Using Evidence Based Practice: The Relationship Between Work Environment, Nursing Leadership and Nurses at the Bedside

Abstract

Evidence based practice (EBP) is essential to the practice of nursing for purposes of promoting optimal patient outcomes. Research suggests that the implementation of EBP by staff nurses is problematic and influenced by beliefs, nursing leadership and the work environment. The purpose of this descriptive study was to examine variables that describe the relationship among beliefs about EBP, the work environment and nursing leadership on the EBP implementation activities of the staff nurse. The variables of interest were 1) individual staff nurse characteristics, 2) beliefs about EBP, 3) the EBP work environment and 4) nursing leadership for EBP. A descriptive, quantitative method was used. A sample of 422 Registered Nurses from two urban hospitals (one Magnet and one non-Magnet) completed an online 58 item survey that included questions related to individual belief’s about EBP, the EBP work environment and nursing leadership for EBP as well as EBP implementation activities. Education, tenure and Magnet status were not significantly related to EBP implementation activities in either the univariate or multivariate analysis. EBP beliefs had a significantly positive relationship with EBP implementation activities in both the univariate and multivariate analyses. Work environment and nursing leadership support for EBP had significant positive relationships with self-reported implementation activities in only the univariate analysis. The most surprising finding was that there were no differences between Magnet and non-Magnet work environments for EBP implementation scores, yet the Magnet hospitals reported higher means on the EBP Beliefs Scale than the non-Magnet hospital. The results of this have implications for identifying and testing strategies to influence EBP implementation activities through development of nursing leadership skills for EBP and creating a more EBP friendly work environment.