Self-Perceived Evidence-Based Practice Competency and Associated Factors among Nurses at a County Referral Hospital in Kenya
DOI:
https://doi.org/10.47604/gjhs.2685Keywords:
Evidence-Based Practice, Evidence-Based Practice Competency, Self-Perceived Competency, Nursing PracticeAbstract
Purpose: Evidence-based practice (EBP) is a crucial approach in healthcare that combines research evidence, clinical expertise, and patient preferences to guide decision-making. There is often a gap between knowledge of and implementation of EBP dependent on the nurses’ ability to acquire and apply knowledge in managing patients and decision-making. This study aimed to assess the self-perceived EBP competency and identify associated factors among nurses at a County Referral Hospital in Kenya.
Methodology: A descriptive cross-sectional approach was used. A total of 75 nurses were recruited through stratified sampling. Semi-structured questionnaire was used to collect data on individual factors while validated tools were used to collect data on institutional factors and EBP competency. Data was presented in frequency tables and inferential statistics such as chi-square used to show associations. P value < 0.05 was considered significant.
Results: The study showed that 52% of nurses who participated in the study had a moderate level of self-perceived EBP competency and 32% showcased a high level of competency. There was a significant association between self-perceived EBP competency and education level (p=0.04), clinical experience (p<0.001), frequency of inter-professional collaboration (p=0.009), and availability of continuing professional development (p=0.003). This study showed that most nurses at the hospital had moderate levels of EBP competency. Self-perceived EBP is significantly associated with the level of education, clinical experience, inter-professional collaboration, and availability of continuing professional development.
Unique Contribution to Theory, Practice and Policy: This study applied the diffusion theory guided by Rogers' five elements. Using this theory in relation to EBP shows that the theory can be used to break down and understand nursing practice principles and factors surrounding their adoption by practitioners. This in turn can inform the restructuring of health care practices, policies formulation and intervention to enhance practice for quality care and improved health outcomes. The findings of this study can inform policy and practice development to facilitate EBP, and education for staff to equip nurses with the knowledge and tools needed to deliver high-quality, safe, and effective patient-centered care.
Downloads
References
Adejumo, P., Kolawole, I., Ojo, I., Ilesanmi, R., Olorunfemi, O., & Tijani, A. (2021). University Students’ Knowledge and Readiness to Practice Genomic Nursing in Nigeria. International Journal of Africa Nursing Sciences, 15, 100371. https://doi.org/10.1016/j.ijans.2021.100371
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
Asiimwe, R., Dwanyen, L., Subramaniam, S., Kasujja, R., & Blow, A. J. (2023). Training of interventionists and cultural adaptation procedures: A systematic review of culturally adapted evidence-based parenting programs in Africa. Family Process, 62(1), 160–181. https://doi.org/10.1111/famp.12780
Atakro, C., Atakro, A., Akuoko, C., Aboagye, J., Blay, A., Boatemaa, S., Adatara, P., Agyare, D., Amoa-Gyarteng, K., Garti, I., Menlah, A., Ansong, I., Boni, G., Sallah, R., & Sarpong, Y. (2020). Knowledge, attitudes, practices and perceived barriers of Evidence-based Practice among Registered Nurses in a Ghanaian Teaching Hospital. International Journal of Africa Nursing Sciences, 12, 100204. https://doi.org/10.1016/j.ijans.2020.100204
Aynalem, Z. B., Yazew, K. G., & Gebrie, M. H. (2021). Evidence-based practice utilization and associated factors among nurses working in Amhara Region Referral Hospitals, Ethiopia. PloS One, 16(3), e0248834. https://doi.org/10.1371/journal.pone.0248834
Bam, V., Diji, A. K.-A., Asante, E., Lomotey, A. Y., Adade, P., & Akyeampong, B. A. (2020). Self-assessed competencies of nurses at an emergency department in Ghana. African Journal of Emergency Medicine, 10(1), 8–12. https://doi.org/10.1016/j.afjem.2019.09.002
Brekelmans, G., Maassen, S., Poell, R. F., & van Wijk, K. (2015). The development and empirical validation of the Q-PDN: A questionnaire measuring continuing professional development of nurses. Nurse Education Today, 35(1), 232–238. https://doi.org/10.1016/j.nedt.2014.09.007
Chien, L.-Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research: JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
Connor, S., Sisimayi, C., Downing, J., King, E., Lim Ah Ken, P., Yates, R., & Marston, J. (2014). Assessment of the need for palliative care for children in South Africa. International Journal of Palliative Nursing, 20(3), 130–134. https://doi.org/10.12968/ijpn.2014.20.3.130
Degu, A. B., Yilma, T. M., Beshir, M. A., & Inthiran, A. (2022). Evidence-based practice and its associated factors among point-of-care nurses working at the teaching and specialized hospitals of Northwest Ethiopia: A concurrent study. PLoS ONE, 17(5), e0267347. https://doi.org/10.1371/journal.pone.0267347
Dolezel, J., Zelenikova, R., Finotto, S., Mecugni, D., Patelarou, A., Panczyk, M., Ruzafa-Martínez, M., Ramos-Morcillo, A. J., Skela-Savič, B., Gotlib, J., Patelarou, E., Smodiš, M., & Jarosova, D. (2021). Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements. Worldviews on Evidence-Based Nursing, 18(3), 226–233. https://doi.org/10.1111/wvn.12506
Duncombe, D. C. (2018). A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice—PubMed. Journal of Clinical Nursing, 27(5–6), 1216–1226. https://doi.org/10.1111/jocn.14168
Fiset, V. J., Graham, I. D., & Davies, B. L. (2017). Evidence-Based Practice in Clinical Nursing Education: A Scoping Review. Journal of Nursing Education, 56(9), 534–541. https://doi.org/10.3928/01484834-20170817-04
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, 0046958020927876. https://doi.org/10.1177/0046958020927876
Gallagher-Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The Effects of an Intensive Evidence-Based Practice Educational and Skills Building Program on EBP Competency and Attributes. Worldviews on Evidence-Based Nursing, 17(1), 71–81. https://doi.org/10.1111/wvn.12397
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
Kaseka, P. U., & Mbakaya, B. C. (2022). Knowledge, attitude and use of evidence based practice (EBP) among registered nurse-midwives practicing in central hospitals in Malawi: A cross-sectional survey. BMC Nursing, 21, 144. https://doi.org/10.1186/s12912-022-00916-z
Kimani, R. W., & Gatimu, S. M. (2023). Nursing and midwifery education, regulation and workforce in Kenya: A scoping review. International Nursing Review, 70(3), 444–455. https://doi.org/10.1111/inr.12840
Koslo, H. (2020). Evidence-Based Practice Guideline: Breastfeeding Support of the Active Duty Servicewoman [Walden University]. https://scholarworks.waldenu.edu/dissertations/8303
Labrague, L. J., Denise McEnroe-Pettite, Konstantinos Tsaras, Melba Sheila D’Souza, Dennis C Fronda, Ephraim C Mirafuentes, Asma Al Yahyei, & Marleise McBean Graham. (2019). Predictors of evidence-based practice knowledge, skills, and attitudes among nursing students. Nursing Forum, 54(2), 238–245. https://doi.org/10.1111/nuf.12323
Lam, C. K., & Schubert, C. (2019). Evidence-Based Practice Competence in Nursing Students: An Exploratory Study With Important Implications for Educators. Worldviews on Evidence-Based Nursing, 16(2), 161–168. https://doi.org/10.1111/wvn.12357
Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., O’Connor, M., Corrigan, M., Burke, F., Hayes, M., Lynch, H., Sahm, L., Heffernan, E., O’Keeffe, E., Blake, C., Horgan, F., & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: An expert view. BMJ Evidence-Based Medicine, 24(3), 103–108. https://doi.org/10.1136/bmjebm-2018-111019
Melnyk, B. M., Buck, J., & Gallagher-Ford, L. (2015). Transforming Quality Improvement Into Evidence-Based Quality Improvement: A Key Solution to Improve Healthcare Outcomes. Worldviews on Evidence-Based Nursing, 12(5), 251–252. https://doi.org/10.1111/wvn.12112
Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The First U.S. Study on Nurses’ Evidence‐Based Practice Competencies Indicates Major Deficits That Threaten Healthcare Quality, Safety, and Patient Outcomes. Worldviews on Evidence-Based Nursing, 15(1), 16–25. https://doi.org/10.1111/wvn.12269
Mkonyi, E., Mwakawanga, D. L., Rosser, B. R. S., Bonilla, Z. E., Lukumay, G. G., Mohammed, I., Mushy, S. E., Mgopa, L. R., Ross, M. W., Massae, A. F., Trent, M., & Wadley, J. (2021). The management of childhood sexual abuse by midwifery, nursing and medical providers in Tanzania. Child Abuse & Neglect, 121, 105268. https://doi.org/10.1016/j.chiabu.2021.105268
Moyimane, M. B., Matlala, S. F., & Kekana, M. P. (2017). Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: A qualitative study. The Pan African Medical Journal, 28, 100. https://doi.org/10.11604/pamj.2017.28.100.11641
Negussie, B. B., & Oliksa, G. B. (2020). Factors influence nurses’ job motivation at governmental health institutions of Jimma Town, South-west Ethiopia—ScienceDirect. International Journal of Africa Nursing Sciences, 1300. https://doi.org/10.1016/j.ijans.2020.100253
Nzengya, D. M., Mutisya, A. K., Wagoro, M. C. A., Secor-Turner, M., & Edwards, J. (2023). Nurses’ and midwives’ participation and utilization of health-related research in Kenya: Implications for evidence-based practice—ScienceDirect. International Journal of Nursing Sciences, 10(2), 199–205. https://doi.org/10.1016/j.ijnss.2023.02.001
Oh, E. G., & Yang, Y. L. (2019). Evidence-based nursing education for undergraduate students: A preliminary experimental study. Nurse Education in Practice, 38, 45–51. https://doi.org/10.1016/j.nepr.2019.05.010
Oikarainen, A., Mikkonen, K., Kenny, A., Tomietto, M., Tuomikoski, A.-M., Meriläinen, M., Miettunen, J., & Kääriäinen, M. (2019). Educational interventions designed to develop nurses’ cultural competence: A systematic review. International Journal of Nursing Studies, 98, 75–86. https://doi.org/10.1016/j.ijnurstu.2019.06.005
Orta, R., Messmer, P. R., Valdes, G. R., Turkel, M., Fields, S. D., & Wei, C. C. (2016). Knowledge and Competency of Nursing Faculty Regarding Evidence-Based Practice. Journal of Continuing Education in Nursing, 47(9), 409–419. https://doi.org/10.3928/00220124-20160817-08
Oster, C., & Braaten, J. (2017). High Reliability Organizations: A Healthcare Handbook for Patient Safety & Quality. Journal of Nursing Regulation, 8, 64. https://doi.org/10.1016/S2155-8256(17)30162-X
Patelarou, A., Mechili, E. A., Ruzafa-Martinez, M., Doležel, J., Gotlib, J., Skela-Savič, B., Ramos-Morcillo, A., Finotto, S., Jarosova, D., Smodiš, M., Mecugni, D., Panczyk, M., & Patelarou, E. (2020). Educational Interventions for Teaching Evidence- Based Practice to Undergraduate Nursing Students: A Scoping Review. International Journal of Environmental Research and Public Health, 17, 6351. https://doi.org/10.3390/ijerph17176351
Pérez-Campos, M. A., Sánchez-García, I., & Pancorbo-Hidalgo, P. L. (2014). Knowledge, Attitude and Use of Evidence-Based Practice among nurses active on the Internet. Investigacion Y Educacion En Enfermeria, 32(3), 451–460. https://doi.org/10.17533/udea.iee.v32n3a10
Persellin, D. C., & Daniels, M. B. (2023). A Concise Guide to Improving Student Learning: Six Evidence-Based Principles and How to Apply Them. Routledge.
Rezayi, S., Amanollahi, A., Shahmoradi, L., Rezaei, N., Katigari, M. R., Zolfaghari, M., & Manafi, B. (2022). Effects of technology-based educational tools on nursing learning outcomes in intensive care units: A systematic review and meta-analysis. BMC Medical Education, 22(1), 835. https://doi.org/10.1186/s12909-022-03810-z
Ritchie, K., snelgrove-clarke, E., & Murphy, A. (2018). The 23-item Evidence Based Practice-Knowledge Attitudes and Practices (23-item EBP-KAP) Survey: Initial validation among health professional students. Health Professions Education, 5. https://doi.org/10.1016/j.hpe.2018.09.004
Rogers, E. M. (1983). Diffution of Innovations (Third edition). The Free Press. https://teddykw2.files.wordpress.com/2012/07/everett-m-rogers-diffusion-of-innovations.pdf
Ruzafa-Martínez, M., Fernández-Salazar, S., Leal-Costa, C., & Ramos-Morcillo, A. J. (2022). Questionnaire to Evaluate the Competency in Evidence-Based Practice of Registered Nurses (EBP-COQ Prof©): Development and Psychometric Validation. Worldviews on Evidence-Based Nursing, 17(5), 366–375. https://doi.org/10.1111/wvn.12464
Saunders, H., Gallagher‐Ford, L., Kvist, T., & Vehviläinen-Julkunen, K. (2019). Practicing Healthcare Professionals’ Evidence‐Based Practice Competencies: An Overview of Systematic Reviews. Worldviews on Evidence-Based Nursing, 16. https://doi.org/10.1111/wvn.12363
Saunders, H., & Vehviläinen-Julkunen, K. (2017). Nurses’ Evidence-Based Practice Beliefs and the Role of Evidence-Based Practice Mentors at University Hospitals in Finland. Worldviews on Evidence-Based Nursing, 14(1), 35–45. https://doi.org/10.1111/wvn.12189
Skela-Savič, B., Hvalič-Touzery, S., & Pesjak, K. (2017). Professional values and competencies as explanatory factors for the use of evidence-based practice in nursing. Journal of Advanced Nursing, 73(8), 1910–1923. https://doi.org/10.1111/jan.13280
Tomotaki, A., Fukahori, H., & Sakai, I. (2020). Exploring sociodemographic factors related to practice, attitude, knowledge, and skills concerning evidence-based practice in clinical nursing. Japan Journal of Nursing Science: JJNS, 17(1), e12260. https://doi.org/10.1111/jjns.12260
Tucker, S., McNett, M., Mazurek Melnyk, B., Hanrahan, K., Hunter, S. C., Kim, B., Cullen, L., & Kitson, A. (2021). Implementation Science: Application of Evidence-Based Practice Models to Improve Healthcare Quality. Worldviews on Evidence-Based Nursing, 18(2), 76–84. https://doi.org/10.1111/wvn.12495
Ushiro, R. (2009). Nurse-Physician Collaboration Scale: Development and psychometric testing. Journal of Advanced Nursing, 65(7), 1497–1508. https://doi.org/10.1111/j.1365-2648.2009.05011.x
White-Williams, C., Patrician, P., Fazeli, P., Degges, M. A., Graham, S., Andison, M., Shedlarski, A., Harris, L., & McCaleb, K. A. (2013). Use, knowledge, and attitudes toward evidence-based practice among nursing staff. Journal of Continuing Education in Nursing, 44(6), 246–254; quiz 255–256. https://doi.org/10.3928/00220124-20130402-38
Wubante, S. M., & Tegegne, M. D. (2022). Evidence-based practice and its associated factors among health professionals in Ethiopia: Systematic review and meta-analysis. Informatics in Medicine Unlocked, 32. https://doi.org/10.1016/j.imu.2022.101012
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pauline Muthoni , Faith Cherotich Mutai
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.