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Evidence-based nursing is the concept of critically appraising the best evidence from research. It integrates research evidence with clinical expertise into decision making in nursing care for patients. The method is derived from the new paradigm in medicine--evidence-based medicine, developed as a learning method by epidemiologists at the McMaster University in Canada. This article states the necessity of this method for nursing. With the help of a clinical scenario (fall prevention in the elderly) the author explains how to use evidence-based nursing in practice.
Evidence-based practice, or evidence-based decision-making, is rapidly developing as a growth industry in nursing and the health professions more widely. It has its origins in the work of the British epidemiologist Archie Cochrane and has recently been re-energized in Canada by the National Forum on Health and its call for a culture of evidence-based decision-making. Before we adopt evidence-based nursing (EBN) as a mantra for the 21st century, we should examine its origins and its consequences, and we should probe related concepts, 2 of which are the nature and structure of practice-based knowledge and the nature and structure of evidence generally. Findings of a recent survey of nurses in western Canada are used to illustrate that nurses use a broad range of practice knowledge, much of which is experientially based rather than research-based.
AIMS: This paper is a report of a study conducted to explore the relationship between nurses' personal and professional factors and evidence-based nursing practice. BACKGROUND: Like most health-related professions, nursing is shifting from the traditional intuition-based paradigm to evidence-based nursing practice. METHODS: A cross-sectional survey was conducted in 2007 with a convenience sample of 243 nurses from northern Israel, who worked in hospitals or in the community. Associations between background variables and evidence-based nursing practice were examined. For the purpose of finding factors that predicted behaviour, a logistic regression analysis was conducted. RESULTS: The self-reported professional behaviour of nurses with a degree was more evidence-based than that of those without a degree. Moreover, evidence-based nursing practice was more likely where there was access to a rich library with nursing and medical journals, and opportunities for working with a computer and for searching the Internet in the workplace. The variables emerging as predicting evidence-based nursing practice were: education, skills in locating various research sources, support of the organization for searching and reading professional literature, knowledge sources based on colleagues and system procedures (inhibiting variable), knowledge sources based on reading professional literature, and knowledge sources based on experience or intuition. CONCLUSION: The findings point to the need for research-based information, exposure to professional journals and, in particular, organizational support for evidence-based nursing practice.
This article explores the concept of evidence-based nursing education. Because nurse educators incorporate evidence-based practice as a basic tenet of their programs, they assume nursing education itself is evidence based. Nursing education has a body of knowledge on which nurse educators base teaching, educational strategies, and curricular designs, but most of this knowledge is tacit, experiential, and based on practice. This knowledge relates to the art of teaching in nursing and can warrant the practice of nurse educators. However, research is also necessary to demonstrate the effectiveness of teaching approaches and strategies. Nurse educators need to develop the science of nursing education through qualitative and quantitative research, to add to the tacit knowledge underpinning nursing education strategies. When the science of nursing education is adequately developed through rigorous research, we will truly be able to say that nursing education is evidence based. Until then, it may be only a myth.
BACKGROUND: Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses. OBJECTIVES: To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing. SEARCH METHODS: We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011.We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations. SELECTION CRITERIA: We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3, 6, 12 and 24 months follow-up. MAIN RESULTS: We included one study from the USA (re-analysed as an ITS) involving one hospital and an unknown number of nurses and patients. The study evaluated the effects of a standardised evidence-based nursing procedure on nursing care for patients at risk of developing healthcare-acquired pressure ulcers (HAPUs). If a patient's admission Braden score was below or equal to 18 (i.e. indicating a high risk of developing pressure ulcers), nurses were authorised to initiate a pressure ulcer prevention bundle (i.e. a set of evidence-based clinical interventions) without waiting for a physician order. Re-analysis of data as a time series showed that against a background trend of decreasing HAPU rates, if that trend was assumed to be real, there was no evidence of an intervention effect at three months (mean rate per quarter 0.7%; 95% confidence interval (CI) 1.7 to 3.3; P = 0.457). Given the small percentages post intervention it was not statistically possible to extrapolate effects beyond three months. AUTHORS' CONCLUSIONS: Despite extensive searching of published and unpublished research we identified only one low-quality study; we excluded many studies due to non-eligible study design. If policy-makers and healthcare organisations wish to promote evidence-based nursing successfully at an organisational level, they must ensure the funding and conduct of well-designed studies to generate evidence to guide policy.
Evidence-based nursing is central to the knowledge base for nursing practice. Critics of evidence-based nursing dislike the central role that randomized controlled trials (RCTs) take in providing evidence for nursing, claiming that the context and experience of nursing care are removed from evaluation. Many nursing decisions involve questions regarding the effectiveness of interventions, best evaluated by RCTs. This article explores the epistemological and practical feasibility of combining qualitative research with RCTs (mixed methods research) in evaluations of nursing practice. Through theoretical and practical examples, it proposes that mixed methods research has the potential to enhance the evidence base for nursing.
During the brief time that we have been engaged in developing Evidence-Based Nursing we have been fascinated by the reactions of friends, professional colleagues, and the media. The overwhelming majority of responses to the concepts of evidence-based nursing and the creation of this journal have been positive. But there have also been misgivings, sometimes generated by misunderstandings. This editorial addresses the following criticisms which we have encountered in person and in print: (1) evidence-based practice isn't new: it's what we have been doing for years, (2) evidence-based nursing leads to "cookbook" nursing and a disregard for individualised patient care and, (3) there is an over-emphasis on randomised controlled trials and systematic reviews in evidencebased health care. We intend the paper to generate, rather than close the debate! A model for evidence-based clinical decisions (adapted from Haynes et al.
To improve patient outcomes currently and in the future, it is important that an evidence-based approach to nursing care be incorporated into clinical practice settings. Nurse educators and clinical nurse educators have a mandate to model and facilitate evidence-based nursing through learning activities. Unfortunately, issues present within clinical practice settings have made this approach difficult for registered nurses to fully incorporate into practice. This article outlines issues inhibiting evidence-based nursing, such as time factors, access to information and resources, nurses' research knowledge, skills, and learning opportunities, and the current nursing culture. Strategies for change that can be used by clinical nurse educators to enhance the use of evidence-based nursing in clinical practice areas are also described.
Evidence-Based Nursing: The Research-Practice Connection, Third Edition introduces students to research methods and evidence-based practice (EBP). Written in an accessible style, the content moves readers through understanding how research is produced to appraisal at the critical thinking level. Timely information links evidence-based practice to recent work in the Safety and Quality programs that are underway in healthcare and nursing. Key Features: * Offers five common research designs, systematic reviews, and clinical practice guidelines by using a consistent, easy-to-read Why-How-What approach. * Exemplar research reports include Profile and Commentary that explain results of studies and help students better understand the methodological components of a study Accompanied by Instructor Resources: * Save time with a Test Bank and sample syllabus * Encourage critical thinking using additional learning activities, including discussion questions and small group assignments * Plan classroom lectures using PowerPoint Presentations created by the author Navigate eFolio Now Available! Navigate eFolio: Evidence-Based Nursing , a fully supported and hosted online learning solution featuring an ebook and course management tools is also available for purchase. Navigate eFolio transforms how students learn and instructors teach by bringing together authoritative and interactive content aligned to course objectives, with student practice activities and assessments, an ebook, and reporting tools. For more information visit go.jblearning.com/nursingef
Evidence-based nursing management, developed as a framework for improving the quality of decisions to provide the most effective health-care outcomes, is a synthesis of clinical expertise, research evidence, and patient values, to create effective patient care strategies. Effective use of evidence-based nursing management requires identifying the sources of evidence and assessing their utilization. This article suggests a model for evidence-based nursing management in nursing practice. The literature shows six sources utilized for nursing management decisions: scientific and research evidence, information from hospitals, political-social development plans, managers' professional expertise, ethical-moral evidence, and values and expectations of all stakeholders.
Readers of Evidence-Based Nursing will be familiar with “review articles.” They are among the most common types of research abstracted for the journal, and although systematic reviews of randomised controlled trials (RCTs) predominantly feature in the Treatment section, reviews that address questions of assessment, causation, quality improvement, prognosis, and quality assessment have also been abstracted. Reviews of qualitative research have been abstracted less frequently—7 times since the journal began in 1998. Qualitative research is an important component of the evidence base for nursing. Almost one quarter of all abstracts published in Evidence-Based Nursing (n = 205) have been primary qualitative research articles, and they have examined several areas of nursing practice. Like quantitative researchers, qualitative researchers have become interested in synthesising qualitative research in order to develop new cumulative knowledge.1 This notebook will explore how syntheses of qualitative research may contribute to the practice of evidence-based nursing. Systematic reviews and meta-analyses of RCTs are at the top of the hierarchy for providing evidence of the effectiveness of interventions. This is because all individual trials have limitations, such as low statistical power, researcher or expert bias, and contextual variability.2 Similarly, single qualitative studies can be heavily influenced by specific issues of context and generalisability. By synthesising qualitative research, these difficulties can potentially be overcome. Several methodological approaches have been developed to synthesise qualitative research over the past 2 decades. Some have been adapted from methods used to analyse primary qualitative research, whereas others have been specifically developed for this purpose.3 Qualitative synthesis is being promoted by a number of organisations based on the recognition that providing health care involves complex, multifactorial decisions that require a range of evidence. Qualitative synthesis complements the “rationalist” model of synthesis provided by traditional systematic review methods.4 One such organisation is the Cochrane Qualitative …
Evidence-based practice has gained momentum in nursing, and definitions vary widely. Research findings, knowledge from basic science, clinical knowledge, and expert opinion are all considered "evidence"; however, practices based on research findings are more likely to result in the desired patient outcomes across various settings and geographic locations. The impetus for evidence-based practice comes from payor and healthcare facility pressures for cost containment, greater availability of information, and greater consumer savvy about treatment and care options. Evidence-based practice demands changes in education of students, more practice-relevant research, and closer working relationships between clinicians and researchers. Evidence-based practice also provides opportunities for nursing care to be more individualized, more effective, streamlined, and dynamic, and to maximize effects of clinical judgment. When evidence is used to define best practices rather than to support existing practices, nursing care keeps pace with the latest technological advances and takes advantage of new knowledge developments.
Evidence-based practice means integrating the best available research evidence with information about patient preferences, clinician skill level, and available resources to make decisions about patient care. Barriers to the use of research-based evidence occur when time, access to journal articles, search skills, critical appraisal skills, and understanding of the language used in research are lacking. Resources are available to overcome these barriers and support an evidence-based nursing practice. This article highlights available resources and describes strategies that nurses can use to develop and sustain an evidence-based nursing practice.
AIM: To provide a critical analysis of key concepts associated with evidence-based nursing (EBN) to substantiate an operational definition for nurses to use in practice. BACKGROUND: Despite the plethora of literature surrounding what evidence-based nursing is and is not and how it differs from its cousins, evidence-based medicine and evidence-based practice, nurses still struggle to get evidence into practice. Several reasons for this have been reported, for example, a lack of understanding about what evidence-based nursing means or time to engage with and apply the evidence into practice. DESIGN: An in-depth critical review and synthesis of literature was undertaken. METHOD: Using the key words; evidence-based nursing, evidence-based medicine and evidence-based practice 496 articles were yielded. These articles were limited to 83. Using Burns and Grove's (2001) phased approach to reviewing the literature the articles were critically reviewed and categorised into key concepts and themes. RESULTS: The in-depth critical review and synthesis of the literature demonstrated that evidence-based nursing could be defined as a distinct concept. The review clearly shows that for evidence-based nursing to occur, nurses need to be aware of what evidence-based nursing means, what constitutes evidence, how evidence-based nursing differs from evidence-based medicine and evidence-based practice and what the process is to engage with and apply the evidence. CONCLUSION: The in-depth critical review and synthesis of the evidence-based nursing literature reinforces the need to consolidate a position for nursing in the evidence-based field. The review confirms that evidence-based nursing can be defined and conceptualised; however, for nurses to engage and apply with the evidence-based processes they need to be informed of what these are and how to engage with them in practice. RELEVANCE TO CLINICAL PRACTICE: This paper examines the concept of evidence-based nursing and its application to clinical practice.
Unit 1 Steps Zero, One, Two: Getting Started Chapter 1 Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry Chapter 2 Asking Compelling, Clinical Questions Chapter 3 Finding Relevant Evidence to Answer Clinical Questions Unit 1 Making EBP Real: A Success Story. Using Evidence-Based Practice to Reduce Catheter-Associated Urinary Tract Infections in a Long- Term Acute Care Facility Unit 2: Step Three: Critically Appraising Evidence Chapter 4 Critically Appraising Knowledge for Clinical Decision Making Chapter 5 Critically Appraising Quantitative Evidence for Clinical Decision Making Chapter 6 Critically Appraising Qualitative Evidence for Clinical Decision Making Unit 2 Making Ebp Real: A Success Story. Making EBP a Reality by Reducing Patient Falls Through Transdisciplinary Teamwork Unit 3: Steps Four and Five: Moving From Evidence to Sustainable Practice Change Chapter 7 Integration of Patient Preferences and Values and Clinician Expertise Into Evidence-Based Decision Making Chapter 8 Advancing Optimal Care With Rigorously Developed Clinical Practice Guidelines and Evidence-Based Recommendations Chapter 9 Implementing Evidence in Clinical Settings Chapter 10 The Role of Outcomes and Quality Improvement in Enhancing and Evaluating Practice Changes Chapter 11 Leadership Strategies and Evidence-Based Practice Competencies to Sustain a Culture and Environment That Supports Best Practice Unit 3 Making EBP Real: A Success Story. Improving Outcomes for Depressed Adolescents with the Brief Cognitive Behavioral COPE Intervention Delivered in 30-Minute Outpatient Visits Unit 4: Creating and Sustaining a Culture and Environment for Evidence-Based Practice Chapter 12 Innovation and Evidence: A Partnership in Advancing Best Practice and High Quality Care Chapter 13 Models to Guide Implementation and Sustainability of Evidence-Based Practice Chapter 14 Creating a Vision and Motivating a Change to Evidence-Based Practice in Individuals, Teams, and Organizations Chapter 15 Teaching Evidence-Based Practice in Academic Settings Chapter 16 Teaching Evidence-Based Practice in Clinical Settings Chapter 17 ARCC Evidence-Based Practice Mentors: The Key to Sustaining Evidence-Based Practice Unit 4 Making EBP Real: A Success Story. Mercy Heart Failure Pathway Unit 5: Step Six: Disseminating Evidence and Evidence-Based Practice Implementation Outcomes Chapter 18 Disseminating Evidence Through Publications, Presentations, Health Policy Briefs, and the Media Unit 5 Making EBP Real: A Success Story. Faculty Research Projects Receive Worldwide Coverage Unit 6: Next Steps: Generating External Evidence and Writing Successful Funding Proposals Chapter 19 Generating Evidence Through Quantitative Research Chapter 20 Generating Evidence Through Qualitative Research Chapter 21 Writing a Successful Grant Proposal to Fund Research and Evidence-Based Practice Implementation Projects Chapter 22 Ethical Considerations for Evidence Implementation and Evidence Generation Unit 6 Making EBP Real: Selected Excerpts From a Funded Grant Application. COPE/Healthy Lifestyles for Teens: A School-Based RCT Appendix A Templates for Asking Clinical Questions Appendix B Rapid Critical Appraisal Checklists Appendix C Evaluation and Synthesis Tables Templates for Critical Appraisal Appendix D Walking the Walk and Talking the Talk: An Appraisal Guide for Qualitative Evidence Appendix E Example of a Health Policy Brief Appendix F Example of a Press Release Appendix G An Example of a Successful Media Dissemination Effort: Patient-Directed Music Intervention to Reduce Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support Appendix H Approved Consent Form for a Study Appendix I System-Wide ARCC Evidence-Based Practice Mentor Role Description 587 Appendix J ARCC Timeline for an EBP Implementation Project Appendix K Sample Instruments to Evaluate Organizational Culture and Readiness for Integration of EBP, EBP Beliefs, and EBP Implementation in Clinical and Academic Settings Glossary Index
Unit 1: Steps Zero, One, Two: Getting Started Chapter 1: Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry Chapter 2: Thoroughly Revised! Asking Compelling, Clinical Questions Chapter 3: Thoroughly Revised! Finding Relevant Evidence to Answer Clinical Questions Unit 2: Step Three: Critically Appraising Evidence Chapter 4: Critically Appraising Knowledge for Clinical Decision Making Chapter 5: Thoroughly Revised! Critically Appraising Quantitative Evidence for Clinical Decision Making Chapter 6: Critically Appraising Qualitative Evidence for Clinical Decision Making Unit 3: Steps Four and Five: Moving from Evidence to Action Chapter 7: Patient Concerns, Choices, and Clinical Judgment in Evidence-Based Practice Chapter 8: Advancing Optimal Care with Clinical Practice Guidelines Chapter 9: NEW! Implementing Evidence in Clinical Settings Chapter 10: Thoroughly Revised! The Role of Outcomes in Evaluating Practice Change Unit 4: Creating and Sustaining a Culture for Evidence-Based Practice Chapter 11: NEW! Models to Guide Implementation of Evidence-Based Practice Chapter 12: Creating a Vision and Motivating a Change to Evidence-Based Practice in Individuals, Teams, and Organizations Chapter 13: Teaching Evidence-Based Practice in Academic Settings Chapter 14: NEW! Teaching Evidence-Based Practice in Clinical Settings Chapter 15: NEW! ARCC Evidence-Based Practice Mentors: The Key to Sustaining Evidence-Based Practice Unit 5: Step Six: Disseminating Evidence and Evidence-Based Practice Implementation Outcomes Chapter 16: Disseminating Evidence Through Publications, Presentations, Health Policy Briefs, and the Media Unit 6: Next Steps: Generating External Evidence Chapter 17: Generating Evidence Through Quantitative Research Chapter 18: Generating Evidence Through Qualitative Research Chapter 19: Writing a Successful Grant Proposal to Fund Research and Evidence-Based Practice Implementation Projects Chapter 20: NEW! Ethical Considerations for Evidence Implementation and Evidence Generation Appendices Appendix A: Case Examples: Evidence-Based Care and Outcomes in Adult Depression and in Critically Ill Children Appendix B: Template for Asking PICOT Questions Appendix C: Walking the Walk and Talking the Talk: An Appraisal Guide for Qualitative Evidence Appendix D: Rapid Critical Appraisal Checklists Appendix E: Templates for Evaluation and Synthesis Tables for Conducting an Evidence Review Appendix F: Example of a Slide Show for a 20-Minute Paper Presentation Appendix G: Example of a Health Policy Brief Appendix H: Example of a Press Release Appendix I: Example of a Successful Media Dissemination Effort: When Rocking Chairs in Nursing Homes Make the News Appendix J: Example of an Approved Consent Form for a Study Appendix K: A Data and Safety Monitoring Plan for an Intervention Study Appendix L: System-Wide ARCC Evidence-Based Practice Mentor Role Description Appendix M: Timeline for an EBP Implementation Project Appendix N: Instruments to Evaluate Organizational Culture and Readiness for System-Wide Integration of EBP, EBP Beliefs, and EBP Implementation and Psychometrics Glossary
AIM: This paper is a presentation of a study to clarify the concept of evidence-based nursing and to explore the factors that influence evidence-based nursing by Iranian nurses. BACKGROUND: Evidence-based practice was introduced as an approach to high-quality care intended to improve results for patients. Several nurse researchers have studied factors affecting implementation of evidence-based nursing in western countries. However, there is little or no research on the perceptions of evidence-based nursing and its barriers in eastern countries, especially Iran. METHODOLOGY: Grounded theory method was used. Interviews with 21 participants and 30 hours of observation were conducted in hospitals in Iran during 2005. Constant comparative analysis was used to analyse the data. FINDINGS: Two main categories, 'the meaning of evidence-based nursing', and 'factors affecting it', emerged from the data. From participants' perspectives, evidence-based nursing was defined as 'caring for patients based on the nurse's professional knowledge in meeting patients' needs'. The second category, factors affecting evidence-based care, had six subcategories: possessing professional knowledge and experience; having time and opportunity; becoming accustomed; self-confidence; the process of nursing education; and the work environment and its expectations. CONCLUSION: Managers and educators need to be committed to the principles of EBP, provide resources and create a supportive environment for its implementation. Individual nurses also have a responsibility to carry out evidence-based nursing, and researchers should work with practitioners to generate high quality evidence to support nursing practice.
AIM: This paper adopts an epistemological perspective in order to support the assertion that there is very little evidence to support the existence of evidence-based nursing as a distinct construct or process. RATIONALE: This analysis of concept meaning is based on the theory of symbolic interactionism. By adopting this theory the commonalities and inconsistencies in the use of evidence-based symbolism by nurses and other health care professionals can be used to evaluate the perceived meaning of the term. METHODS: A frequency analysis of relevant key words in one publications data-base demonstrates the increasing use of evidence-based terminology and its euphemistic status visa vi research. An epistemological analysis is conducted on a sample of concept clarification statements taken from the popular literature, defining the nature of 'evidence' and 'evidence-based practice'. FINDINGS: The results of the frequency analysis show that the keywords 'evidence-based medicine' revealed 5612 papers, evidence-based practice (EBP) 432 papers, evidence-based nursing 47 papers, evidence-based health care 60 papers, and evidence-based decision making 43. Almost all of these papers have been published since 1995 and the earliest use of the symbol 'evidence-based' is 1992. There is also an increase in papers adopting 'evidence-based' symbolism along with a commensurate decrease in the use of the term 'research' in the nursing context. CONCLUSION: 'Evidence-based practice' is commonly a euphemism for information management, clinical judgement, professional practice development or managed care. There is insufficient evidence to demonstrate that evidence-based nursing is a single construct or process that can be distinguished from its concomitants. The term adds little more to the existing long standing traditions of quality assurance and research-based practice. Nurses must avoid the inefficiency brought about by the 'intense enthusiasm followed by sad disenchantment' that has been associated with other attempts to introduce innovation in health care delivery (Fienstein & Horowitz 1997).
PURPOSE: To describe a model that has been developed to guide nurses and other health professionals in collaborative efforts toward evidence-based nursing practice. METHOD: A review of literature was conducted using MEDLINE and CINAHL to search for articles on research utilization for evidence-based practice in health care delivery. Empirical studies; reviews; and theoretical, opinion, and information articles were included in the review in order to provide a more comprehensive view of the state of evidence-based nursing internationally. FINDINGS: Findings revealed a number of barriers to evidence-based nursing practice, which have persisted over the last two decades, including inadequate knowledge of research among practicing nurses, lack of administrative support for research activities in clinical settings, lack of empowerment of nurses, and lack of needed mentoring from nursing research consultants. CONCLUSIONS: Barriers in the areas of nursing education and administrative support appear to be major. A need was identified for a pragmatic model that encourages cooperation and collaboration between educators/researchers in academia and the administrative leaders in the clinical facilities if evidence-based nursing practice is to become the norm. FRAMEWORK OF MODEL: The Tyler Collaborative Model is based on an eclectic approach to planned change for creating evidence-based practice. This model identifies a step-by-step process for change, while allowing for the opportunity to integrate any of the previously available methods of critical appraisal to determine the best evidence for practice in each clinical setting.
AIM: This paper is a report of a study to describe nurses' practices, knowledge, and attitudes related to evidence-based nursing, and the relation of perceived barriers to and facilitators of evidence-based practice. BACKGROUND: Evidence-based practice has been recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. Barriers and facilitators for the adoption of evidence-based practice in nursing have been identified by researchers. Healthcare organizations have been challenged to foster an environment conducive to providing care based on evidence and not steeped in ritualized practice. METHODS: A descriptive, cross-sectional research study was conducted in 2006-2007 with a convenience sample of 458 nurses at an academic medical center in California (response rate 44.68%). Two reliable and valid questionnaires were electronically formatted and administered using a secured website. Relationships between responses to the two instruments were examined and results compared with previously published data. RESULTS: Organizational barriers (lack of time and lack of nursing autonomy) were the top perceived barriers. Facilitators were learning opportunities, culture building, and availability and simplicity of resources. Statistically significant correlations were found between barriers and practice, knowledge and attitudes related to evidence-based practice. CONCLUSION: Similar barriers to the adoption of evidence-based practice have been identified internationally. Educators must work with managers to address organizational barriers and proactively support evidence-based practice.