1. Objective: Evidence-based practice (EBP) andevidence-based guidelines (EBGs) have been viewed as the most effective way toimprove the clinical practice in the hospitals. The aim of this research studywas to compare the evidence-based practice’s (EBP) belief and its knowledgeamong different groups of nurses in Finland, and the nurses’ attitude towardsevidence-based guidelines (EBG). In addition, the research study will alsodiscuss the barriers and limitations regarding the EBGs. 2. Introduction: EBP and EBGs have been widelyaccepted and studied in English-speaking countries. However, it’s still unclearhow non-English speaking countries responded to EBP and EBGs and if theregistered nurses (RNs) really adopted EBP and EBGs in clinical practice at thehospitals.
3. Methods:Two methods were conducted in the three evidence-based practice journals: Thefirst was a descriptive cross-sectional survey. The survey randomly collected943 samples from 5 university hospitals systems in Finland, serving over 5million Finnish population. In addition, the survey was translated from Englishinto Finnish and was composed of demographics questions such as age, gender, andyears of nursing experience. Other questions include nurses’ EBP beliefs, EBP knowledge,and job-related questions such as nurse retention, job satisfaction, and intentto resign the nurse position.
The second method was a focus group interviews. Theparticipants were 10 experienced occupation health (OH) doctors and 8experienced nurses. The research started recording the interviews, transcribing,and then beginning the data analysis. The interviewer asked participants abouttheir attitudes towards EBG’s reliability, usefulness, availability, awarenessof the guidelines and occupation competence.
4. Results: Afteranalyzing the survey data from 943 nurses, the researcher concluded that therewere several significant differences among different groups of RNs in terms oftheir EBP beliefs and the knowledge. First, RNs who had fewer years of nursing experiencewere more likely to have stronger beliefs compared to the RNs who had moreyears of working experiences. Second, the RNs who had earned a bachelor degreeor a master degree have stronger beliefs as to the degree to which their ownpractice was based on EBP than those who earned an associate degree in nursing.In addition, RN clinicians were significantly more likely than RNs who workedas managers to have stronger beliefs in the degree to which their own practiceis based on evidence.
However, RN managers were significantly more likely thanRN clinicians to have stronger beliefs in the degree to which EPB improvesquality of care and which EBP improves patient outcomes. According to the focusgroup interview analysis, the researcher concluded that both doctors and nursesare familiar with EBGs. Especially doctors demonstrated a higher level ofawareness of EBGs compared to the nurses. And both of them agree that theguidelines could be perfectly fitted in Finnish OH system. In general, EBGswere considered extremely practice in decision-making and the participantsincluding doctors and nurses thought that EBGs were mainly targeted at doctorsinstead of nurses. Also, several participants complained that EBGs formats weretoo long and complicated. Moreover, both doctors and nurses complained that thepatient’s information did not match the scientific information and thus it’shard for them to make a decision even though they were aware of the guidelines.
5. Discussion: The situation was not very clear forthe registered nurses (RNs). Even though the doctors used EBGs and adopted EBPfor practice, the nurses viewed EBP and EBGs as strict instructions offered bytheir employers and doctors. Also, even nurses demonstrated strong beliefs andfamiliarity in terms of EBP and EBGs, sometimes they were still difficult to recognizethem.
Also, the nurses didn’t view searching skills as an important andnecessary skill. Hence, the hospitals should provide more education on nursesin an easy-to-use and user-friendly format. 6. Conclusion: Even though nurses demonstratedstrong beliefs for EBP and their familiarity for EBGs, they still lacked theEBP knowledge that integrated the best evidence into clinical care. Accordingto the goal from the Institute of Medicine in Finland, 90% of all clinicaldecision should be made by evidence-based practice by 2020. Hence, there aretwo effective strategies to improve nurses’ knowledge about integrating the EBPand EBGs with clinical care.
One is transforming the guidelines into easy-to-useand user-friendly format to facilitate the implementation of EBP. The secondstrategy is to offer EBP mentoring programs to improve the decision-making atthe hospitals.