Needs Assessment Survey on Evidence-Based Practice Patricia McCartney, RNC, PhD, FAAN, Siobhan Moose, RNC, BSN, Cathie Guzzetta, PhD, RN, FAAN Department of Nursing, Washington Hospital Center, Washington, DC Background

Findings

•Multiple tools to measure practicing nurses’ needs in developing evidence-based practice (EBP) •Developing Evidence-Based Practice (DEBP) Questionnaire (Gerrish, et al, 2008) is an assessment tool that incorporates a broad definition of sources of evidence •Developed and tested in England, used globally, adapted for US •DEBP provides an assessment of EBP needs for planning organizational strategies

Over 600 surveys were submitted, 574 useful, response rate 30%

Purpose To conduct a needs assessment survey of factors that influence the development of evidence-based practice in nurses at the Washington Hospital Center.

Sample

Characteristics

Age Gender Race

64% over 40 years old 93% female 41% Black or African American, 38% White, 19% Asian

Level of education Years of clinical experience Specialty area of clinical practice

48% Baccalaureate or higher degree 70% > 10 years 33% Medical Surgical, 21% Critical Care, 16% Women & Infant Services 76% clinical, 24% leadership 41% belong to one or more

Job title Membership in professional organizations

Exploratory Factor Analysis Methodology •Design – non-experimental descriptive survey, IRB approved •Sample – 1,936 RNs at Washington Hospital Center (WHC), inpatient and ambulatory care •Setting – tertiary acute care medical center, 926 beds, 58 units, Washington DC •Instrument - Developing Evidence-Based Practice Questionnaire (DEBP), adapted and used with permission. Adapted to include 69 items: 49 Likert (1-5), 2 open ended, 13 demographic •Procedures - online questionnaire open to nurses for 4 weeks •Outcomes – Item statistics, factor analysis, and demographics •Sample size justification = 500 subjects (surveys)

EFA identified 7 factors influencing EBP. Analysis included varimax orthogonal rotation, factor loadings >40 considered, 9 items dropped for total of 40 items with 95.92% total variance explained, Cronbach’s alpha for each factor > 0.70)

Gerrish, K., Ashworth, P., Lacey, A., & Bailey, J. (2008). Developing evidencebased practice: Experiences of senior and junior clinical nurses. Journal of Advanced Nursing, 62(1), 62-73. Gerrish, K., Ashworth, P., Lacey, A., Bailey, J., Cooke, J., Kendall, S., & McNeilly, E. (2007). Factors Influencing the development of evidence -based practice: a research tool. Journal of Advanced Nursing. 57, 328-338.

This subscale measures a range of resources including research, professional information, and publically available information ( =0.87)

Work Environment Barriers to Achieving EBP This subscale measures specific obstacles in the hospital organization including time, resources, and authority ( =0.83)

Evidence from Personal Nursing Knowledge This subscale measures information gathered from the individual’s nursing practice ( =0.82)

Conclusions •DEBP Questionnaire successfully adapted and implemented •7 underlying factors with sound psychometric properties •Factors and nurse characteristics are related •Limitations include self-selecting convenience sample & response rate 30%

Integrating Information Skills This subscale measures the individual nurse’s self-assessment of the ability to locate and apply information in practice ( =0.85) This subscale measures the influence of professional co-workers in facilitating a practice change ( =0.84)

Research Skill Barriers to Achieving EBP This subscale measures obstacles in the individual nurse’s ability to locate and apply research in practice ( =0.80)

Evidence from Institutional Experts This subscale measures information provided by hospital leaders ( =0.72)

Contact: [email protected]

Factor 2 Work Environment Barriers and Age Nurses over age 50 disagree that work barriers exist more than nurses under age 50 disagree Factor 2 Work Environment Barriers and Experience: Nurses with >10 years experience disagree that work barriers exist more than nurses with < 10 years experience Factor 6 Research Skill Barriers and Age Nurses under age 30 disagree that skill barriers exist more than nurses over age 30 Factor 6 Research Skill Barriers and Experience Nurses with >10 years experience disagree that work barriers exist more than nurses with < 10 years experience Factor 6 Research Skill Barriers and Education Nurses with 2 years experience

Evidence from Healthcare Information

Colleague Support for Achieving EBP References

Comparison of Factor Scores with Sample Characteristics

Implications for Nursing EBP •Focus on where nurses seek evidence •Cannot generalize about work environment and skill barriers •Combine the strengths of differing age, experience, & education on project teams •Use DEBP to measure baseline before, to individualize strategies, and to measure impact after