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Abstract
Objective: To analyze the perception of renal nurses in Spain regarding the organizational environment for evidence-based clinical practice (EBCP), and to determine what professional and context factors influence such perception.
Material and Method: A cross-sectional observational multicenter study was carried out in 15 nephrology services from different Spanish hospitals and 2 dialysis centers. The Practice Environment Scale of Nursing Work Index (PES-NWI) and Evidence-Based Practice Questionnaire (EBPQ) tools were used. A descriptive, bivariate statistical analysis (ANOVA, Kruskall-Wallis) and logistic regression were performed with the EBPQ total score as the dependent variable.
Results: A total of 397 surveys were received (participation rate: 84.28%), and after processing the surveys 382 were valid (81.1% of the population): 82.7% were women, with a mean age of 42 years, a mean of 18.2 years of professional experience as a nurse (12.2 years in nephrology), 94.8% were clinical nurses, and 81.9% worked in hemodialysis. The average PES-NWI score was 62.35±15.10 (95% CI:60.78-48.06). Nurses in centers with more than 500 nurses, those who worked in hemodialysis, and those with more than 11 years of professional experience had lower scores on some PES-NWI factors. Nurse managers had higher scores in all PES-NWI factors. The average EBPQ score was 81.05±21.92 (95% CI:78.70-83.4). Nurses with less professional experience the better PES-NWI scores; also, postgraduate nurses had higher scores on several EBPQ factors.
Conclusions: Factors that most influence the perception of Spanish renal nurses are professional experience, role within the organization, a favorable context, and postgraduate education.
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References
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- Peiró S, Bernal-Delgado E. What incentives foster hospital use in the National Health Service?. Gac Sanit 2006;20 Suppl 1:S110–6.
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- De Pedro-Gómez J, Morales-Asencio JM, Abad AS, Veny MB, Vives GA, Campaner CP. Entorno de práctica de los profesionales de enfermería y competencia para la incorporación de la evidencia a las decisiones: Situación en las Islas Baleares. Gac Sanit 2011;25(3):191–7. DOI: https://doi.org/10.1016/j.gaceta.2010.11.007
- De Pedro Gómez JE, Morales Asencio JM, Sesé Abad A, Bennasar Veny M, Artigues Vives G, Pericàs Beltran J. Validación y adaptación al español de la escala del entorno de práctica enfermera del Nursing Work Index. Metas de enfermería 2009;12(7):65–75.
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- Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. Int J Nurs Stud 2016;60:54–68. DOI: https://doi.org/10.1016/j.ijnurstu.2016.03.006
- Koehn ML, Lehman K. Nurses’ perceptions of evidence-based nursing practice. J Adv Nurs 2008;62(2):209–15. DOI: https://doi.org/10.1111/j.1365-2648.2007.04589.x
- Gerrish K, Guillaume L, Kirshbaum M, Mcdonnell A, Tod A, Nolan M. Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. J Adv Nurs 2011;67(5):1079–90. DOI: https://doi.org/10.1111/j.1365-2648.2010.05560.x
- Gerrish K, Nolan M, Mcdonnell A, Tod A, Kirshbaum M, Guillaume L. Factors Influencing Advanced Practice Nurses’ Ability to Promote Evidence-Based Practice among Frontline Nurses. Worldviews Evidence-Based Nurs 2012;9(1):30–9. DOI: https://doi.org/10.1111/j.1741-6787.2011.00230.x
- Al-Busaidi IS, Al Suleimani SZ, Dupo JU, Al Sulaimi NK, Nair VG. Nurses’ Knowledge, Attitudes, and Implementation of Evidence-based Practice in Oman: A Multi-institutional, Cross-sectional Study. Oman Med J 2019;34(6):521. DOI: https://doi.org/10.5001/omj.2019.95
- Pericas-Beltran J, Gonzalez-Torrente S, De Pedro-Gomez J, Morales-Asencio JM, Bennasar-Veny. Perception of Spanish primary healthcare nurses about evidence-based clinical practice: A qualitative study. Int Nurs Rev 2014;61(1 PG-90–98):90–8. DOI: https://doi.org/10.1111/inr.12075
- Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España. Aten Primaria 2021;53(7). DOI: https://doi.org/10.1016/j.aprim.2021.102050
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- Shirey MR. Authentic leaders creating healthy work environments for nursing practice. Am J Crit Care 2006;15(3):256–67. DOI: https://doi.org/10.4037/ajcc2006.15.3.256
- Strout TD, Lancaster K, Schultz AA. Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. Nurs Clin North Am 2009;44(1):93–102. DOI: https://doi.org/10.1016/j.cnur.2008.10.007
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- Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. J Adv Nurs 2009;65(2):371–81. DOI: https://doi.org/10.1111/j.1365-2648.2008.04878.x
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References
Bashar FJ. Assessing Attitudes towards Knowledge and use of Evidence-Based Practice among Nurses Working in a Teaching Hospital in Kuala Lumpur. Int J Educ Lit Stud 2019;7(1):25. DOI: https://doi.org/10.7575/aiac.ijels.v.7n.1p.25
Hutchinson AM, Johnston L. Beyond the BARRIERS Scale: Commonly reported barriers to research use. J Nurs Adm 2006;36(4):189–99. DOI: https://doi.org/10.1097/00005110-200604000-00008
Zauszniewski JA, Suresky MJ, Bekhet AK, Kidd L. Moving from tradition to evidence: a review of psychiatric nursing intervention studies. Online J Issues Nurs 2007;12(2):9. DOI: https://doi.org/10.3912/OJIN.Vol12No02HirshPsy01
Stokke K, Olsen NR, Espehaug B, Nortvedt MW. Evidence based practice beliefs and implementation among nurses: A cross-sectional study. BMC Nurs 2014;13(1):8. DOI: https://doi.org/10.1186/1472-6955-13-8
Glasziou P, Haynes B. The paths from research to improved health outcomes. Evid Based Nurs 2005;8(2):36–8. DOI: https://doi.org/10.1136/ebn.8.2.36
Thompson C, McCaughan D, Cullum N, Sheldon TA, Mulhall A, Thompson DR. Research information in nurses’ clinical decision-making: what is useful? J Adv Nurs 2001;36(3):376–88. DOI: https://doi.org/10.1046/j.1365-2648.2001.01985.x
Klein R. The NHS and the new scientism: solution or delusion? QJM 1996;89(1):85–7. DOI: https://doi.org/10.1093/oxfordjournals.qjmed.a030142
Peiró S, Bernal-Delgado E. What incentives foster hospital use in the National Health Service?. Gac Sanit 2006;20 Suppl 1:S110–6.
McKenna HP, Ashton S, Keeney S. Barriers to evidence-based practice in primary care. J Adv Nurs 2004;45(2):178–89. DOI: https://doi.org/10.1046/j.1365-2648.2003.02879.x
Bryar RM, Closs SJ, Baum G, Cooke J, Griffiths J, Hostick T, et al. The Yorkshire BARRIERS project: Diagnostic analysis of barriers to research utilisation. Int J Nurs Stud 2003;40(1):73–84. DOI: https://doi.org/10.1016/S0020-7489(02)00039-1
Nolan M, Morgan L, Curran M, Clayton J, Gerrish K, Parker K. Evidence-based care: can we overcome the barriers? Br J Nurs 1998;7(20):1273–8. DOI: https://doi.org/10.12968/bjon.1998.7.20.5567
Pedro Gómez JE de, Morales Asencio JM. Las organizaciones ¿favorecen o dificultan una práctica enfermera basada en la evidencia? Index de Enfermería 2004;13(44–45):26–31. DOI: https://doi.org/10.4321/S1132-12962004000100006
Dijkstra R, Wensing M, Thomas R, Akkermans R, Braspenning J, Grimshaw J, et al. The relationship between organisational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Serv Res 2006;28:6. DOI: https://doi.org/10.1186/1472-6963-6-53
González-Torrente S, Pericas-Beltrán J, Bennasar-Veny M, Adrover-Barceló R, Morales-Asencio JM, De Pedro-Gámez J. Perception of evidence-based practice and the professional environment of Primary Health Care nurses in the Spanish context: A cross-sectional study. BMC Health Serv Res 2012;12(1):1–9. DOI: https://doi.org/10.1186/1472-6963-12-227
Ramos-Morcillo AJ, Fernández-Salazar S, Ruzafa-Martínez M, Del-Pino-Casado R. Effectiveness of a Brief, Basic Evidence-Based Practice Course for Clinical Nurses. Worldviews Evidence-Based Nurs 2015;12(4):199–207. DOI: https://doi.org/10.1111/wvn.12103
Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Evidence-Based Practice competency and associated factors among Primary Care nurses in Spain. Aten Primaria 2021;53(7).
Solís Muñoz M. Competencias en práctica clínica basada en la evidencia de las enfermeras en España. [Madrid]: Universidad Complutense de Madrid; 2015.
Ruzafa-Martinez M, Lopez-Iborra L, Moreno-Casbas T, Madrigal-Torres M. Development and validation of the competence in evidence based practice questionnaire (EBP-COQ) among nursing students. BMC Med Educ 2013;13(1):1–10. DOI: https://doi.org/10.1186/1472-6920-13-19
De Pedro-Gómez J, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Pericas-Beltran J, Miguélez-Chamorro A. Psychometric testing of the Spanish version of the practice environment scale of the nursing work index in a primary healthcare context. J Adv Nurs 2012;68(1):212–21. DOI: https://doi.org/10.1111/j.1365-2648.2011.05730.x
De Pedro-Gómez J, Morales-Asencio JM, Abad AS, Veny MB, Vives GA, Campaner CP. Entorno de práctica de los profesionales de enfermería y competencia para la incorporación de la evidencia a las decisiones: Situación en las Islas Baleares. Gac Sanit 2011;25(3):191–7. DOI: https://doi.org/10.1016/j.gaceta.2010.11.007
De Pedro Gómez JE, Morales Asencio JM, Sesé Abad A, Bennasar Veny M, Artigues Vives G, Pericàs Beltran J. Validación y adaptación al español de la escala del entorno de práctica enfermera del Nursing Work Index. Metas de enfermería 2009;12(7):65–75.
Zhou F, Hao Y, Guo H, Liu H. Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China. Evid Based Complement Alternat Med 2016;2016. DOI: https://doi.org/10.1155/2016/5478086
Jun J, Kovner CT, Stimpfel AW. Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. Int J Nurs Stud 2016;60:54–68. DOI: https://doi.org/10.1016/j.ijnurstu.2016.03.006
Koehn ML, Lehman K. Nurses’ perceptions of evidence-based nursing practice. J Adv Nurs 2008;62(2):209–15. DOI: https://doi.org/10.1111/j.1365-2648.2007.04589.x
Gerrish K, Guillaume L, Kirshbaum M, Mcdonnell A, Tod A, Nolan M. Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. J Adv Nurs 2011;67(5):1079–90. DOI: https://doi.org/10.1111/j.1365-2648.2010.05560.x
Gerrish K, Nolan M, Mcdonnell A, Tod A, Kirshbaum M, Guillaume L. Factors Influencing Advanced Practice Nurses’ Ability to Promote Evidence-Based Practice among Frontline Nurses. Worldviews Evidence-Based Nurs 2012;9(1):30–9. DOI: https://doi.org/10.1111/j.1741-6787.2011.00230.x
Al-Busaidi IS, Al Suleimani SZ, Dupo JU, Al Sulaimi NK, Nair VG. Nurses’ Knowledge, Attitudes, and Implementation of Evidence-based Practice in Oman: A Multi-institutional, Cross-sectional Study. Oman Med J 2019;34(6):521. DOI: https://doi.org/10.5001/omj.2019.95
Pericas-Beltran J, Gonzalez-Torrente S, De Pedro-Gomez J, Morales-Asencio JM, Bennasar-Veny. Perception of Spanish primary healthcare nurses about evidence-based clinical practice: A qualitative study. Int Nurs Rev 2014;61(1 PG-90–98):90–8. DOI: https://doi.org/10.1111/inr.12075
Fernández-Salazar S, Ramos-Morcillo AJ, Leal-Costa C, García-González J, Hernández-Méndez S, Ruzafa-Martínez M. Competencia en Práctica Basada en la Evidencia y factores asociados en las enfermeras de Atención Primaria en España. Aten Primaria 2021;53(7). DOI: https://doi.org/10.1016/j.aprim.2021.102050
Alleyne J, Jumaa MO. Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services. J Nurs Manag. 2007;15(2):230–43. DOI: https://doi.org/10.1111/j.1365-2834.2007.00750.x
Shirey MR. Authentic leaders creating healthy work environments for nursing practice. Am J Crit Care 2006;15(3):256–67. DOI: https://doi.org/10.4037/ajcc2006.15.3.256
Strout TD, Lancaster K, Schultz AA. Development and implementation of an inductive model for evidence-based practice: A grassroots approach for building evidence-based practice capacity in staff nurses. Nurs Clin North Am 2009;44(1):93–102. DOI: https://doi.org/10.1016/j.cnur.2008.10.007
Li S, Cao M, Zhu X, Ford C. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore).2019;98(39):e17209. DOI: https://doi.org/10.1097/MD.0000000000017209
Brown CE, Wickline MA, Ecoff L, Glaser D. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center. J Adv Nurs 2009;65(2):371–81. DOI: https://doi.org/10.1111/j.1365-2648.2008.04878.x
Hain D, Haras MS. Changing Nephrology Nurses’ Beliefs about the Value of Evidence-Based Practice and Their Ability to Implement in Clinical Practice - PubMed. Nephrol Nurs J 2015;42(6):563–6.