Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers.

OBJECTIVE: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. METHOD: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. RESULTS: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. CONCLUSION: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses.

Nurses' perception of evidence-based practice at the National University Hospital of Singapore.

BACKGROUND: A study was conducted at Singapore's National University Hospital to elicit registered nurses' attitudes, knowledge, barriers, facilitating factors, education, and training regarding evidence-based practice. METHODS: A 13-question survey that was administered to all registered nurses yielded 1,114 (75.4%) usable returns for analysis. RESULTS: Findings showed that Singapore nurses had a positive and supportive attitude toward evidence-based practice but lacked the competence and knowledge to conduct it. Time constraints were identified as the main barrier to implementing evidence-based practice. There is a need for proper training, mentoring by senior nurses, and adequate time for evidence-based practice. Nurses with a higher level of nursing education who indicated the greatest perceived barriers tended to have less difficulty applying evidence-based practice but identified a need for more training in information skills. CONCLUSION: Evidence-based practice is still in its infancy in Singapore compared with hospitals in other developed countries.

Evidence-based practice and related information literacy skills of nurses in Singapore: an exploratory case study.

Increased demand for medical or healthcare services has meant that nurses are to take on a more proactive and independent role intending to patients, providing basic treatment and deciding relevant clinical practice. This, in turn, translates into the need for nurses to be able to translate research and evidence into their practice more efficiently and effectively. Hence, competencies in looking for, evaluating, synthesizing and applying documented information or evidence-based practice becomes crucial. This article presents a quantitative study that involved more than 300 nurses from a large government hospital in Singapore. A self-reporting questionnaire was developed to collect data pertaining to evidence-based practice and activities, including those that demonstrate information literacy competencies. Results seem to suggest that the nurses preferred to use print and human information sources compared to electronic information sources; were not proactive in looking up research or evidence-based information and, instead, preferred such information to be fed to them; and that they perceived they lacked the ability to evaluate research papers or effectively search electronic information related to nursing or evidence-based practice. It was also found that more than 80% of the nurses have not had any training related to evidence-based practice.