AmericancJournalcofcNursingcResearch,c2023,cVol.c11,cNo.c1,c21-45
Availableconlinecatchttp://pubs.sciepub.com/ajnr/11/1/3
cPublishedcbycSciencecandcEducationcPublishingcDOI:1
0.12691/ajnr-11-1-3
Evidence-
based Practice among Clinical Nurses in Bahrain:
c c c c c c c
Basis for a Policy Brief c c c c
JohncMichaelcMadambacFerrer1,*,cJomancBaliton2
1GraduatecSchool,cSaintcMary’scUniversity,cBayombong,cNuevacVizcaya
2Professor,cGraduatecSchool,cSaintcMary’scUniversity,cBayombong,cNuevacVizcaya
*Correspondingcauthor:c
ReceivedcNovemberc28,c2022;cRevisedcJanuaryc07,c2023;cAcceptedcJanuaryc16,c2023
Abstractc Thecstudycaimedctocdeterminecclinicalcnurses'cbeliefs,cknowledge,corganizationalcreadiness,candcevidenc
e-basedcpracticecimplementationclevelscandcidentifycthecperceivedcfactorscaffectingcevidence-
basedcpracticecimplementation.cAcdescriptive-
correlationalcincquantitativecapproachcwithctriangulationcwascused.cDatacwerecgatheredcthroughcthecadministrationcof
cadaptedcsurveycquestionnaires calongcwithcstructuredcinterviewscand cpersonal cobservationctocsupplementcthecdata.cFor
ty-
twocvoluntarilycparticipatedcandccompletedcthecsurvey.cFrequency,cpercent,cmean,candcstandardcdeviationcwerecusedctoc
analyzecandcinterpretcthecparticipants'cdemographiccprofilecandcevidence-cbasedcpractice-
relatedcvariables.cRegressioncanalysiscwascusedctocidentifycthecpredictorscfromctheclistcofcvariables.cForcfacilitatingca
ndchinderingcfactorscincthecevidence-basedcpracticecimplementationcofcclinicalcnurses,cancopen-
cendedcquestioncwascaskedcto ctriangulate cthecquantitative cdata.c Mostcofcthecnursescarecfemalecinctheircmiddlecadultho
od,chaveccompletedcacbachelor’scdegreecincnursing,candchavecworkedcincthechospitalcascacseniorcstaffcnursecforcconsider
ablectime.cThecresultcshowscthatcnursescsomewhatctrulycbelievecincevidence-
basedcpractice,chavecacceptablecevidence-
basedcpracticecknowledge,cprobablycconsidercthecculturecandcorganizationalcreadiness,candcarecinterestedcincimplemen
tingcspecificcevidence-basedcpracticectasks.cAlso,citcwascfoundcthatconlycknowledgecofcevidence-
basedcpracticeciscachighlycsignificantcpredictorcofcevidence-
basedcpracticecimplementation.cPerceivedcfacilitatingcfactorscincludecsupportivecpolicies,ctrainingcopportunities,cma
nagement,candcpeercsupport.cAtcthecsamectime,clackcofcknowledgecandcinsufficientctimecwerecrecordedcascbarriersctoc
implementingcevidence-basedcpractice.cThecsalientcfindingscwerecusedcinccraftingcthecpolicycbrief.
Keywords:cEBPcbelief,cEBPcknowledge,cEBPcorganizationalcreadiness,cEBPcimplementation
CitecThiscArticle:cJohncMichaelcMadambacFerrer,candcJomancBaliton,c“Evidence-
basedcPracticecamongcClinicalcNursescincBahrain:cBasiscforcacPolicycBrief.”cAmericancJournalcofcNursingcResearch
,cvol.c11,cno.c1c(2023):c21-45.cdoi:c10.12691/ajnr-11-1-3.
ons.cWhencusedcconsistently,cthiscpracticecresultscincpatientsc
moreclikelyctocobtaincthecbestcpossiblecoutcomesc[2].
1. Introduction
1.1. Rationale
Increcentcdecades,cevidence-
basedcpracticecincnursingchascbecomecessentialctocproviding
cexceptionalcpatientccare coutcomes. cNursescusecevidence-
basedcinterventionsctocprovidecthecbestcpossibleccarectocimp
rovecthecprocesscandcstructurecofchealthccarecand,ctocaclimit
edcextent,cimprovecthecpatients'coutcomesc[1].cThesecinterv
entionscarecevidencescgatheredcthroughccriticallycappraisedc
studies,cwhichcincturnchelpcthemcidentifycpossibleccarecstrat
egiescforctheircpatients.
Incevidence-
basedcpracticec(EBP),cnursesccombinecthecbestcavailablecev
idencecwithctheircclinicalcknowledgecandcexpertisecaschealt
hcarecprofessionalscandcconsidercpatients'cspecificcexpectati
onscandcpreferencesctocarrivecatcappropriatecmedicalcdecisi
,22 AmericancJournalcofcNursingcResearch
Evidence-
basedcpracticecencouragescnursesctocthinkccritically,canaly
zeccomplexcsituations,candcmakecdecisions.cClinicalcnurse
scshouldcalwayscemphasizecEBPctocmeetcthecchallengescof
cdefiningcthecdirectioncofchealthccare,cpromotingcoptimalco
utcomes,candcensuringcpatientcsafety.cHowever,cinctheirca
nalysiscofc8409cparticipantscinclowcandcmiddle-
incomeccountries,ctheycfoundcthatcthecnurses'ccommitment
ctocEBPcisclimitedcbecausecofcperceivedclimitationscincthei
rcscopecofcpractice,ctime,candcknowledgecofcEBPcandctheir
cindividual-
relatedcbarriersc[3].cAlso,cnovicecclinicalcnursescrelyconcpr
ecisecinstructionscandclackcpower,cauthority,candcprofessio
nalcjudgmentcincnursingcdecision-
makingc[4,5].cNevertheless,cthiscdecision-
makingccancprogresscfromcpersonalcopinionctocrelyingconc
reliablecscientificcdatacusingcevidence-
basedcpractices.cIncfact,cdecision-
makingcbasedconcEBPcleadsctocsubstantialcimprovementsci
ncpatientcsafetycwhichcincturncimprovecclinicalcandcorgani
zationalcqualitycandcsafetyc[6,7].cFurthermore,cevidence-
basedcpracticecmaychelpcclinicalcnursescachievecprofessio
nalismcinctheircfieldcbycempoweringcthemcinctheircprofessi
onalcgrowth,c particularlyc inc problem-
solvingc andc decision-makingc [8].
,AmericancJournalcofcNursingcResearch,c2023,cVol.c11,cNo.c1,c21-45
Incaddition,cintegrationcshouldcalwayscbecacpartcofcstandardc knowledgecofcevidence-
practicecandcnotcbeccarriedcoutcincacconfusingcmannercthatcf basedcpractice,cbeliefscconcerningcEBP,candcimplementatio
requentlychappenscinctoday'scworld. ncofcEBPccontributectoclimitlesscopportunitiescforcimprove
Whencnursescarecatctheccentercofcthechealthcarecdeliveryc mentcwhencsupportedcbyctheircorganizationc[14].cThisckno
process,cthechighestcqualitycresearchcevidencechascthecpoten wledgeccouldchelpcthemcevaluatecandcstrengthencthecorgani
tialctocbectransformedcintocacmorecopencandcfinanciallycstab zation'sccurrentcEBPcstatusctocimprovecthecqualitycandcsafet
lechealthcarecsystem.cMorecimportantly,cthectranslationcofce ycofcitscpatients.
videnceccancchangecculturalcnorms,cbehavioralcpatterns,can DespitecthecimportancecofcnursescincadoptingcEBPcinc th
dcpractices,ctherebycbridgingcthec gapcbetweencresearchcand echealthcarecsetting,cevidencecsuggestscseveralcobstaclesctoc
cpractice.cThectransformationcofcnursecbehaviorciscessentialc EBPcimplementation.cItcshowedcthatcthecbiggestc obstacleci
tocaccomplishingcthecgoalscsetcforcthecimplementationcofcre ncusingcresearchcincpracticeciscthecinsufficientcimplementati
searchcincthechealthcarecfield,candcthisctransformationcneeds oncfacilitiescandclackcofcpowerctocchangeccarecproceduresc[1
ctocbecincorporatedcintocthecimplementation cstrategyc[9]. 5].cIncIran,cindividualcfactorscaccountcforc57%cofcthecbarrier
Evidence- scpreventingcEBPcimplementation.c Thesecincludecaclackcofc
basedcpracticeschavecbeenccriticalcforcdevelopingccountries, proficiencycincthecEnglishclanguage,cancinabilityctocoperatec
cparticularlycmaximizingclimitedchealthcresources,candcachi accomputer,candcaclackcofctimectocreadcliterature.cIncaddition
evingcexcellentcpatientccarecoutcomescandcefficientchealthc ,cthecmostcsignificantcorganizationalcchallengescincludecacla
arecsystems.cThesecadvantagesccancleadctocacreductioncincpo ckcofcinternetcaccesscatcwork,cancinsufficientcnumbercofcregi
verty- steredcnurses,candc ancexcessivecamountcofcworkcneededc[1
relatedcproblemscandcimprovedchealthcoutcomes.cButcdespi 6].cThoughc79.7%cofcclinicalcnursescwerecawarecofcEBPcorc
tecthecapparentcbenefitscofcapplyingcEBPcconcepts,cthecrisec relatedctermscsuchcascevidence-
ofcEBPcincdevelopingccountrieschascbeencmodest.cHence,cth basedcnursingcorchealthccare,conlyc66.5%cbelievedcitcwasci
ecEuropeancCommissioncandcthecWorldcHealthcOrganizatio mportantcforcimprovingcpatientccarecquality,c25.5%cofcnurs
nchavecproposedcthatcmedicalccarecshouldcbecestablishedcba escratedctheircknowledgecofcimplementingcEBP,cwhilec12.3
sedconcthecmostcrecentcscientificcresearchcfindingscstandard %cfeltctheychadcsufficientcskillsc[17].
izingcnursingcpractice.cSuchcmoveccanchavecpositivecoutco Interestingly,citcseemscthatcpositivecattitude,cknowledgec
mes.cIncparticular,cthecprovisioncofcsafecpatientccarecandcthe andcskillscdocnotcnecessarilyctranslatectocpractice.cForcexam
cachievementcofcpositivecpatientcoutcomesccancleadctocacred ple,c[18]crevealedcthatcnursescwhochavecacpositivecattitude,c
uctioncincthectimecspentcbycnursescprovidingccarecforcpatient knowledge,candcskillsctowardcEBPchavecnotcsuccessfullyci
s,candcaclowercoverallccostcofcmedicalctreatment. mplementedcEBP.cIncacmulti-institutionalccross-
Manychealthcarecpractitionerscfrequentlycusectheircopini sectionalcstudycofcnursescincOman,c73.5%cofcrespondentsch
onscorcnon-generalizablecexperiencescrathercthancevidence- adcacdiplomacincnursingcandc10.9cyearscofcexperiencecincthec
basedcfindingsctocguidectheircpractice.cTocreducecvariationsc clinicalcsettingcandcalthoughctheircperspectivesctowardcEBP
incclinicalcpracticecandcimprovecpatientccare,cthechospitalcor cwerecgood,cknowledgecandcimplementationcofcthe cmethod
ganizationcshouldcissuecclinicalcpracticecguidelinescbasedco ologycwereclackingc[19].c Thecmostcconsiderablecperceivedc
nctheclatestcevidencectocclinicalcnursescandcmedicalchealthcp knowledgecandcskillc gapscwerecrecognizedcascresearchcskil
ractitionerscworkingcincthechealthcarecindustry.cThecpolicy ls,cawarenesscofckindcandcsources,cabilitiesctocobtainceviden
makercshouldcdevelopcthesecevidence- ce,ccriticalcevaluation,candctranslatingcinformationcintocque
cbasedcguidelinescsystematicallycbecause cusingcancapproach stions.
cthatciscnotcsystematicccould csignificantlycnegativelycimpact Conversely,csomecstudiescdiscoveredcaclinkcamongc som
cthecvaliditycandcreliabilitycofcthecevidence cusedctocguidecre ecfactorsclikecknowledge,cattitudecandcpracticecorcimplemen
commendations,cleadingctocmisleadingcinformationcandcinc tation.cIncthecstudy,cstatisticscshowcthatc18%cofcrespondents
onsistentcresultsc[10].cPuttingcthesecguidelinescintocclinicalc chavecacbachelor'scdegreecandc17cyearscofcclinicalcexperienc
practicecmightcalsocprovectocbecdifficultcduectocaclackcofctim e.cMoreover,ctherecwascaclinkcbetweenctheircEBPcskillscandc
ecmanagement,cbudget,candcspecialistcprofessionalscthatchin knowledgecandchighercprofessionalcqualificationc[18].cMea
dercthechealthccarecsystem.cOthercsignificantcissuescthatccan nwhile,cresearcherscfoundcthatc50%cofctheircrespondentscha
chindercthecimplementationcofcclinicalcpracticecguidelinesca vecacbachelor'scdegreecandc18.4cyearscofcclinicalcexperience
mongchealthcprofessionalscmaycincludeclackcofcclaritycandc .cTheircfindingscalsocshowcthatcparticipants'ceducationalcbac
credibilitycincthecevidence,clackcofcknowledgecaboutctheccli kgroundscandcyearscofcclinicalcnursingcexperiencecincreasec
nicalcpracticecguidelines,clackc c ofc c motivation,c c andc c lac theircknowledgecadaptationcofcevidence-
kc c ofc c self- basedcpracticecshowingcthatcmorecexposurectocEBPcthrough
confidence.cIncaddition,cacnegativecattitudectowardcimplem outctheircpreparationcprogramscresultscincadaptationcandcpra
entationcandcsocioculturalcperspectivesccancinfluencecthech cticec[20].cFindingscfromcacgrowingcbodycofcresearchcalsoci
ealthcarecprofessionals.cThus,citccancbecsaidcthatcthecimple ndicatecthatctheclevelscofceducationcandcexperiencecthatcnur
mentationcofcEBPciscchallengingceithercbecausecnursescdocn sescpossesscarectwocofcthecprimarycfactorscthatcinfluencecthe
otcunderstandcenoughcorcdocnotcwantctocdocsomethingcabout cfullcimplementationcofcEBP.cAccordingcto cthecresearchcfin
c itc[11,12,13]. dings,cseniorcnursescwhococcupiedcseniorcpositionscandcpos
Furthermore,catcthecnationalcandcinternationalclevels,cthec sessedcacdegreecorchadcpriorcexperiencecincEBPctrainingcha
nursingcprofessioncneedsctocunderstandcthecbeliefs,cknowle dcacgreatercintentionctocutilizecEBPcinctheircpracticec[21,22].
dge,candcorganizationalcculturecandcreadinesscofcclinicalcnu cMoreover,cnursescwithoutcadministrative cpositionschadcles
rsesctocimplementcEBPcincacclinicalcsettingcwithcthec helpc of scintentionctocutilizecEBPcinctheircpracticec[23].cResearchers
c their c hospitalc organization.c Itc wasc notedc that calsocfoundcthatcadvancedcnurses'clevelscofcknowledge candca
bilitycwere
,
Availableconlinecatchttp://pubs.sciepub.com/ajnr/11/1/3
cPublishedcbycSciencecandcEducationcPublishingcDOI:1
0.12691/ajnr-11-1-3
Evidence-
based Practice among Clinical Nurses in Bahrain:
c c c c c c c
Basis for a Policy Brief c c c c
JohncMichaelcMadambacFerrer1,*,cJomancBaliton2
1GraduatecSchool,cSaintcMary’scUniversity,cBayombong,cNuevacVizcaya
2Professor,cGraduatecSchool,cSaintcMary’scUniversity,cBayombong,cNuevacVizcaya
*Correspondingcauthor:c
ReceivedcNovemberc28,c2022;cRevisedcJanuaryc07,c2023;cAcceptedcJanuaryc16,c2023
Abstractc Thecstudycaimedctocdeterminecclinicalcnurses'cbeliefs,cknowledge,corganizationalcreadiness,candcevidenc
e-basedcpracticecimplementationclevelscandcidentifycthecperceivedcfactorscaffectingcevidence-
basedcpracticecimplementation.cAcdescriptive-
correlationalcincquantitativecapproachcwithctriangulationcwascused.cDatacwerecgatheredcthroughcthecadministrationcof
cadaptedcsurveycquestionnaires calongcwithcstructuredcinterviewscand cpersonal cobservationctocsupplementcthecdata.cFor
ty-
twocvoluntarilycparticipatedcandccompletedcthecsurvey.cFrequency,cpercent,cmean,candcstandardcdeviationcwerecusedctoc
analyzecandcinterpretcthecparticipants'cdemographiccprofilecandcevidence-cbasedcpractice-
relatedcvariables.cRegressioncanalysiscwascusedctocidentifycthecpredictorscfromctheclistcofcvariables.cForcfacilitatingca
ndchinderingcfactorscincthecevidence-basedcpracticecimplementationcofcclinicalcnurses,cancopen-
cendedcquestioncwascaskedcto ctriangulate cthecquantitative cdata.c Mostcofcthecnursescarecfemalecinctheircmiddlecadultho
od,chaveccompletedcacbachelor’scdegreecincnursing,candchavecworkedcincthechospitalcascacseniorcstaffcnursecforcconsider
ablectime.cThecresultcshowscthatcnursescsomewhatctrulycbelievecincevidence-
basedcpractice,chavecacceptablecevidence-
basedcpracticecknowledge,cprobablycconsidercthecculturecandcorganizationalcreadiness,candcarecinterestedcincimplemen
tingcspecificcevidence-basedcpracticectasks.cAlso,citcwascfoundcthatconlycknowledgecofcevidence-
basedcpracticeciscachighlycsignificantcpredictorcofcevidence-
basedcpracticecimplementation.cPerceivedcfacilitatingcfactorscincludecsupportivecpolicies,ctrainingcopportunities,cma
nagement,candcpeercsupport.cAtcthecsamectime,clackcofcknowledgecandcinsufficientctimecwerecrecordedcascbarriersctoc
implementingcevidence-basedcpractice.cThecsalientcfindingscwerecusedcinccraftingcthecpolicycbrief.
Keywords:cEBPcbelief,cEBPcknowledge,cEBPcorganizationalcreadiness,cEBPcimplementation
CitecThiscArticle:cJohncMichaelcMadambacFerrer,candcJomancBaliton,c“Evidence-
basedcPracticecamongcClinicalcNursescincBahrain:cBasiscforcacPolicycBrief.”cAmericancJournalcofcNursingcResearch
,cvol.c11,cno.c1c(2023):c21-45.cdoi:c10.12691/ajnr-11-1-3.
ons.cWhencusedcconsistently,cthiscpracticecresultscincpatientsc
moreclikelyctocobtaincthecbestcpossiblecoutcomesc[2].
1. Introduction
1.1. Rationale
Increcentcdecades,cevidence-
basedcpracticecincnursingchascbecomecessentialctocproviding
cexceptionalcpatientccare coutcomes. cNursescusecevidence-
basedcinterventionsctocprovidecthecbestcpossibleccarectocimp
rovecthecprocesscandcstructurecofchealthccarecand,ctocaclimit
edcextent,cimprovecthecpatients'coutcomesc[1].cThesecinterv
entionscarecevidencescgatheredcthroughccriticallycappraisedc
studies,cwhichcincturnchelpcthemcidentifycpossibleccarecstrat
egiescforctheircpatients.
Incevidence-
basedcpracticec(EBP),cnursesccombinecthecbestcavailablecev
idencecwithctheircclinicalcknowledgecandcexpertisecaschealt
hcarecprofessionalscandcconsidercpatients'cspecificcexpectati
onscandcpreferencesctocarrivecatcappropriatecmedicalcdecisi
,22 AmericancJournalcofcNursingcResearch
Evidence-
basedcpracticecencouragescnursesctocthinkccritically,canaly
zeccomplexcsituations,candcmakecdecisions.cClinicalcnurse
scshouldcalwayscemphasizecEBPctocmeetcthecchallengescof
cdefiningcthecdirectioncofchealthccare,cpromotingcoptimalco
utcomes,candcensuringcpatientcsafety.cHowever,cinctheirca
nalysiscofc8409cparticipantscinclowcandcmiddle-
incomeccountries,ctheycfoundcthatcthecnurses'ccommitment
ctocEBPcisclimitedcbecausecofcperceivedclimitationscincthei
rcscopecofcpractice,ctime,candcknowledgecofcEBPcandctheir
cindividual-
relatedcbarriersc[3].cAlso,cnovicecclinicalcnursescrelyconcpr
ecisecinstructionscandclackcpower,cauthority,candcprofessio
nalcjudgmentcincnursingcdecision-
makingc[4,5].cNevertheless,cthiscdecision-
makingccancprogresscfromcpersonalcopinionctocrelyingconc
reliablecscientificcdatacusingcevidence-
basedcpractices.cIncfact,cdecision-
makingcbasedconcEBPcleadsctocsubstantialcimprovementsci
ncpatientcsafetycwhichcincturncimprovecclinicalcandcorgani
zationalcqualitycandcsafetyc[6,7].cFurthermore,cevidence-
basedcpracticecmaychelpcclinicalcnursescachievecprofessio
nalismcinctheircfieldcbycempoweringcthemcinctheircprofessi
onalcgrowth,c particularlyc inc problem-
solvingc andc decision-makingc [8].
,AmericancJournalcofcNursingcResearch,c2023,cVol.c11,cNo.c1,c21-45
Incaddition,cintegrationcshouldcalwayscbecacpartcofcstandardc knowledgecofcevidence-
practicecandcnotcbeccarriedcoutcincacconfusingcmannercthatcf basedcpractice,cbeliefscconcerningcEBP,candcimplementatio
requentlychappenscinctoday'scworld. ncofcEBPccontributectoclimitlesscopportunitiescforcimprove
Whencnursescarecatctheccentercofcthechealthcarecdeliveryc mentcwhencsupportedcbyctheircorganizationc[14].cThisckno
process,cthechighestcqualitycresearchcevidencechascthecpoten wledgeccouldchelpcthemcevaluatecandcstrengthencthecorgani
tialctocbectransformedcintocacmorecopencandcfinanciallycstab zation'sccurrentcEBPcstatusctocimprovecthecqualitycandcsafet
lechealthcarecsystem.cMorecimportantly,cthectranslationcofce ycofcitscpatients.
videnceccancchangecculturalcnorms,cbehavioralcpatterns,can DespitecthecimportancecofcnursescincadoptingcEBPcinc th
dcpractices,ctherebycbridgingcthec gapcbetweencresearchcand echealthcarecsetting,cevidencecsuggestscseveralcobstaclesctoc
cpractice.cThectransformationcofcnursecbehaviorciscessentialc EBPcimplementation.cItcshowedcthatcthecbiggestc obstacleci
tocaccomplishingcthecgoalscsetcforcthecimplementationcofcre ncusingcresearchcincpracticeciscthecinsufficientcimplementati
searchcincthechealthcarecfield,candcthisctransformationcneeds oncfacilitiescandclackcofcpowerctocchangeccarecproceduresc[1
ctocbecincorporatedcintocthecimplementation cstrategyc[9]. 5].cIncIran,cindividualcfactorscaccountcforc57%cofcthecbarrier
Evidence- scpreventingcEBPcimplementation.c Thesecincludecaclackcofc
basedcpracticeschavecbeenccriticalcforcdevelopingccountries, proficiencycincthecEnglishclanguage,cancinabilityctocoperatec
cparticularlycmaximizingclimitedchealthcresources,candcachi accomputer,candcaclackcofctimectocreadcliterature.cIncaddition
evingcexcellentcpatientccarecoutcomescandcefficientchealthc ,cthecmostcsignificantcorganizationalcchallengescincludecacla
arecsystems.cThesecadvantagesccancleadctocacreductioncincpo ckcofcinternetcaccesscatcwork,cancinsufficientcnumbercofcregi
verty- steredcnurses,candc ancexcessivecamountcofcworkcneededc[1
relatedcproblemscandcimprovedchealthcoutcomes.cButcdespi 6].cThoughc79.7%cofcclinicalcnursescwerecawarecofcEBPcorc
tecthecapparentcbenefitscofcapplyingcEBPcconcepts,cthecrisec relatedctermscsuchcascevidence-
ofcEBPcincdevelopingccountrieschascbeencmodest.cHence,cth basedcnursingcorchealthccare,conlyc66.5%cbelievedcitcwasci
ecEuropeancCommissioncandcthecWorldcHealthcOrganizatio mportantcforcimprovingcpatientccarecquality,c25.5%cofcnurs
nchavecproposedcthatcmedicalccarecshouldcbecestablishedcba escratedctheircknowledgecofcimplementingcEBP,cwhilec12.3
sedconcthecmostcrecentcscientificcresearchcfindingscstandard %cfeltctheychadcsufficientcskillsc[17].
izingcnursingcpractice.cSuchcmoveccanchavecpositivecoutco Interestingly,citcseemscthatcpositivecattitude,cknowledgec
mes.cIncparticular,cthecprovisioncofcsafecpatientccarecandcthe andcskillscdocnotcnecessarilyctranslatectocpractice.cForcexam
cachievementcofcpositivecpatientcoutcomesccancleadctocacred ple,c[18]crevealedcthatcnursescwhochavecacpositivecattitude,c
uctioncincthectimecspentcbycnursescprovidingccarecforcpatient knowledge,candcskillsctowardcEBPchavecnotcsuccessfullyci
s,candcaclowercoverallccostcofcmedicalctreatment. mplementedcEBP.cIncacmulti-institutionalccross-
Manychealthcarecpractitionerscfrequentlycusectheircopini sectionalcstudycofcnursescincOman,c73.5%cofcrespondentsch
onscorcnon-generalizablecexperiencescrathercthancevidence- adcacdiplomacincnursingcandc10.9cyearscofcexperiencecincthec
basedcfindingsctocguidectheircpractice.cTocreducecvariationsc clinicalcsettingcandcalthoughctheircperspectivesctowardcEBP
incclinicalcpracticecandcimprovecpatientccare,cthechospitalcor cwerecgood,cknowledgecandcimplementationcofcthe cmethod
ganizationcshouldcissuecclinicalcpracticecguidelinescbasedco ologycwereclackingc[19].c Thecmostcconsiderablecperceivedc
nctheclatestcevidencectocclinicalcnursescandcmedicalchealthcp knowledgecandcskillc gapscwerecrecognizedcascresearchcskil
ractitionerscworkingcincthechealthcarecindustry.cThecpolicy ls,cawarenesscofckindcandcsources,cabilitiesctocobtainceviden
makercshouldcdevelopcthesecevidence- ce,ccriticalcevaluation,candctranslatingcinformationcintocque
cbasedcguidelinescsystematicallycbecause cusingcancapproach stions.
cthatciscnotcsystematicccould csignificantlycnegativelycimpact Conversely,csomecstudiescdiscoveredcaclinkcamongc som
cthecvaliditycandcreliabilitycofcthecevidence cusedctocguidecre ecfactorsclikecknowledge,cattitudecandcpracticecorcimplemen
commendations,cleadingctocmisleadingcinformationcandcinc tation.cIncthecstudy,cstatisticscshowcthatc18%cofcrespondents
onsistentcresultsc[10].cPuttingcthesecguidelinescintocclinicalc chavecacbachelor'scdegreecandc17cyearscofcclinicalcexperienc
practicecmightcalsocprovectocbecdifficultcduectocaclackcofctim e.cMoreover,ctherecwascaclinkcbetweenctheircEBPcskillscandc
ecmanagement,cbudget,candcspecialistcprofessionalscthatchin knowledgecandchighercprofessionalcqualificationc[18].cMea
dercthechealthccarecsystem.cOthercsignificantcissuescthatccan nwhile,cresearcherscfoundcthatc50%cofctheircrespondentscha
chindercthecimplementationcofcclinicalcpracticecguidelinesca vecacbachelor'scdegreecandc18.4cyearscofcclinicalcexperience
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credibilitycincthecevidence,clackcofcknowledgecaboutctheccli kgroundscandcyearscofcclinicalcnursingcexperiencecincreasec
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confidence.cIncaddition,cacnegativecattitudectowardcimplem outctheircpreparationcprogramscresultscincadaptationcandcpra
entationcandcsocioculturalcperspectivesccancinfluencecthech cticec[20].cFindingscfromcacgrowingcbodycofcresearchcalsoci
ealthcarecprofessionals.cThus,citccancbecsaidcthatcthecimple ndicatecthatctheclevelscofceducationcandcexperiencecthatcnur
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otcunderstandcenoughcorcdocnotcwantctocdocsomethingcabout cfullcimplementationcofcEBP.cAccordingcto cthecresearchcfin
c itc[11,12,13]. dings,cseniorcnursescwhococcupiedcseniorcpositionscandcpos
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nursingcprofessioncneedsctocunderstandcthecbeliefs,cknowle dcacgreatercintentionctocutilizecEBPcinctheircpracticec[21,22].
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c their c hospitalc organization.c Itc wasc notedc that calsocfoundcthatcadvancedcnurses'clevelscofcknowledge candca
bilitycwere
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