Wudu Muluken Amare, Tarekegn Setegn Mihret, Wondifraw Endalk Birrie, Birhanu Tarikua Afework, Hailu Molla Kassa, Bekalu Yemane Eshetu, Yosef Selamyhun Tadesse, Belete Melaku Ashagrie
Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Front Pharmacol. 2024 Jul 18;15:1421690. doi: 10.3389/fphar.2024.1421690. eCollection 2024.
While evidence-based practice has demonstrated its capacity to enhance healthcare quality and bolster clinical outcomes, the translation of research into clinical practice encounters persistent challenges. In Ethiopia, there remains a dearth of comprehensive and nationally representative data concerning the extent of Evidence-based practice adoption among nurses. Thus, this systematic review and meta-analysis endeavors to assess the overall prevalence of Evidence-based practice implementation and delve into its determinants among Ethiopian nurses. A systematic review and meta-analysis were conducted following the PRISMA guidelines. In order to identify pertinent studies, a search was conducted across PubMed, Scopus, Google Scholar, and EMBASE databases. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence. Cochrane's Q-test and I statistics were calculated to assess heterogeneity among studies. Funnel plots and Egger's test were utilized to evaluate publication bias. Pooled implementation rates and meta-regression analysis were carried out using STATA 17. Of the total 1,590 retrieved articles, twelve studies including 4,933 nurses were included in the final analysis. The pooled prevalence of Evidence-based practice uptake among nurses in Ethiopia is 53% (95% CI: 46%-60%). Having knowledge about Evidence-based practice (AOR = 2.29; 95% CI: 1.90, 2.69; I = 70.95%), holding a favorable attitude towards Evidence-based practice (AOR = 2.56; 95% CI: 1.63, 3.49; I = 88.39%), occupying a head nurse position (AOR = 3.15; 95% CI: 1.85, 4.46; I = 87.42%), possessing effective communication skills (AOR = 4.99; 95% CI: 1.47, 8.51; I = 99.86%), and having access to Evidence-based practice guidelines (AOR = 1.90; 95% CI: 1.55, 2.24; I = 57.24%) were identified as predictors of the uptake of Evidence-based practice. Only half of Ethiopia's nurses exhibit a strong embrace of Evidence-Based Practice within clinical settings, underscoring the urgent necessity for coordinated endeavors to cultivate this essential practice. Possessing knowledge, effective communication skills, access to updated guidelines, maintaining a positive attitude towards Evidence-Based Practice, and holding a position as head nurse emerged as predictors of successful implementation of Evidence-Based Practice. Hence, policymakers must prioritize capacity-building initiatives, disseminate the latest EBP guidelines widely, and strengthen mentorship roles for head nurses. https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CRD42023488943.
虽然循证实践已证明其有能力提高医疗质量并改善临床结果,但将研究成果转化为临床实践仍面临持续挑战。在埃塞俄比亚,关于护士采用循证实践程度的全面且具有全国代表性的数据仍然匮乏。因此,本系统评价和荟萃分析旨在评估埃塞俄比亚护士中循证实践实施的总体患病率,并深入探究其决定因素。按照PRISMA指南进行了系统评价和荟萃分析。为了识别相关研究,在PubMed、Scopus、谷歌学术和EMBASE数据库中进行了检索。采用加权逆方差随机效应模型来估计合并患病率。计算了Cochrane Q检验和I统计量以评估研究间的异质性。使用漏斗图和Egger检验来评估发表偏倚。使用STATA 17进行合并实施率和元回归分析。在检索到的1590篇文章中,最终纳入了12项研究,涉及4933名护士。埃塞俄比亚护士中采用循证实践的合并患病率为53%(95%可信区间:46%-60%)。了解循证实践(优势比=2.29;95%可信区间:1.90, 2.69;I²=70.95%)、对循证实践持积极态度(优势比=2.56;95%可信区间:1.63, 3.49;I²=88.39%)、担任护士长职位(优势比=3.15;95%可信区间:1.85, 4.46;I²=87.42%)、具备有效的沟通技巧(优势比=4.99;95%可信区间:1.47, 8.51;I²=99.86%)以及能够获取循证实践指南(优势比=1.90;可信区间:1.55, 2.24;I²=57.24%)被确定为循证实践采用的预测因素。在埃塞俄比亚,只有一半的护士在临床环境中积极采用循证实践,这凸显了协同努力培养这一重要实践的迫切必要性。具备知识、有效的沟通技巧、获取最新指南、对循证实践保持积极态度以及担任护士长职位成为循证实践成功实施的预测因素。因此,政策制定者必须优先开展能力建设举措,广泛传播最新的循证实践指南,并加强护士长的指导作用。https://www.crd.york.ac.uk/prospero/#searchadvanced,标识符CRD42023488943 。