1. and the nurses’ attitude towards evidence-based guidelines (EBG).

Objective: Evidence-based practice (EBP) and
evidence-based guidelines (EBGs) have been viewed as the most effective way to
improve the clinical practice in the hospitals. The aim of this research study
was to compare the evidence-based practice’s (EBP) belief and its knowledge
among different groups of nurses in Finland, and the nurses’ attitude towards
evidence-based guidelines (EBG). In addition, the research study will also
discuss the barriers and limitations regarding the EBGs.


Introduction: EBP and EBGs have been widely
accepted and studied in English-speaking countries. However, it’s still unclear
how non-English speaking countries responded to EBP and EBGs and if the
registered nurses (RNs) really adopted EBP and EBGs in clinical practice at the

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Two methods were conducted in the three evidence-based practice journals: The
first was a descriptive cross-sectional survey. The survey randomly collected
943 samples from 5 university hospitals systems in Finland, serving over 5
million Finnish population. In addition, the survey was translated from English
into Finnish and was composed of demographics questions such as age, gender, and
years of nursing experience. Other questions include nurses’ EBP beliefs, EBP knowledge,
and job-related questions such as nurse retention, job satisfaction, and intent
to resign the nurse position. The second method was a focus group interviews. The
participants were 10 experienced occupation health (OH) doctors and 8
experienced nurses. The research started recording the interviews, transcribing,
and then beginning the data analysis. The interviewer asked participants about
their attitudes towards EBG’s reliability, usefulness, availability, awareness
of the guidelines and occupation competence. 


Results: After
analyzing the survey data from 943 nurses, the researcher concluded that there
were several significant differences among different groups of RNs in terms of
their EBP beliefs and the knowledge. First, RNs who had fewer years of nursing experience
were more likely to have stronger beliefs compared to the RNs who had more
years of working experiences. Second, the RNs who had earned a bachelor degree
or a master degree have stronger beliefs as to the degree to which their own
practice was based on EBP than those who earned an associate degree in nursing.

In addition, RN clinicians were significantly more likely than RNs who worked
as managers to have stronger beliefs in the degree to which their own practice
is based on evidence. However, RN managers were significantly more likely than
RN clinicians to have stronger beliefs in the degree to which EPB improves
quality of care and which EBP improves patient outcomes. According to the focus
group interview analysis, the researcher concluded that both doctors and nurses
are familiar with EBGs. Especially doctors demonstrated a higher level of
awareness of EBGs compared to the nurses. And both of them agree that the
guidelines could be perfectly fitted in Finnish OH system. In general, EBGs
were considered extremely practice in decision-making and the participants
including doctors and nurses thought that EBGs were mainly targeted at doctors
instead of nurses. Also, several participants complained that EBGs formats were
too long and complicated. Moreover, both doctors and nurses complained that the
patient’s information did not match the scientific information and thus it’s
hard for them to make a decision even though they were aware of the guidelines.


Discussion: The situation was not very clear for
the registered nurses (RNs). Even though the doctors used EBGs and adopted EBP
for practice, the nurses viewed EBP and EBGs as strict instructions offered by
their employers and doctors. Also, even nurses demonstrated strong beliefs and
familiarity in terms of EBP and EBGs, sometimes they were still difficult to recognize
them. Also, the nurses didn’t view searching skills as an important and
necessary skill. Hence, the hospitals should provide more education on nurses
in an easy-to-use and user-friendly format.



Conclusion: Even though nurses demonstrated
strong beliefs for EBP and their familiarity for EBGs, they still lacked the
EBP knowledge that integrated the best evidence into clinical care. According
to the goal from the Institute of Medicine in Finland, 90% of all clinical
decision should be made by evidence-based practice by 2020. Hence, there are
two effective strategies to improve nurses’ knowledge about integrating the EBP
and EBGs with clinical care. One is transforming the guidelines into easy-to-use
and user-friendly format to facilitate the implementation of EBP. The second
strategy is to offer EBP mentoring programs to improve the decision-making at
the hospitals.