Nurses’ Perception And Practice Of Evidence–Based Practice in Nursing Care in Federal Teaching Hospital Abakaliki (FETHA II), Ebonyi State

PROJECT TOPIC- Nurses’ Perception And Practice Of Evidence–Based Practice in Nursing Care in Federal Teaching Hospital Abakaliki (FETHA II), Ebonyi State

ABSTRACT

This study aims primarily at finding the Nurses’ perception and practice of Evidence-based nursing care in Federal Teaching Hospital Abakaliki in Ebonyi State. The objectives of the study were to access nurses’ knowledge of evidence-based practice, determine nurses’ attitude towards evidence-based practice, identify the barriers to implementation of evidence-based practice and identify factors that facilitate implementation of evidence-based practice. To assist the research, four research questions and one hypothesis were formulated and fourteen itemized questionnaire formed from the research questions. Relevant literature were reviewed. The study design was a descriptive survey and convenient sampling technique was used to get 100 nurses out of 284 nurses, representing 35.2% of the total population. The instrument for data collection was a questionnaire. Data was analysed using descriptive statistics and charts, while hypothesis was tested using Pearson Product movement correlation. The results of the findings revealed that nurses in Federal Teaching Hospital Abakaliki, were aware of evidence-based practice and their attitude towards it was favourable. There was a significant relationship between nurses’ knowledge and attitude towards implementation of evidence-based when calculated r-value of 0.73 was greater than the critical r-value of 0.211 at 0.5 level of significance with 81 degree freedom, perceived barriers to implementation were lack of time, resources, education, uncooperative attitude of doctors and unavailability of relevant research and the perceive factors that facilitate implementation are enhancing administrative support and encouragement, cooperative and supportive colleagues, improving availability and accessibility of research reports, sufficient staffing and improving understandability of research reports. Based on these findings it was recommended that health service should support and provide a receptive environment that is amendable to change and recognizes the role of research and its relevant, Promotion of research utililization through formulation of research committee as a potent way to promote evidence-based practice by nurses in Ebonyi State. Lastly, the government should provide research grants and resources to support implementation of evidence-based practice in health settings.

CHAPTER ONE

INTRODUCTION

Background of the Study

 Healthcare is filled with uncertainty (for example, what type of treatment is most effective to have the best outcome for the patient? How have patients coped with their diseases? What is the best nursing plan based upon a nursing assessment?). Nevertheless, in complicated health care system, the uncertainty can be revealed if clinicians base their practice on evidence.

Evidence-base practice in nursing is getting important in delivering high quality healthcare. It has become a prominent issue in international healthcare, rising health costs, the management principle of doing things right and desire for quality improvement have created a climate for the evolution of evidence-based healthcare (Rycroft-Malon, Bucknall, Melynk, 2004).

 Consumers of healthcare are more informed than ever, and with the internet, consumers have access to more healthcare and treatment information. As a result, consumers are expected and should receive the most current effective, state-of-the-art care  but nurses are faced with the challenge of providing effective care. One way to achieve this goal is to provide evidence-based practice (potter and perry, 2005).

 As nursing became involved in this movement, the quest to define best practices began, often resulting in complex challenges that have no easy solution. What is clear is responsibility of nurses to deliver care based on evidence for best available evidence in order to improve practice and patient outcome (Rycroft et al, 2004). The imperative is to reduce the gap between knowledge development and implementation of evidence-base nursing.

Evidence-based practice is a problem solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinicians’ expertise and patient preference and values according to Fineout-Overholt, (2010). Health Care that is evidence-based and conducted in caring context leads to better clinical decision and patient outcomes. Gaining knowledge and skills in evidence –based practice process provides nurses and clinicians tools needed to take ownership in their practices and transforms healthcare.

Evidence-based practice is essential for nurses to get acquainted with the available evidence and implement research findings to patient care said Hockenberry, (2006). Evidence-based practice in nursing is a framework for clinical practice that integrates the best available scientific evidence with nurses’ expertise and the patient preference and values to decide about healthcare of individuals, families and communities, who are served.

This assumes that optimal nursing care is provided when nurses and healthcare decision-makers have access to a synthesis of latest research, a consensus of expert opinion, and plan and provide care that takes account of cultured and personal values and preferences. These approach to nursing care bridges the gap between the best evidence available and the most appropriate nursing care of individuals, groups and populations with varied needs.

The past two decades have seen evidence-based practice become increasingly important in health care planning, clinical thinking and choice of treatment. It is based on scientific rationalism and adherents claim that decisions based on evidence-based practice are superior to other approaches to care. In addition to using traditional and well-established procedures and practices, health care practitioners are adopting Innovation Interventions that are based on practice as well as solid research-based. Evidence-based practice is one such techniques and its potential to effectively handle clinical issues and provide better patient care Dale A.E (2005).

Historically, care of the patient was influenced by the experiences and opinions of those involved in providing treatment. Evidence-based practice marks a shift among health-care professionals from a traditional emphasis on authoritative opinions to an emphasis on data-extracted from prior research and studies. Scudder, Laurie N.P (2006). There are so many calls for shift towards the use of research and scientific evidence to guide nursing practice, but most nurses continue to base practice decisions largely on anecdotal evidence, intuition, trial and error and utilize treatment techniques with little scientific support.

Nurses appear to rely more heavily on initial education and training when selecting treatment techniques and modalities instead of using scientific evidence to guide practice which makes their clinical decision-making to be guided by personal experience and expert opinion. Evidence-based practice according to Bauman (2010), seeks to replace practice as usual, with practice guide by vigorous outcome-oriented research, ideally randomized controlled trials, it also seeks to make practice less subjective enterprise and to raise it to a high level of accountability, it is associated with efforts to identify best practices in nursing and other disciplines.

The same author states that, evidence-based nursing aims to provide the highest quality and most cost-efficient nursing care possible. To advance quality of care provided by nurses, to increase satisfaction of patients, to focus on nursing practice away from habits and tradition to evidence and research. It is not clear to what extent nurses in Nigeria have been integrated into this newer model of clinical practice.

Today, nurses are still faced with many questions and uncertainties about relevance of evidence-based practice in clinical practices, there seems to be little research regarding the perceptions, knowledge and attitudes of nurses in Nigeria toward evidence-based practice. Thus, this study sought to look into Nurses’ perception and practice of evidence based nursing care in Federal Teaching Hospital Abakaliki.

PROJECT TOPIC- Nurses’ Perception And Practice Of Evidence–Based Practice in Nursing Care in Federal Teaching Hospital Abakaliki (FETHA II), Ebonyi State

Statement of Problem

Considering the problems of implementation of evidence-based practice in nursing care, which is still in very primitive stage in many parts of Nigeria. Nursing practice in most parts of Nigeria such as Ebonyi State is based on experience, tradition, intuition, common sense and untested theories. There is lack of research evidence in many areas of nursing practice. A study conducted by Donna (2010) on credibility of research shows that nurses involved in research activities did not implement the findings of nursing research consistently in their nursing practice.

As a result of this, the researcher during her clinical experiences observed that nurses are faced with challenges translating best evidence into clinical practice for example; the relevant research-based data bases were not comprehensive in many areas. Also there is ongoing explosion in the amount and type of information available. Challenged to the address this important issue an international commitment to evidence-based health care has resulted in a number of initiatives to improve access to research findings such as the evidence-based practice, research utilization conference and evidence-based journals (Idang, Ukaegbu, and Ebong, 2012).

Despite these efforts, research findings still suggests that nurses perceived a lot of barriers to implementation of evidence-based practice in clinical setting such as lack of time, knowledge, limited access to literature lack of training in information seeking and critical appraisal skills (Idang etal,2012). In view of this, the study wishes to answer the question how do nurses in Federal Teaching Hospital Abakaliki perceive and practice evidence-based nursing care.

       Purpose of the Study

The general aim of this study is to assess nurses’ perception and practice of evidence-based nursing in Federal Teaching Hospital Abakaliki.

Objectives of the Study

The specific objectives of this study were:

  • To assess nurses knowledge of evidence-based practice in Federal Teaching Hospital Abakaliki.
  • To determine nurses attitude towards evidence-based practice.
  • To identify the barriers to implementation of evidence-based practice.
  • To identify the factors that will facilitate implementation of evidence-based practice.

       Significance of the Study

The study will highlight areas of need where intervention can be carried out. The findings will provide information to nurses to enhance delivery of highest quality health-care to patient and best patient outcome.

The findings will also provide baseline information in the development of other researches in evidence-based practice.

       Research Questions

  1. Do nurses in Federal Teaching Hospital Abakaliki know what evidence-based practice entail?
  2. What is the nurses’ attitude towards evidence-based practice?
  3. What are the perceived barriers to utilizing research findings among nurses in Federal Teaching Hospital Abakaliki.
  4. What are the factors that may facilitate the use of evidence-based practice in Federal Teaching Hospital Abakaliki?

       Scope of the Study

The scope of the study is on nurses’ perception and practice of evidence-based nursing care and is delimited to practicing nurses in Federal Teaching Hospital Abakaliki, Ebonyi State.

Research Hypothesis

There is no significant relationship between nurses’ knowledge and attitude towards evidence-based practice in Federal Teaching Hospital Abakalki.

        Limitations of Study

The constraints encountered by the researcher in the process of the study are as follows:

Uncooperative attitude: This is the major problem as some of the respondents were reluctant to give information to the questions asked as some of them do not want to accept that they had no knowledge of evidence-based practice.

Unavailability of Literature Materials: The researcher also found it difficult locating materials for this work.

Time: This was also a constraint to the completion of the work as the researcher had other academic exercise to meet up with, during the period of this research work.

Operational Definition of Terms

EVIDENCE-BASE as used in this study are facts or signs that make one believe that something was done correctly with good result.

NURSING CARE is the careful assistance, care and treatment given by qualified nurses to patients admitted into the hospital.

PERCEPTION: This is an idea, a belief or an image you have as a result of how you see or understand something.

PRACTICE: This is the way of doing something that is usual or expected in a particular situation.

EVIDENCE-BASED PRACTICE: This is the conscientious, explicit and judicious use of current best evidence in making-decision about the care of the individual patient.

PROJECT TOPIC- Nurses’ Perception And Practice Of Evidence–Based Practice in Nursing Care in Federal Teaching Hospital Abakaliki (FETHA II), Ebonyi State

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