A compendium of evidence-based practice instruments for nursing education, practice and research.

BACKGROUND: Evidence-based practice (EBP) is a cornerstone for safe, high-quality care. Implementation science recognizes that many factors influence the successful use of EBP, from attitudes and beliefs, self-efficacy, and knowledge and skills to contextual factors related to unit and organizational culture. This integrative review aimed to identify valid and reliable instruments measuring critical EBP domains with nursing professionals. METHODS: A systematic search of the literature was conducted. CINAHL, PubMed, EMBASE, Cochrane, and Joanna Briggs were searched to identify original research publications testing the reliability and validity of EBP nursing instruments. RESULTS: Of 347 records, 48 studies representing 50 instruments were identified as having undergone psychometric testing, thus meeting the inclusion criteria. Most instruments were validated in English-speaking countries. Content validity, construct validity, and internal consistency standards were met for 70%, 62%, and 94% of instruments, respectively. Limited testing was found for other types of validity, test-retest reliability, acceptability, feasibility, or responsivity and sensitivity, thus representing gaps in psychometric validation. Less than 20% of instruments have been translated to other languages limiting their use to advance EBP worldwide. LINKING EVIDENCE TO ACTION: Eighty-two percent of instruments met minimal psychometric standards and are sound for education, practice, and research. Expanding psychometric testing and utilizing validated EBP instruments will further the EBP movement to improve global population health.

Facilitating a Culture of Evidence-Based Practice and Quality Improvement Excellence: Streamlining Processes to Improve Care.

This article defines evidence-based practice (EBP) and quality improvement (QI) and examines the positive impact on patient care when they are in place, as well as the barriers to their implementation. An effective tool, Ovid Synthesis, was created to enable clinicians and administrators to streamline the processes for EBP and QI, provide oversight on the initiatives underway, and enable clinical educators to help nursing staff develop the necessary competencies and successfully execute their EBP and/or QI projects.

An objective test to measure evidence-based practice knowledge and skill competency of acute care nurses: A psychometric validation study.

BACKGROUND: Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, was validated first with medicine, followed by versions for physical therapists, occupational therapists, speech therapists, social workers, dietitians, pediatric nurses, and health care students. The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of the 14 items required revision to achieve acceptable psychometrics. AIM: The aim of this second validation study was to revise and validate a new version of the test, The Modified Fresno Test-Acute Care Nursing (MFT-ACN), to determine if it could distinguish EBP knowledge/skills among acute care nurses. METHODS: A panel of eight EBP experts were engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83 to 1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master, and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Two doctorally prepared EBP experts independently scored tests using the standardized rubric. RESULTS: The MFT-ACN yielded strong psychometric properties (intra-class correlation coefficients > 0.80; item discrimination indices > 0.20; item-total correlations > 0.30). One poorly performing item was dropped per a priori cut-off values. The final test included 13 items, with a Cronbach's alpha = 0.77. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years of acute care experience, and formal EBP or research workshops or conferences or courses or immersions. Perceived level of EBP expertise was not associated with mean scores. Further research is recommended with a larger sample to assess the tests' responsiveness to change in EBP knowledge/skills over time and enhance its acceptability and feasibility. Additional research should further evaluate construct and concurrent validity against other objective assessments of EBP knowledge/skills. LINKING EVIDENCE TO ACTION: The validated 13-item MFT-ACN can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing workforce.

Pilot Evaluation of a Functional Pain Assessment Scale.

PURPOSE/AIMS: Common pain assessment tools measure intensity, ignoring other dimensions of pain like function. The aim of this study was to test the psychometric properties of a newly developed functional pain assessment scale (FPAS) for use in clinical practice. DESIGN/METHODS: In this descriptive correlational study, an FPAS was developed and then evaluated against 2 validated pain tools in 68 hospitalized adult patients experiencing acute and/or chronic pain. These tools included the numeric pain rating scale and a 100-mm visual analog scale. RESULTS: The FPAS was significantly correlated (ρ = 0.72-0.87; P < .001) with the numeric pain rating scale and visual analog scale in cognitively intact patients but not the cognitively impaired (ρ = 0.22-0.34; P > .05). Test-retest reliability coefficients for the 3 scales were high (ρ = 0.82-0.94; P < .001), demonstrating stability of the measures. Overall, patients preferred the FPAS; this preference was significantly greater in patients older than 40 years. CONCLUSIONS: This pilot study provided support for the reliability and validity of the FPAS in cognitively intact patients experiencing pain. Although more research is needed, clinicians may consider using the FPAS with cognitively intact adults to assess the functional impact of pain on pain intensity. Clinical nurse specialists play a pivotal role in role modeling and guiding the introduction and testing of new assessment approaches into clinical practice settings across the continuum of care.