Evidence-Based Nursing Clinical Trial
Official title:
The Effectiveness of an Evidence Based Practice (EBP) Educational Programme in Undergraduate Nursing Students' EBP Beliefs and Knowledge, and the Extent of Their EBP Implementation: A Cluster Randomized Control Trial
Evidence-based practice (EBP) prevents unsafety/inefficiency and improves healthcare quality. However, EBP implementation and sustainment are challenging for healthcare organizations and providers considering gaps between research and practice. An educational preparation of the future healthcare professionals can minimize these gaps. Thus, it is mandatory that undergraduate curricula in health sciences, namely in nursing, promote an EBP culture so that future health professionals use it into clinical practice. Within the Portuguese context, there is no available scientific literature about the current state of EBP integration in the undergraduate nursing curricula. Thereby, the investigators intend to verify if an EBP educational programme would be successful in improving the undergraduate nursing students' EBP knowledge and beliefs and, and the extent of their EBP implementation This will be tested using a prospective cluster randomized control trial with two-armed parallel group design.
Evidence-Based Practice (EBP), also known as Evidence-Informed Practice, could be defined as
a "clinical decision-making that considers the best available evidence; the context in which
the care is delivered; client preference; and the professional judgment of the health
professional".
It has been recognizing that the adoption, implementation and sustainment of EBP in
healthcare organizations are very important to promotes high-value health care, improves the
patient experience and health outcomes, and reduces health care costs.
In consequence, several organizations acclaim EBP implementation, because this implementation
improves the quality of care; reduces the uncertainty, risk and variability; and becomes the
decision-making more simplified. Moreover, Dawes et al at the "Sicily statement on
evidence-based practice" highlighted that "all health care professionals need to understand
the principles of EBP, recognize EBP in action, implement evidence-based policies, and have a
critical attitude to their own practice and to evidence".
Nevertheless, nowadays EBP is not the standard of care in the world and some studies
recognized education as a strategy to promotes the adoption, implementation and sustainment
of EBP.
In fact, the Committee on the Health Professions Education Summit in 2003 recommended the
development of competencies regarding the EBP use in all health professional educational
programs. Therefore, it is important that undergraduate nursing curricula are based on EBP
principles to educate the future nurses to use EBP into clinical practice. This will,
consequently, improve health outcomes, with a positive impact in patients' safety, costs and
health systems. Regardless of the above recommendation, the nursing curricula still provide
contents related to traditional nursing research and do not integrate the EBP content and
process.
Therefore, this randomized control trial aims to evaluate the effectiveness of an educational
EBP programme in undergraduate nursing students' EBP beliefs and knowledge, and the extent of
their EBP implementation. This study will have two arms: experimental group (EBP educational
program) and control group (no intervention - education as usual) and it will have the
following methodology:
- Sample: For sample size calculation it was used the software G*Power 3.1.9.2. Power
analysis was based on a type I error of 0.05; power of 0.80; effect size f=0.25; and
ANOVA: repeated measures between factors determined a total sample size of 92. In a
Portuguese nursing school, six optional courses of the 8th semester of the nursing
graduation were randomly assigned to experimental (EBP educational programme) or control
group (no intervention - education as usual). An independent researcher performed this
assignment using random.org.
- Intervention: The EBP educational programme will be implemented over 17 weeks (12 hours
of lessons - expositive method and practice method and 3 sessions of mentorship to small
groups of students - 2/3 students - with the duration of 2 hours each).
- Assessment: All participants will be assessed before (week 0) and after the intervention
(week 18) by a blind assessor using the validated instruments to assess undergraduate
nursing students' EBP beliefs, the extent of their EBP implementation and their
knowledge in EBP.
- Data analysis: The data will be analyzed using Statistical Package for the Social
Sciences (SPSS) to conduct a descriptive and inferential analysis. To minimize the
noncompliance impact, the intention to treat analysis - Last observation carried forward
will be used.
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