Group-Learning Activities and Nurses Internalization of Evidence-Based Practices: Secondary Analysis of a Cross-Sectional Study in Hospital Wards.

This study is a secondary analysis aimed at verifying the relationship between organizational learning activities for evidence-based practices (EBPs) in hospital wards and nurses' internalization of those EBPs and analyzing the contextual effects. This study used data from a previous study which was conducted to develop the group organizational learning activity inventory and used the same sampling method. The participants were asked about the extent of their internalization of EBPs, the organizational learning activities in their ward, and individual and ward characteristics. This study employed two-level hierarchical linear modeling with nurses' internalization of EBPs as the objective variable, eight factors of the Group Organizational Learning Activity (GOLA) Inventory as the explanatory variable, and individual and ward characteristics as control variables. Nurses' individual scores for the eight factors of the GOLA Inventory were analyzed by centering within clusters, and the wards' mean GOLA Inventory scores were also examined. To show the effectiveness of concrete activities for the internalization of EBPs, we calculated the contextual effects of the wards' organizational learning activities on the internalization of EBPs. As in the primary analysis, a total of 422 nurses from 56 wards in 12 hospitals responded to the survey and 360 nurses from 48 departments were included in this secondary analysis. Although the mean scores of all eight factors of the GOLA Inventory (ward level) were significantly positively associated with the internalization of EBPs, the contextual effect of each factor differed. Rather than creating an EBP team, specific ward-level activities, such as those designed to ensure that the staff can understand why EBPs are implemented and encourage them to take ownership of EBPs, are necessary for nurses' internalization of EBPs. Based on the results of this research, hospital or ward managers, as well as staff involved in introducing new practices, can implement efforts to promote nurses' internalization of EBPs.