Melnyk Bernadette Mazurek, Gallagher-Ford Lynn, Zellefrow Cindy, Tucker Sharon, Thomas Bindu, Sinnott Loraine T, Tan Alai
Vice President for Health Promotion, University Chief Wellness Officer, Dean and Professor, College of Nursing, Professor of Pediatrics and Psychiatry, College of Medicine, and Executive Director, Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, The Ohio State University, Columbus, OH, USA.
Senior Director, Helene Ford Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH, USA.
Worldviews Evid Based Nurs. 2018 Feb;15(1):16-25. doi: 10.1111/wvn.12269. Epub 2017 Dec 26.
Tremendous variability in EBP persists throughout the United States even though research supports that implementation of EBP leads to high-quality cost-effective care. Although the first set of EBP competencies for nurses was published in 2014, the state of EBP competency in U.S. nurses is currently unknown.
The purposes of this study were to: (a) describe the state of EBP competency in nurses across the United States; and (b) determine important factors associated with EBP competency.
A cross-sectional descriptive study was conducted that gathered data from an anonymous online survey of practicing nurses throughout the U.S. Measures tapped EBP knowledge, beliefs, culture, mentorship, implementation, and reported competency for each of the 13 EBP competencies for practicing nurses and an additional 11 competencies for advanced practice nurses.
A total of 2,344 nurses completed the survey from 19 hospitals or healthcare systems. Overall, the nurses reported that they were not yet competent in meeting any of the 24 EBP competencies. Younger nurses and those with higher levels of education reported higher EBP competency (p < .001). The EBP competency scores were not significantly different between nurses in Magnet and non-Magnet designated organizations (p = .28). There were strong positive associations between EBP competency with EBP beliefs (r = .66) and EBP mentorship (r = .69), a moderate positive association between EBP competency and EBP knowledge (r = .43), and a small positive association between EBP competency and culture (r = .29).
There is a tremendous need to enhance nurses' skills so that they achieve competency in EBP in order to ensure the highest quality of care and best population health outcomes. Academic programs should ensure competency in EBP in students by the time of graduation and healthcare systems should set it as an expectation and standard for all clinicians.
尽管研究表明实施循证实践（EBP）可带来高质量的成本效益护理，但美国各地的EBP仍存在巨大差异。尽管2014年发布了第一套护士EBP能力标准，但目前美国护士的EBP能力状况尚不清楚。
本研究的目的是：（a）描述美国护士的EBP能力状况；（b）确定与EBP能力相关的重要因素。
进行了一项横断面描述性研究，通过对美国执业护士的匿名在线调查收集数据。测量指标涉及EBP知识、信念、文化、指导、实施情况，并报告了执业护士13项EBP能力标准以及高级实践护士另外11项能力标准的达标情况。
共有来自19家医院或医疗系统的2344名护士完成了调查。总体而言，护士们表示他们在24项EBP能力标准中的任何一项上都尚未达标。年轻护士和受教育程度较高的护士报告的EBP能力较高（p <.001）。在磁铁指定组织和非磁铁指定组织的护士中，EBP能力得分无显著差异（p =.28）。EBP能力与EBP信念（r =.66）和EBP指导（r =.69）之间存在强正相关，EBP能力与EBP知识之间存在中度正相关（r =.43），EBP能力与文化之间存在小正相关（r =.29）。
迫切需要提高护士的技能，使其在EBP方面达到能力标准，以确保最高质量的护理和最佳的人群健康结果。学术项目应确保学生在毕业时具备EBP能力，医疗系统应将其作为对所有临床医生的期望和标准。
