independent variables.
Results:
Data were analyzed from 360 nurses across 47 wards in 12 hospitals. Nurses’ collaborative problem-solving behavior, EBP beliefs, and ward-level organizational learning were positively associated with EBP implementation. However, the hospital nursing practice environment and EBP type were not significantly related to EBP implementation.
Conclusions:
Organizational management and support fostering EBP belief, collaboration, and organizational learning at the ward level may enhance nurses’ implementation of EBP. However, the roles of the hospital environments and financial incentives should be interpreted cautiously, as their potential effects remain unclear.
Spanish abstract:
https://links.lww.com/IJEBH/A703