Search Results (69)

Background: Sustained implementation of evidence-based practice (EBP) remains a challenge in complex clinical environments. Structured knowledge translation frameworks, such as the Knowledge-to-Action model (KTA), have been proposed to facilitate integration of evidence into care. However, less is known about how nurses experience the consolidation of KTA-guided implementation in clinical practice. This study aimed to explore nurses’ experiences of changes in clinical practice and professional development following consolidation of KTA guided implementation in a pediatric inpatient unit. Methods: A qualitative descriptive study was conducted using two focus groups with 20 pediatric nurses who had participated in the implementation process. One year after consolidation of the implementation process, data were collected via videoconference using a semi-structured interview guide and analyzed through thematic content analysis following Bardin’s methodological framework. Results: Four themes emerged: (1) contribution of the KTA to the clinical context; (2) influence on EBP competencies; (3) impact on professional development; and (4) sustainability within the organizational context. The implementation was experienced as a shift in care philosophy, with evidence becoming central to clinical reasoning, team alignment, and service structures. Conclusions: Participants perceived that the implementation of the KTA framework extended beyond competence development, influencing clinical practice, professional interactions, and organizational routines within the unit. Sustainability was associated with contextual adaptation, leadership alignment, and structural integration of evidence-based practices into care. These findings contribute to understanding mechanisms supporting durable EBP implementation in pediatric settings. Full article

Background: The importance of evidence-based practice (EBP) is well recognized, yet its implementation remains challenging across healthcare systems, especially in low- and middle-income countries, where resource constraints, workforce turnover, and organizational barriers can hinder practice change. The traditional approach to implementation has focused on training, guidelines, and leadership support; however, these strategies do not always sustain frontline staff engagement. Objective: This descriptive case study examined how social movement strategies supported a multi-year EBP implementation initiative within a Philippine academic–clinical partnership. Methods: Program documents, training records, implementation reports, curriculum materials, and internal records of guideline-related activities were reviewed. Data were organized using the Social Movement Action Framework, with attention to preconditions for change, social movement mechanisms, and implementation outcomes. Results: The initiative included champion training, guideline integration, awareness activities, academic–clinical collaboration, and practice-focused implementation efforts related to breastfeeding, vascular access device management, and pressure injury prevention. These activities provided observable process indicators of stakeholder engagement, shared ownership, and continued use of guideline-informed practices. Conclusions: Social movement strategies may offer a useful complementary lens for understanding how EBP implementation gains momentum in real-world healthcare settings. Additional studies should explore their relationship to implementation outcomes and clinical care processes. Full article

Background: Evidence-based practice (EBP) is a cornerstone of high-quality and safe nursing care. However, undergraduate nursing students often experience cognitive, methodological, and contextual barriers to learning and applying EBP. Active teaching strategies, such as the flipped classroom, may support the development of EBP competencies, yet qualitative evidence exploring students’ learning experiences remains limited. Objectives: To explore nursing students’ perceptions and experiences of learning evidence-based practice through a flipped classroom model. Methods: A qualitative descriptive study was conducted at the Faculty of Nursing of the University of Murcia (Spain). Purposeful maximum variation sampling was used to recruit undergraduate nursing students from the second and fourth academic years who had completed an EBP course delivered using a flipped classroom approach supported by an online learning platform. Twenty semi-structured interviews were conducted via videoconference. Data were transcribed verbatim and analyzed using reflexive thematic analysis with independent coding by two researchers and consensus procedures. Ethical approval and confidentiality were ensured. Results: Three main themes were identified: (1) transformation of the meaning of EBP learning and professional role, (2) cognitive and metacognitive processes in EBP learning, and (3) the learning experience as a catalyst for deep learning. Students described a shift from initial fear and perceived difficulty toward recognizing the practical value of EBP, accompanied by increased critical thinking, autonomous learning, and a growing evidence-informed professional identity. The flipped classroom model facilitated engagement and understanding, while the transfer of learning to clinical practice was influenced by contextual facilitators and barriers. Conclusions: Learning EBP through a flipped classroom was experienced as a transformative process that fostered critical thinking, self-regulated learning, and the construction of an evidence-oriented professional identity among nursing students. Strengthening information literacy skills and improving alignment between academic and clinical environments may enhance the sustainable application of EBP in clinical practice. Full article

Background/Objectives: Evidence-based practice (EBP) is essential to high-quality nutrition care. Despite its critical importance, its use among clinical dietitians in Saudi Arabia remains poorly understood. This study aims to examine the behavioral factors of EBP engagement among Saudi clinical dietitians using the Capability–Opportunity–Motivation–Behavior (COM-B) model. Methods: This cross-sectional mixed-methods study was conducted in fall 2023 among 82 licensed clinical dietitians (LCDs). Participants completed a self-administered questionnaire including 19 items adapted from the Health Sciences Evidence-Based Practice (HS-EBP) instrument and mapped to the COM-B domains. Qualitative data were obtained from open-ended survey questions completed by a separate sample of LCDs (n = 12) and analyzed using inductive thematic analysis. Results: Descriptive analysis showed higher mean scores for capability (7.49 ± 2.76) and motivation (7.50 ± 2.57) than for opportunity (6.61 ± 2.74) and behavioral engagement (6.09 ± 1.25). All COM-B domains demonstrated excellent internal consistency (Cronbach’s α = 0.857–0.959) and were significantly intercorrelated (p < 0.001). Multiple regression analysis indicated that motivation (β = 0.563, p = 0.001) and opportunity (β = 0.290, p = 0.002) independently predicted behavioral engagement (adjusted R² = 0.681), while capability was not independently associated. Qualitative findings identified professional motivation and research literacy as facilitators, and time pressure and administrative workload as key barriers. Conclusions: EBP engagement among Saudi clinical dietitians is strongly influenced by motivational and organizational factors rather than by knowledge or skills. Full article

Background/Objectives: Evidence-based practice (EBP) is a core competence in physiotherapy, yet its implementation in routine clinical practice remains inconsistent. This study aimed to describe self-reported EBP competencies among physiotherapists and to examine factors associated with daily EBP and readiness to implement EBP. Methods: A cross-sectional analytic survey was conducted among 337 practicing Estonian physiotherapists (75% female) between 2022 and 2024. EBP competencies were assessed using the Estonian version of the Evidence-Based Practice Questionnaire (EBPQ-E). Two multiple linear regression models examined associations of demographic and professional characteristics and EBP competencies with (1) daily EBP and (2) readiness to implement EBP. Results: The mean total EBPQ-E score was 4.72 (SD = 0.89), with the highest scores in Attitude, followed by Knowledge/Skills, Practice, and Sharing. While physiotherapists strongly endorsed the value of EBP, critical appraisal and knowledge sharing were less frequent. Readiness to implement EBP was associated with supervisory experience, dual employment, and working with colleagues (p < 0.05), explaining 7.5% of the variance. Daily EBP was primarily explained by EBP competencies (40.8% variance), whereas 5–10 years of qualification showed a negative association. Conclusions: While professional and contextual factors support readiness for EBP, sustained implementation relies on continuous competency development and career-long support for practicing physiotherapists, shifting focus away from static background characteristics, workload, and time constraints. Full article

Background: Evidence-based practice (EBP) has become a foundational component of modern healthcare globally. In Saudi Arabia, the understanding and application of EBP by respiratory therapists (RTs) remains underexplored. This study aimed to assess RTs’ behaviors, attitudes, awareness, knowledge, and barriers related to EBP. Methods: A previously validated online questionnaire was distributed to RTs across Saudi Arabia between February and July 2025. The survey collected sociodemographic data and included 14 items assessing behaviors, attitudes, awareness, knowledge, prior formal EBP training, and perceived barriers to EBP implementation. Results: A total of 301 RTs participated, with 290 completing the survey. Most participants (75.2%) held a bachelor’s degree. Overall, respondents demonstrated positive attitudes toward EBP, with more than 60% agreeing that understanding research methods is essential to respiratory therapy practice. The most frequently used resources for clinical decision-making were personal experience (67.3%), expert opinion (65.5%), and national or international guidelines (65.5%). Awareness of core EBP concepts was moderate; approximately 30% of participants reported a good understanding of terms such as “systematic review,” “quality of evidence,” and “risk of bias.” Several barriers to EBP implementation were identified, most commonly limited access to resources (25.2%), insufficient research knowledge and skills (23.8%), and lack of interest (21.0%). Conclusions: RTs in Saudi Arabia generally support EBP principles and use evidence-based resources in clinical decision-making. However, gaps in training, access to resources, and research competency limit full EBP implementation. Targeted strategies, including integrating mandatory EBP education, expanding professional development, and enhancing access to research resources, are recommended. Full article

Background/Objectives: Evidence-Based Practice (EBP) positively impacts health safety and quality while also empowering nursing as a discipline. A useful strategy for promoting EBP is to build learning paths adapted to the individuality of nurses. These elements establish the framework for effective learning, determining the availability of specific content at certain times and influencing the design of learning objects to ensure optimal efficacy in the teaching-learning process. It is essential to identify effective strategies in evidence-based nursing education to advance EBP and thereby enhance the quality and safety of nursing care. This review aims to summarize the evidence on the effectiveness of learning paths in the acquisition of EBP competencies by nurses. Methods: A systematic review of the literature will be carried out in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. The results of the review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA-P). The protocol is registered in the PROSPERO database (CRD4202453155). The search will be performed using the EBSCOhost search engine in the following databases: CINAHL Plus, MedicLatina, MEDLINE, Psychology and Behavioral Sciences Collection, Academic Search Complete, eBook Collection, and Education Resources Information Center. The inclusion of studies, data extraction, and analysis will be carried out by two reviewers independently. Disagreements will be resolved by a third reviewer. All studies involving nurses, learning paths, EBP competencies, regardless of geographical area and context, with no time limit or language constraints, will be included. Results: Not applicable; this is a protocol. Findings will be synthesized as specified in the Methods. Conclusions: This review will provide a better understanding of the effectiveness of a learning path in the acquisition of EBP competencies by nurses. It will also assist in the identification of knowledge gaps in the literature and potential areas for future research and development. Full article

Background: Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in intensive care units (ICUs), particularly in low- and middle-income countries (LMICs). Evidence-based practice (EBP) bundles have shown effectiveness in reducing VAP; however, the implementation in Bangladesh remains limited. This study aimed to evaluate the effectiveness of EBP to reduce the incidence rate of VAP among adult ICU patients in Bangladesh. Methods: A quasi-experimental study with a historical control group was conducted among 347 eligible ICU patients from October 2024 to April 2025. The intervention included nurse training on VAP bundle practices with advanced equipment support. Data on VAP incidence as a primary endpoint and VAP-related patients’ outcomes were analyzed. Results: The clinically suspected VAP incidence was 30.1 and 51.1 per 1000 ventilator-days, and the prevalence decreased significantly in the intervention group compared to the control group (26.9% vs. 46.1%; p < 0.001), respectively. Logistic regression indicated VAP bundle implementation was associated with reduced VAP (Exp(B) = 0.417, 95% CI: 0.262–0.666), while ventilation ≥96 h was a significant risk factor (Exp(B) = 2.6, 95% CI: 1.385–4.881). Early-onset VAP was reduced (25.0% vs. 10.2%), though late-onset predominated in the intervention group (75.0% vs. 89.8%). Conclusion: Implementation of an EBP-based VAP bundle by trained nurses significantly reduced VAP incidence. However, increased overall ICU mortality highlights the need for broader critical care improvements, including advanced comorbidity management and comprehensive ICU services. This study underscores the feasibility and effectiveness of VAP bundle implementation in the ICU of an LMIC. Full article

Background/Objectives: Evidence-based practice (EBP) remains limited among clinical nurses worldwide, with Korean healthcare settings facing challenges. This study examined the effectiveness of the research practice ability enhancement program (RPAEP) in strengthening evidence-based practice (EBP) competencies among clinical nurses who had completed master’s coursework without a thesis. Methods: A non-randomized controlled trial was conducted at a tertiary hospital in Korea (June–December 2022). Thirty participants were assigned by convenience sampling to intervention (n = 15) or control (n = 15) groups. The intervention comprised 12 biweekly sessions. The primary outcome was research practice ability (RPA); the secondary outcomes were EBP beliefs (EBPBs), EBP Attitudes (EBPAs), and Nursing Professional Values (NPVs). Analyses employed Wilcoxon signed-rank and Mann–Whitney U tests. The qualitative evaluation used thematic analysis of focus group interviews (FGIs) (n = 12). Results: All participants completed the study. The intervention group showed significant improvements in RPA (within-group: Z = −1.96, p = 0.050, ES = 0.82; between-group: t = −2.39, p = 0.016, ES = 1.02) and EBPBs (t = −3.30, p = 0.005, ES = 0.87). NPVs showed significant between-group differences (t = 2.38, p = 0.024, ES = 0.87), while EBPAs remained unchanged. The FGIs revealed three major themes related to participation in the research practice ability enhancement program: “barriers to research practice,” “guidance for research practice,” and “enhancing research practice ability.” Conclusions: The RPAEP enhanced nurses’ EBP competencies despite the non-randomized design. However, single-site implementation and convenience sampling limit generalizability. Sustained EBP integration requires addressing individual and organizational barriers through comprehensive education with institutional commitment. Full article

Background/Objectives: Evidence-based practice (EBP) has been widely adopted in clinical nursing practice, with nursing education efforts consistently emphasizing its importance in strengthening implementation efforts. Despite these efforts to promote translational research, the level of implementation of evidence-based practice (EBP) in clinical nursing practice remains unsatisfactory. This study aimed to identify specific organizational, individual, and research-related barriers to the utilization of research in clinical practice among nurses in Sabah, Malaysia, to determine factors associated with these perceived barriers and to assess nurses’ awareness and understanding of the implementation of evidence-based practice. Methods: A cross-sectional study was conducted in 2019 using the BARRIERS scale, a validated tool that measures perceived barriers to the utilization of research across four domains: organizational barriers, nurses’ research awareness and values, quality of research, and research communication. This study involved nurses from five tertiary hospitals in Sabah, Malaysia. Results: A total of 562 nurses participated in the study, with a mean age of 34.3 years (SD = 7.96) and mean duration of clinical practice of 10.0 years (SD = 7.58). While 66.5% of the nurses had heard of EBP, only 7.3% reported understanding it very well. The top three barriers to the utilization of research were ‘the nurse does not feel she/he has enough authority to change patient care procedures’ (35.9%), ‘the nurse does not have time to read research’ (27.8%), and ‘research reports/articles are not published fast enough’ (25.8%). Among the four domains, organizational barriers scored highest (mean = 2.7, SD = 0.72), followed by research communication (mean = 2.6, SD = 0.73). Conclusions: The study findings emphasize the challenges nurses encounter in integrating research into clinical practice and highlight the need for ongoing efforts to promote the utilization of evidence-based practice and research among nurses in Sabah, while addressing the identified gaps. Full article

Background: The concept of evidence-based practice (EBP) is globally relevant in current healthcare climates. However, nursing students and teachers often struggle with integrating EBP effectively into a curriculum. This has implications for the way students learn to use evidence for their nursing practice. A new undergraduate EBP module was co-designed with current nursing students and university staff throughout 2023. Underpinning the module was a UDL (universal design for learning) pedagogy consisting of flexible approaches to learning for nursing students which included co-developed videos, co-developed audio podcasts, and co-developed serious games to complement traditional flipped classroom learning. The module commenced in September 2023, running in Year 1 one of a 3-year undergraduate nursing program, and was co-taught by staff and senior students. Methods: A pre/post-test design was used to collect data on student attitude, knowledge, and utilization of EBP. A total of 430 students completed two validated questionnaires, the EBP Beliefs Scale© and EBP Implementation Scale©, before and after the module. Following the post-test, six focus group interviews were also conducted with 58 students to explore how the module informed student nursing practice whilst attending clinical placement during Year 1. A convergent mixed-methods design was employed. Sample attrition occurred (~25%). Effect sizes and 95% confidence intervals were calculated for primary outcomes. Results: Quantitative data was analyzed using paired t-tests and this highlighted statistically significant improvements in attitude, knowledge and utilization of evidence-based practice after learning (p < 0.001). Qualitative data was transcribed verbatim, thematically analyzed, and highlighted three main findings; EBP is my business, EBP positively influenced the care of my patients and EBP has positively impacted my professional development. Conclusions: Partnership with current nursing students in the co-design and implementation of a module about EBP was associated with improvements in student knowledge, attitude and utilization of evidence in practice. These factors are likely to also improve professional competence and ultimately patient care. Full article

Evidence-based practice in nursing supports clinical practice. Several studies have tested the knowledge and attitudes of nurses toward journal clubs (JCs) and evidence-based practice. However, no study has reported knowledge of and attitudes towards evidence-based practice (EBP) and journal club workshops in Oman whilst attending highly structured workshops with the aim of critiquing the method. This study aims to assess the knowledge of and attitude towards evidence-based practice (EBP) and JC sessions among nurses attending the EBP/JC workshop at Royal Hospital, Oman. Data were collected from 22 nurses who participated in the workshop through an online self-report validated questionnaire that examined knowledge, attitude, and satisfaction. The knowledge among the participants showed improvement after the EBP intervention (p = 0.002). There was no statistical difference (p = 0.33) between the pretest and post-test attitudes towards EBP. The indicators suggest that the workshop with the highest mean value (4.14 out of 5 points), followed by the EBP workshop, which is helpful for clinical practices (mean value = 4.09), should continue in the future. The participants of the EBP workshop also agreed that they would recommend others for similar workshops. Research and EBP workshops can increase nurses’ knowledge and effectively engage them in EBP activities. Care should be given to the organization of the workshops as it directly influences the level of satisfaction. Nurses who are satisfied with EBP workshops are more likely to recommend them to others and maintain their future attendance. Full article

Background: Evidence-Based Nursing Practice (EBNP) plays a crucial role in ensuring high-quality patient care. This study evaluates master’s degree nursing students’ knowledge, attitudes, and skills related to EBNP, identifying strengths and key gaps that require curriculum improvements to enhance their competencies in evidence-based practice. Methods: A cross-sectional study was conducted among 103 master’s degree nursing students at Wrocław Medical University. Data were collected using a demographic questionnaire and the standardized Polish version of the Evidence-Based Practice Profile Questionnaire (EBP2Q). Results: The findings indicate that students demonstrated generally positive attitudes toward EBNP (mean score: 53.43 ± 10.05 out of 70). However, knowledge of research terminology was moderate (44.66 ± 18.01 out of 85), and the frequency of EBNP utilization in practice was relatively low (22.15 ± 8.74 out of 45). Significant differences were observed based on study mode and academic progression, with part-time students scoring higher in attitudes toward competency development (p = 0.02). A weak but positive correlation was found between professional experience and the frequency of EBNP utilization (r = 0.182, p = 0.068), while knowledge of research terminology showed a non-significant association with age (r = 0.167, p = 0.092). Conclusions: These findings highlight the need for targeted curriculum enhancements, particularly in research literacy, practical application opportunities, and the integration of mentorship and educational resources. Strengthening EBNP education will better equip nursing students to implement evidence-based practices in clinical settings, ultimately improving patient care quality. Full article

Implementation science (IS) models play a crucial role in translating evidence-based practice (EBP) into sustainable policy reforms. However, the competencies required for nurses to lead these transformations remain poorly defined. Objective: This study develops a framework for implementation lead (IL) nurses, identifying the core competencies needed to drive evidence-based policy transformation within healthcare systems. Method: A secondary data analysis (SDA) was conducted using qualitative data from focus group interviews originally collected, recorded, and transcribed as part of the EQUIP (Evidence-based Quality Improvement Project). The dataset includes insights from 12 IL nurses who participated in PEACE-based training, addressing real-world clinical challenges. Their perspectives were thematically analyzed to generate a competency framework for policy leadership. Findings: The study developed the Implementation Science Competencies for Policy Transformation (ISCPT) framework, which highlights three pillars: (1) evidence appraisal and guideline development, (2) collaborative leadership for policy advocacy, and (3) continuous improvement through data-driven decision-making. Conclusions: Grounded in IL nurses’ perspectives, the ISCPT framework provides a nurse-centric roadmap for policy transformation, integrating interdisciplinary collaboration, adaptive leadership, and evidence-based decision-making into nursing education and practice. While the findings reflect a single healthcare context, the framework offers actionable guidance for preparing nurses to lead policy-driven healthcare improvements. Full article

Teacher preparation programs (TPPs) can equip pre-service teachers (PSTs) with skills to implement evidence-based reading interventions with fidelity by engaging PSTs in carefully designed clinical experiences with feedback via coaching. To individualize support and facilitate a responsive approach to feedback centered on PSTs’ levels of fidelity, first, this study examined the impact of a multilevel coaching intervention on PSTs’ fidelity of implementation of an evidence-based reading intervention during a tutoring clinical experience. Second, this study examined PSTs’ perceptions of the feasibility, effectiveness, and future impact of the multilevel coaching intervention. Results of a single-case, multiple baseline across participants design indicated a functional relation between the multilevel coaching intervention and PSTs’ fidelity, inclusive of both structural and process dimensions. Furthermore, PSTs found the multilevel coaching intervention to be socially valid, indicating the intervention was feasible, effective, and impactful on their future teaching experiences. Major implications for teacher preparation and coaching support include (a) providing PSTs with authentic clinical experiences, inclusive of coaching support, when implementing EBPs; (b) viewing fidelity as a multidimensional construct that can inform coaching support and teacher practices; and (c) enhancing TPPs with experiences that impact PSTs’ perceptions about their own ability to teach reading. Full article