Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift

Worldviews Evid Based Nurs. 2004;1(3):185-93. doi: 10.1111/j.1524-475X.2004.04024.x.


Background: The paradigm shift to evidence-based nursing practice in the United States has been slow. Although multiple barriers to evidence-based practice (EBP) have been identified through prior studies, there is a gap in the literature specifically identifying key variables (e.g., belief that EBP produces quality outcomes) that are correlated with the extent to which nurses engage in EBP.

Aim: The primary aims of this study were to (1) describe nurses' knowledge, beliefs, skills, and needs regarding EBP; (2) determine whether relationships exist among these variables; and (3) describe major barriers and facilitators to EBP.

Methods: A descriptive survey was conducted with a convenience sample of 160 nurses who were attending EBP conferences or workshops in four states located within the Eastern Region of the United States.

Results: Although participant beliefs about the benefit of EBP were high, knowledge of EBP was relatively low. Significant relationships were found between the extent to which the nurses' practice is evidence-based and (1) nurses' knowledge of EBP, (2) nurses' beliefs about the benefits of EBP, (3) having an EBP mentor, and (4) using the Cochrane Database of Systematic Reviews and the National Guideline Clearinghouse.

Conclusion and implications: Health care systems need to implement interventions that not only increase nurses' EBP knowledge and skills, but also strengthen their beliefs about the benefit of evidence-based care. EBP mentors may be key in accelerating a more rapid shift toward evidence-based nursing practice. Theoretically driven randomized controlled trials are urgently needed to test the effectiveness of interventions on advancing evidence-based care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Attitude of Health Personnel*
  • Clinical Competence
  • Diffusion of Innovation*
  • Education, Nursing, Continuing
  • Evidence-Based Medicine* / education
  • Evidence-Based Medicine* / organization & administration
  • Health Knowledge, Attitudes, Practice*
  • Health Services Needs and Demand
  • Humans
  • Knowledge
  • Mentors
  • Models, Nursing
  • Nurse's Role / psychology
  • Nurses / organization & administration
  • Nurses / psychology*
  • Nursing Research* / education
  • Nursing Research* / organization & administration
  • Organizational Innovation
  • Outcome Assessment, Health Care
  • Philosophy, Nursing
  • Randomized Controlled Trials as Topic
  • Self Efficacy
  • Social Support
  • Surveys and Questionnaires
  • United States