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Factors Affecting the Implementation and Barriers to Evidence-Based Practice among Nurse Practitioners in Hail Region, Saudi Arabia

*Majed Shafi Alshammari  -  Department of Nursing, University of Hail, Saudi Arabia
Raad Alshurtan  -  Hail General Hospital, Ministry of Health, Saudi Arabia
Gadah Alsuliman  -  Hail General Hospital, Ministry of Health, Saudi Arabia
Marzoogha Alshammari  -  Hail General Hospital, Ministry of Health, Saudi Arabia
Housam Alhamazani  -  Hail General Hospital, Ministry of Health, Saudi Arabia
Samiha Alshammry  -  Hail General Hospital, Ministry of Health, Saudi Arabia
Richard Dennis Dayrit  -  Department of Nursing, University of Hail, Saudi Arabia
Mohannad Alkwiese  -  Department of Nursing, University of Hail, Saudi Arabia
Open Access Copyright (c) 2021 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: While previous studies explored the implementation and barriers to evidence-based practice (EBP), there is a dearth of literature on the causative factors such as demographics that affect the implementation and barriers to EBP.

Purpose: This study aimed to investigate the factors affecting the implementation of EBP and determine its barriers as perceived by nurse practitioners.

Methods: This study employed a quantitative correlational design. A total of 228 staff nurses from the hospitals in the Hail region, Saudi Arabia, participated in this study through purposive sampling. The evidence-based practice questionnaire (EBPQ) and the barriers scale questionnaire were used to collect the data between June and July 2020. The descriptive statistics, t-test, and analysis of variance (ANOVA) were used to analyze the collected data.

Results: The nurses showed a positive attitude (x=15.25±5.07), good knowledge (x=63.44±19.81), as well as good application of EBP (x=28.02±6.68) with an outstanding EBP score of 106.73 out of 168. Nurses’ civil status (p<0.02), nationality (p<0.05), highest degree (p<0.01), job title (p<0.001), and years of experience (p<0.001) significantly affected the implementation of EBP. Also, the biggest barriers to EBP were: “No time to read research” (94.3%), “Research is not readily available” (97.8%), “Not capable to evaluate the quality of research” (90.4 %), and “Uncertain whether to believe results” (68.4%).

Conclusion: Nurses have a positive attitude, good knowledge, and good application of EBP. Civil status, nationality, highest degree, job title, and years of experience were causative factors to EBP. Nurses in hospitals should undergo training continuously to be able to use EBP effectively.
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Keywords: evidence-based practice; nurse practitioners; perceptions; quality of healthcare; Saudi Arabia
Funding: Not applicable

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  1. AbuRuz, M. E., Hayeah, H. A., Al-Dweik G., & Al-Akash, H. Y. (2017). Knowledge, attitudes, and practice about evidence-based practice: A Jordanian study. Health Science Journal, 11(2), 489. https://doi.org/10.21767/1791-809X.1000489
  2. Al-Busaidi, I. S., Al Suleimani, S. Z., Dupo, J. U., Al Sulaimi, N. K., & Nair, V. G. (2019). Nurses' knowledge, attitudes, and implementation of evidence-based practice in Oman: A multi-institutional, cross-sectional study. Oman Medical Journal, 34(6), 521–527. https://doi.org/10.5001/omj.2019.95
  3. Alsaqri S. H., Pasay-an, E., Villacorte, L., Madjid, F., Pacis, C., & Al-Sadi, A. K. A. (2020). Organizational empowerment among nursing faculty in the northwestern region of Saudi Arabia. Makara Journal Health Research, 24(2), 114−120. https://doi.org/10.7454/msk.v24i2.1205
  4. Alshammari, M. H., Pacheco, H., Pasay-an, E., Alshammari, F., Alsharari, A., Felemban, E., & Dayrit, R. D. (2020). Nurses perspectives on the degree of missed nursing care in the public hospitals in Hail City, Kingdom of Saudi Arabia. Belitung Nursing Journal, 6(6), 190-195. https://doi.org/10.33546/bnj.1233
  5. Alqahtani N, Oh K.M., Kitsantas P., & Rodan, M. (2020). Nurses’ evidence-based practice knowledge, attitudes and implementation: A cross-sectional study. Journal of Clinical Nursing, 29(1-2): 274–283. https://doi.org/10.1111/jocn.15097
  6. Ammouri, A. A., Raddaha, A. A., Dsouza, P., Geethakrishnan, R., Noronha, J. A., Obeidat, A. A., & Shakman, L. (2014). Evidence-based practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman. Sultan Qaboos University Medical Journal, 14(4), e537-e545
  7. Cañadas-De la Fuente, G. A., Ortega, E., Ramirez-Baena, L., De la Fuente-Solana, E. I., Vargas, C., & Gómez-Urquiza, J. L. (2018). Gender, marital status, and children as risk factors for burnout in nurses: A meta-analytic study. International Journal of Environmental Research and Public Health, 15(10). https://doi.org/10.3390/ijerph15102102
  8. Chien, L-Y. (2019). Evidence-based practice and nursing research. Journal of Nursing Research, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
  9. Chummum, H., & Tiran, D. (2008). Increasing research evidence in practice: A possible role for the consultant nurse. Journal of Nursing Management, 16(3), 327-333. https://doi.org/10.1111/j.1365-2834.2007.00791.x
  10. Dalheim, A., Harthug, S., Nilsen, R. M., & Nortvedt, M. W. (2012). Factors influencing the development of evidence-based practice among nurses: A self-report survey. BMC health Services Research, 12, 367. https://doi.org/10.1186/1472-6963-12-367
  11. Farokhzadian, J., Khajouei, R., & Ahmadian, L. (2015). Evaluating factors associated with implementing evidence-based practice in nursing. Journal of Evaluation in Clinical Practice, 21(6), 1107-1113. https://doi.org/10.1111/jep.12480
  12. Fu, L., Su, W., Ye, X., Li, M., Shen, J., Chen, C., Guo, Q., Ye, L., & He, Y. (2020). Evidence-based practice competency and related factors among nurses working in public hospitals. INQUIRY: A Journal of Medical Care Organization, Provision and Financing, 57, 46958020927876. https://doi.org/10.1177/0046958020927876
  13. Funk, S. G., Champagne, M. T., Wiese, R. A., & Tornquist, E. M. (1991). BARRIERS: The barriers to research utilization scale. Applied Nursing Research, 4(1), 39–45. https://doi.org/10.1016/s0897-1897(05)80052-7
  14. Harper, M. G., Gallagher-Ford, L., Warren, J. I., Troseth, M., Sinnott, L. T., & Thomas, B. K. (2017). Evidence-based practice and U.S. healthcare outcomes: Findings from a national survey with nursing professional development practitioners. Journal for Nurses in Professional Development, 33(4), 170–179. https://doi.org/10.1097/NND.0000000000000360
  15. Kajermo, K. N, Nordström, G., Krusebrant, A., & Björvell, H. (1998). Barriers to and facilitators of research utilization, as perceived by a group of registered nurses in Sweden. Journal of Advanced Nursing, 27(4), 798–807. https://doi.org/10.1046/j.1365-2648.1998.00614.x
  16. Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A. M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. https://doi.org/10.1111/wvn.12171
  17. Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to implementation of evidence based practice in zahedan teaching hospitals, Iran, 2014. Nursing Research and Practice, 2015, 357140. https://doi.org/10.1155/2015/357140
  18. Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236. https://doi.org/10.3163/1536-5050.99.3.010
  19. Malik, G., McKenna, L., & Plummer, V. (2015). Perceived knowledge, skills, attitude and contextual factors affecting evidence-based practice among nurse educators, clinical coaches and nurse specialists. International Journal of Nursing Practice, 21(2), 46-57 https://doi.org/10.1111/ijn.12366
  20. Mallion, J., & Brooke, J. (2016). Community- and hospital-based nurses’ implementation of evidence-based practice: Are there any differences? British Journal of Community Nursing, 21(3), 148–154. https://doi.org/10.12968/bjcn.2016.21.3.148
  21. Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20, e6. https://doi.org/10.1017/S1463423618000488
  22. Mehrdad, N., Joolaee, S., Joulaee, A., & Bahrani, N. (2012). Nursing faculties' knowledge and attitude on evidence-based practice. Iranian Journal of Nursing and Midwifery Research, 17(7), 506–511
  23. Melnyk, B.M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare. A guide to best practice. 3rd ed. Wolters Kluwer
  24. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. The Journal of Nursing Administration, 42(9), 410–417. https://doi.org/10.1097/NNA.0b013e3182664e0a
  25. Novrianda, D., & Herman, H. (2019). Knowledge, attitude and practice of evidence-based nursing practice and barriers. Journal Keperawatan Padjadjaran, 7(3), 236-245. https://doi.org/10.24198/jkp.v7i3.884.g236
  26. Oyoh, O., Somantri, I., & Sekarwana, N. (2017). Pengalaman perawat dalam pelaksanaan sistem pemberian pelayanan keperawatan profesional di RSUD Cibabat: Studi fenomenologi. [Nurses’ experiences in the implementation of professional nursing services system in Cibabat general hospital: A Phenomenological study]. Jurnal Keperawatan Padjadjaran, 5(3), 329–339. https://doi: 10.24198/jkp.v5i3.678
  27. Ozdemir, L., & Akdemir N. (2009). Turkish nurses’ utilization of research evidence in clinical practice and influencing factors. International Nursing Review, 56(3), 319–325. https://doi: 10.1111/j.1466-7657.2009.00707.x
  28. Panlican A. S., Pasay-an, E. A., Gonzales, F. M., Alreshidi, M. S., Ibno, N. L., & Alenzi S. S. (2020). A survey on the knowledge and attitude on pain management among nurses employed in the government hospitals. Saudi Journal for Health Sciences, 9(2), 97-101. https://doi.org/10.4103/sjhs.sjhs_100_20
  29. Raosoft, I. (2004). Raosoft sample size calculator. http://www.raosoft.com/samplesize.html
  30. Renolen, A., Hoye, S., Hjalmhult, E., Dabolt, L. J., & Kirkevold, M. (2018). “Keeping on track”—hospital nurses’ struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study. International Journal of Nursing Studies, 77, 179–188. https://doi.org/10.1016/j.ijnurstu.2017.09.006
  31. Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. 2nd ed. Churchill-Livingstone
  32. Saunders, H., Stevens, K. R., & Vehviläinen-Julkunen, K. (2016). Nurses’ readiness for evidence-based practice at Finnish university hospitals: A national survey. Journal of Advance Nursing, 72(8), 1863–1874. https://doi: 10.1111/jan.12963
  33. Shafiei, E., Baratimarnani, A., Goharinezhad, S., Kalhor, R., & Azmal, M. (2014). Nurses’ perceptions of evidence-based practice: A quantitative study at a teaching hospital in Iran. Medical Journal of the Islamic Republic of Iran, 28, 135
  34. Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers associated with evidence-based practice among nurses in low- and middle-income countries: A systematic review. Worldviews on Evidence-Based Nursing, 16(1), 12–20. https://doi.org/10.1111/wvn.12337
  35. Shifaza, F., Evans,D., & Bradley,H. (2014). Nurses’ perceptions of barriers and facilitators to implement EBP in the Maldives. Advances in Nursing, 2014, Article ID 698604. https://doi.org/10.1155/2014/698604
  36. Stokke, K., Olsen, N. R., Espehaug, B., & Nortvedt, M. W. (2014). Evidence based practice beliefs and implementation among nurses: A cross-sectional study. BMC Nursing, 13, 8. https://doi.org/10.1186/1472-6955-13-8
  37. Swito, I., Sidin, A. I., & Rachmawaty, R. (2021). Factors related to the implementation of evidenced-based practice (EBP) of nursing staffing levels in hospitals: A literature review. Journal of Asian Multicultural Research for Medical and Health Science Study, 2(1), 60-68. https://doi.org/10.47616/jamrmhss.v2i1.88
  38. Thompson, D. R., Chau, J. P. C., & Lopez, V. (2006). Barriers to, and facilitators of, research utilisation: A survey of Hong Kong registered nurses. International Journal of Evidence-Based Healthcare, 4(2), 77–82. https://doi.org/10.1111/j.1479-6988.2006.00036.x
  39. Upton, D., & Upton, P. (2006). Development of an evidence-based practice questionnaire for nurses. Journal of Advance Nursing, 53(4), 454–458. https://doi: 10.1111/j.1365-2648.2006.03739.x

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