Do educational interventions aimed at nurses to support the implementation of evidence-based practice improve patient outcomes? A systematic review.

BACKGROUND: Numerous articles have sought to identify the impact of educational interventions for improving evidence-based practice (EBP) amongst nurses, most of these focus on skills and knowledge acquired. No systematic review has explored whether this educational input translates into improved patient outcomes. OBJECTIVES: To review the evidence on (1) The change in patient outcomes following educational interventions to support practising nurses in implementing EBP. (2) The instruments or methods used to determine whether EBP education improves patient outcomes. METHODS: A systematic review following PRISMA guidance was conducted. Literature was comprehensive searched including 6 databases, journal handsearching, citation tracking, and grey literature websites. Studies were included if they reported an EBP educational intervention aimed at practising nurses and contained objective or self-reported measures of patient related outcomes. The quality of the included studies was assessed using a modified Health Care Practice R&D Unit (HCPRDU) tool. Because of the poor homogeneity of the included studies, the data were analysed by narrative synthesis. RESULTS: Of the 4284 articles identified, 18 were included: 12 pre-post studies, three qualitative studies, and three mixed-methods study designs. The level of quality was modest in the studies. The results of the EBP educational interventions on patient outcomes were assessed using three methods: individual projects to implement an evidence-based approach, qualitative approaches, and a questionnaire survey. The majority of the articles concluded there was a positive change in patient outcomes following an educational intervention to improve EBP; a wide range of context specific outcomes were described. CONCLUSION: Educational interventions for clinical nurses to support the implementation of EBP show promise in improving patient outcomes. However, the direct impact of EBP interventions on clinical outcomes is difficult to measure. Further testing and development is needed to improve the quality of studies and evaluation instruments in order to confirm the current findings.