Yimam Tariku, Mekonnen Asnakew Molla, Tsega Yawkal, Gebeyehu Endalkachew Mesfin
Department of Health System Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Front Public Health. 2025 Mar 11;13:1540388. doi: 10.3389/fpubh.2025.1540388. eCollection 2025.
Evidence-based practice (EBP) is essential in modern healthcare to improve patient outcomes and enhance the quality of care. Nurses play a crucial role in implementing EBP in clinical settings, yet its utilization remains suboptimal in many healthcare facilities, particularly in resource-limited settings. However, nursing practice in Ethiopia often relies on experience, tradition, intuition, common sense, and untested theories. Additionally, there is a lack of information on the implementation of EBP by nurses in Ethiopia, particularly in the study area. However, there is limited empirical evidence assessing the level of EBP implementation and the associated factors among nurses in these facilities. Therefore, this study aims to assess evidence-based practice and association factors among nurses in public health facilities of Dessie city, Northeast Ethiopia.
An institutional-based cross-sectional study was conducted among 442 nurses in public health facilities of Dessie City from January 17 to February 17, 2023. A stratified random sampling technique was used to select participants. Data were collected using a structured self-administered questionnaire and analyzed using bi-variable and multivariable binary logistic regression. Adjusted odds ratios (AOR) with 95% Confidence Intervals (CI) were calculated, and statistical significance was declared at < 0.05.
The prevalence of good Evidence-Based Practice (EBP) utilization among nurses was 37.6% (95% CI: 32.9-42.2%), indicating a low level of adoption. The mean (±SD) age of the participants was 41.34 (±12.86) years. Key factors significantly associated with EBP implementation included: Knowledge of EBP: Nurses with good knowledge were six times more likely to implement EBP (AOR = 6.01; 95% CI: 3.78, 9.55). Type of Health Facility: Nurses working in hospitals were nearly three times more likely to practice EBP compared to those in health centers (AOR = 2.89; 95% CI: 1.45, 5.76). Attitude towards EBP: Nurses with a favorable attitude were 3.4 times more likely to engage in EBP (AOR = 3.41; 95% CI: 2.04, 5.71). Additionally, barriers to EBP adoption included limited resources (34.4%), high workload (27.5%), and lack of internet access at the workplace (68.7%). Less than 10% of nurses reported using nursing journals as sources of evidence, while 73.4% relied on information from coworkers.
This study highlights a low prevalence of EBP utilization among nurses in Dessie City. The strong association between EBP adoption and factors such as knowledge, attitude, and type of health facility suggests the need for targeted interventions. Improving nurses' access to EBP training, research resources, and institutional support could significantly enhance EBP implementation, leading to better patient care and health outcomes.
循证实践（EBP）在现代医疗保健中对于改善患者预后和提高护理质量至关重要。护士在临床环境中实施循证实践方面发挥着关键作用，然而在许多医疗机构，尤其是资源有限的环境中，其应用仍未达到最佳状态。然而，埃塞俄比亚的护理实践往往依赖于经验、传统、直觉、常识和未经检验的理论。此外，关于埃塞俄比亚护士实施循证实践的信息匮乏，特别是在研究区域。然而，评估这些医疗机构中护士循证实践实施水平及相关因素的实证证据有限。因此，本研究旨在评估埃塞俄比亚东北部德西市公共卫生机构中护士的循证实践及相关因素。
2023年1月17日至2月17日，在德西市公共卫生机构的442名护士中进行了一项基于机构的横断面研究。采用分层随机抽样技术选择参与者。使用结构化的自填问卷收集数据，并采用双变量和多变量二元逻辑回归进行分析。计算调整后的优势比（AOR）及95%置信区间（CI），以P<0.05为具有统计学意义。
护士中良好的循证实践利用率为37.6%（95%CI：32.9 - 42.2%），表明采用水平较低。参与者的平均（±标准差）年龄为41.34（±12.86）岁。与循证实践实施显著相关的关键因素包括：循证实践知识：具备良好知识的护士实施循证实践的可能性高出六倍（AOR = 6.01；95%CI：3.78，9.55）。卫生机构类型：在医院工作的护士实施循证实践的可能性几乎是在健康中心工作的护士的三倍（AOR = 2.89；95%CI：1.45，5.76）。对循证实践的态度：态度积极的护士参与循证实践的可能性高出3.4倍（AOR = 3.41；95%CI：2.04，5.71）。此外，循证实践采用的障碍包括资源有限（34.4%）、工作量大（27.5%）以及工作场所缺乏互联网接入（68.7%）。不到10%的护士报告使用护理期刊作为证据来源，而73.4%依赖同事提供的信息。
本研究突出了德西市护士中循证实践利用率较低的情况。循证实践采用与知识、态度和卫生机构类型等因素之间的紧密关联表明需要有针对性的干预措施。改善护士获得循证实践培训、研究资源和机构支持的机会，可显著提高循证实践的实施水平，从而带来更好的患者护理和健康结局。
