Date of Award

2008-11-01

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson; Jane M. Georges, PhD, RN; Linda D. Urden, DNSc, RN, NE-BC, FAAN

Keywords

educational initiative, evidence-based practice, fellowships, nursing, patients

Abstract

Evidence-based practice (EBP), recognized as essential in providing quality patient care and achieving optimal outcomes, is the integration of the best research evidence, patient preference, and clinician expertise. Healthcare providers must attain expertise in integrating EBP into the clinical setting. Fellowships are one strategy reported in the literature to assist nurses in acquiring needed knowledge and skills for evidence-based care. The purpose of the study was to evaluate the effectiveness of an educational intervention, the Evidence-Based Practice Institute (EPBI), to teach nurses the process of EBP for project implementation to improve nursing and patient outcomes. This descriptive study used a mixed-method design and previously collected data. Two surveys were administered to participants of the EBPI at the beginning (pre-test) and conclusion (post-test) of this educational intervention to assess barriers to utilizing research, knowledge, skills, and attitudes of EBP. Additionally, participants, nurse mentors, and fellows participated in focus groups on the last day of the EBPI. A sample of 17 subjects, eight mentors and nine fellows, completed the surveys and nine mentors and 11 fellows participated in the focus groups. The study used several theories to guide the interpretation of the data; Diffusion of Innovations to inform the findings, Critical Feminist Theory to assess for power relations, and the Quality Outcomes framework of structure, process, and outcome to summarize the results. The one statistically significant finding occurred post-test (p < .05) in the fellow group for one subscale on the EBP survey. Three themes emerged from the focus groups: organizational culture and support, EBPI structure and process, and professional growth and development. Barriers and facilitators within each theme were reported. Hospitals are under increased pressure to provide quality care using the best evidence. A priority for every hospital is the integration of the best evidence into practice in a systematic fashion to ensure safe quality patient outcomes. Educational programs that teach the value of evidence-based practice and the steps to integrate evidence into practice are an effective modality to promote evidence-based clinical decision-making about patient care.

Document Type

Dissertation: Open Access

Department

Nursing

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Nursing Commons

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