Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals

In-Sook Jang; Myonghwa Park

doi:10.7469/kjan.2016.28.1.83

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Jang and Park: Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals

Original Article

Korean J Adult Nurs 2016;28(1):83-94.

Published online: February 2016

DOI: https://doi.org/10.7469/kjan.2016.28.1.83

Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals

In-Sook Jang, Myonghwa Park

College of Nursing, Chungnam National University, Daejeon, Korea

Corresponding author: Park, Myonghwa College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-580-8328, Fax: +82-42-580-8309, E-mail: mhpark@cnu.ac.kr

Received 10 November 201511 February 2016 Accepted 13 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to explore how knowledge management of hospital and nurses’ beliefs and competences on evidence-based practice can affect evidence-based decision making.

Methods

In this descriptive study, a total of 184 nurses who were working in the five general hospitals participated. The data were collected through a self-administered questionnaire in September, 2014. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and step-wise multiple regression with SPSS/WIN Statistics 21.0 program.

Results

Evidence-based decision making was correlated with EBP beliefs (r=.55, p<.001), EBP competence (r=.57, p<.001), and knowledge management (r=.50, p<.001). Hierarchical regression analysis showed that EBP beliefs (β=.18, p=.005), EBP competence (β=.37, p<.001), organizational knowledge management (β=.27, p<.001) explained 48.6% of evidence based decision making (p<.001).

Conclusion

The study results indicated that evidence-based practice competences, organizational knowledge management, and evidence-based practice beliefs were important factors on evidence-based decision making. In order to improve evidence-based practice among nurses through organizational knowledge management, EBP beliefs and competence at individual level need to be considered and incorporated into any systemic training of EBP.

Keywords: Evidence-based practice, Knowledge management, Decision making, Beliefs, Competence

REFERENCES

1.Park MH. Understanding and application of evidence based nursing. 2nd ed. Seoul: Koonja;2006.

2.Melnyk BM., Fineout-Overholt E. Evidence-based practice in nursing and healthcare. A guide to best practice. Philadelphia, PA: Lippincott, Williams, & Wilkins;2011.

3.Choe MA., Bang KS., Park YH., Kang HJ. Current status and direction for future development of evidence-based nursing in Korea. Perspectives in Nursing Science. 2011. 8(2):129–38.

4.Park MH. Implementation of evidence based nursing education into nursing management clinical practicum: outcome evaluation and diffusion strategies. Journal of Korean Academy of Nursing Administration. 2013. 19(1):39–47.

5.Baumann A., Dever R. The limits of decision analysis for rapid decision making in ICU nursing. Image Journal of Nursing scholarship. 1989. 21(2):69–71.

6.Jenkins HM. Improving clinical decision making in nursing. Journal of Nursing Education. 1959. 24(6):242–3.

7.Melnyk BM., Fineout-Overholt E. Evidence-based practice in nursing & healthcare. 2nd ed. Gu MO, Eun Y, Kim SM, Jung JS, Park MH, Park MS, translator. Seoul: Fornurse;2013.

8.Melnyk BM., Fineout-Overholt E., Mays MA. The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing. 2008. 5(4):208–16.

9.Park SM., Kwon IG. Factors influencing nurses' clinical decision making: focusing on critical thinking disposition. Journal of Korean Academy of Nursing. 2007. 37(6):863–71.

10.Yi JE., Park MH. Nurses' access & use of information resources and barriers & competency of evidence based practice. Korean Journal of Adult Nursing. 2011. 23(3):255–66.

11.Cho MS., Song MR., Cha SK. Nurses' perceptions regarding evidence-based practice facilitators in a tertiary hospital. Journal of Korean Academy of Fundamentals of Nursing. 2011. 18(3):300–9.

12.Melnyk BM., Fineout-Overholt E., Feinstein FN., Li H., Small L., Wilcox L, et al. Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews on Evidence-Based Nursing. 2004. 1:185–93.

13.Dragan I. Teaching evidence-based practice: perspectives from the undergraduate and post-graduate viewpoint. Annals Academy of Medicine. 2009. 38(6):559–63.

14.Lim KC., Pack KO., Kwon JS., Jeong JS., Choe MA., Kim JH, et al. Registered nurses' knowledge, attitudes, and practice about evidence-based practice at general hospitals in Korea. Journal of Korean Clinical Nursing Research. 2011. 17(3):375–87.

15.Sandars J., Heller R. Improving the implementation of evidence-based practice: a knowledge management perspective. Journal of Evaluation in Clinical Practice. 2006. 12(3):341–6.

16.Dee C., Stanley EE. Information-seeking behavior of nursing students and clinical nurses: implications for health sciences librarians. Journal of the Medical Library Association. 2005. 93(2):213–22.

17.Oh EG., Oh HJ., Lee YJ. Nurses' research activities and barriers of research utilization. Journal of Korean Academy of Nursing. 2004. 34(5):838–48.

18.Kothari AR., Bickford JJ., Edwards N., Dobbins MJ., Meyer M. Uncovering tacit knowledge: a pilot study to broaden the concept of knowledge in knowledge translation. BMC Health Services Research. 2011. 11:198–208.

19.Hwang MH. Relation between core factors of knowledge management in hospital' nursing organization and nursing competency [master's thesis]. Seoul: Kyung Hee University;2011.

20.Ferguson LM., Day RA. Supporting new nurses in evidence-based practice. Journal of Nursing Administration. 2004. 34:490–2.

21.Ferguson LM., Day RA. Challenges for new nurses in evidence-based practice. Journal of Nursing Management. 2007. 15:107–13.

22.Kim JS., Gu MO., Jo SY. Factors influencing evidence-based practice readiness for tertiary general hospital nurses. Journal of the Korea Academia-Industrial Cooperation Society. 2013. 14(6):2945–57.

23.Bahtsevani C., Willman A., Khalaf A., Ostman M. Developing an instrument for evaluating implementation of clinical practice guidelines: a test-retest study. Journal of Evaluation in Clinical Practice. 2007. 14:839–46.

24.Choi MO. The effect of knowledge management core factor on nursing performance. [master's thesis]. Seoul: Public Health Yonsei University;2005.

25.Yoo JY., Oh EG. Level of beliefs, knowledge and performance for evidence-based practice among nurses experienced in preceptor role. Journal of Korean Academy of Nursing Administration. 2012. 18(2):201–12.

26.Park HY. A structural model of evidence-based practice implementation among clinical nurses [dissertation]. Gwangju: Chonnam National University;2013.

27.Cho MS., Cho YA., Song MR., Kim MK., Cha SK. Development of a program to facilitate evidence-based practice based on the transtheoretical model. Korean Journal of Adult Nursing. 2013. 25(2):136–47.

28.Son YS., Kim SH., Park YS., Lee SK., Lee YM. The influence of information retrieval skill on evidence based practice competency in clinical nurses. Korean Journal of Adult Nursing. 2012. 24(6):635–46.

29.Kim YS., Kim JM., Park MM. Factors influencing competency in evidence-based practice among clinical nurses. Journal of Korean Academy of Nursing Administration. 2015. 21(2):143–53.

30.Fineout-Overholt E., Melnyk BM., Schultz A. Transforming health care from the inside out: advancing evidence-based practice in the 21st century. Journal of Professional Nursing. 2005. 21:335–44.

Table 1.

General·EBP Characteristics of Subjects (N=184)

Variables	Categories	n (%)	M±SD	Range
Age (year)	21~30	86 (46.7)	33.62±8.87	23~60
	31~40	59 (32.1)
	≥41	39 (21.2)
Level of education	College	38 (20.7)
	BSN	69 (37.5)
	MSN & PhD	77 (41.8)
Clinical experience (year)	≤5	59 (32.1)	10.98±8.79	1~37.75
	＞5~≤10	45 (24.5)
	＞10~≤20	48 (26.1)
	＞20	32 (17.4)
Position	Staff nurse	146 (79.3)
Position	Charge & unit manager	38 (20.7)
Research experience	Yes	90 (48.9)
Research experience	No	94 (51.1)
Membership of academic society	Yes	34 (18.5)
Membership of academic society	No	150 (81.5)
Have you heard EBP?	Yes	146 (79.3)
Have you heard EBP?	No	38 (20.7)
Route to know EBP?^†	School	75 (40.8)
	Hospital	72 (39.1)
	Academic society	34 (18.5)
	Article	25 (13.6)
	Colleague	15 (8.2)
	Web site	12 (6.5)
Had EBP education before?	Yes	62 (33.7)
Had EBP education before?	No	122 (66.3)
Know EBP?	Not at all	11 (6.0)
	Only know name	80 (43.5)
	Know a little & know all	93 (50.5)
Do you feel the need for research evidence?	Yes	163 (88.6)
Do you feel the need for research evidence?	No	21 (11.4)
When do you feel the need for evidence?^†	When teaching other nurse	80 (43.5)
	To be a competent professional	82 (44.6)
	To know exactly about the nursing procedure	78 (42.4)
	When an error occurs in nursing practice	52 (28.3)
	When problem occurs	59 (32.1)
What do you do when a you have problem in clinical situation?^†	Browse resources	119 (64.7)
	We ask colleagues Ask the experts	76 (41.3) 33 (17.9)
	Ignore	1 (0.5)
Have EBP education in hospital?	Yes	38 (20.7)
Have EBP education in hospital?	No/do not know	146 (79.3)

EBP=evidence-based practice;

^† Multiple response.

Table 2.

Scores of Knowledge Management, EBP Beliefs, EBP Competence, Evidence-based Decision Making (N=184)

Variables	M±SD
Knowledge Management	3.55±0.04
Knowledge-sharing organizational culture	3.70±0.04
Knowledge management system	3.31±0.05
in nursing department
Innovative leadership	3.56±0.05
Organizational learning	3.67±0.04
EBP beliefs	3.38±0.03
EBP competence	2.60±0.68
Evidence-based decision-making	3.38±0.52
Practice based evidence	3.43±0.55
Patient based evidence	3.53±0.57
Research based evidence	3.23±0.67
Resource based evidence	3.31±0.65

EBP=evidence-based practice.

Table 3.

Knowledge Management, EBP Beliefs & EBP Competence, Evidence-based Decision Making by Characteristics (N=184)

Variables	Categories	n	Knowledge management		EBP beliefs		EBP competency		Evidence-based decision making
Variables	Categories	n	M±SD	F or t (p) Scheffé	M±SD	F or t (p) Scheffé	M±SD F	F or t (p) Scheffé	M±SD	F or t (p) Scheffé
Age (year)	21~30^a	86	3.43±0.49	9.02	3.34±0.37	1.62	2.45±0.60	6.29	3.31±0.47	1.84
	31~40^b	59	3.53±0.51	(＜.001)	3.36±0.47	(.201)	2.61±0.75	(.002)	3.38±0.59	(.161)
	＞41^c	39	3.55±0.51	a, b＜c	3.48±0.41		2.90±0.65	a＜c	3.51±0.49
Level of education	College^a	38	3.41±0.47	6.07	3.26±0.38	10.91	2.30±0.61	23.28	3.23±0.44	10.30
	BSN^b	69	3.45±0.47	(.003)	3.26±0.34	(＜.001)	2.36±0.56	(＜.001)	3.24±0.52	(＜.001)
	MSN & PhD^c	77	3.55±0.51	a, b＜c	3.54±0.44	a, b＜c	2.96±0.64	a, b＜c	3.57±0.49	a, b＜c
Clinical experience (year)	≤5^a	59	3.43±0.50	11.07	3.34±0.34	1.60	2.45±0.58	4.63	3.30±0.50	1.90
	＞5~10^b	45	3.45±0.49	(＜.001)	3.40±0.43	(.191)	2.47±0.73	(.004)	3.35±0.52	(.132)
	＞10~20^c	48	3.55±0.48 a	a, b, c＜d	3.31±0.48		2.66±0.72	a, b＜d	3.37±0.56
	≥20^d	32	3.90±0.45		3.50±0.38		2.95±0.60		3.56±0.48
Position	Staff nurse	146	3.47±0.50	-4.25	3.35±0.41	-2.06	2.51±0.67	-3.41	3.32±0.52	-2.78
	Charge & unit	38	3.85±0.44	(＜.001)	3.50±0.39	(.041)	2.92±0.59	(.001)	3.58±0.49	(.006)
	manager
Research experience	Yes	90	3.70±0.47	4.23	3.48±0.40	3.49	2.85±0.65	5.40	3.53±0.49	4.00
Research experience	No	94	3.40±0.50	(＜.001)	3.28±0.40	(.001)	2.35±0.61	(＜.001)	3.23±0.52	(＜.001)
Membership of academic society	Yes	34	3.80±0.47	3.30	3.51±0.42	2.15	2.83±0.69	2.28	3.59±0.48	2.69
Membership of academic society	No	150	3.49±0.50	(.001)	3.35±0.41	(.033)	2.54±0.67	(.024)	3.33±0.52	(.008)
Awareness of EBP	Yes	146	3.63±0.49	4.42	3.44±0.41	4.40	2.68±0.68	3.34	3.46±0.50	4.58
Awareness of EBP	No	38	3.24±0.46	(＜.001)	3.13±0.34	(＜.001)	2.28±0.96	(.001)	3.05±0.46	(＜.001)
Knowledge of EBP	Not at all^a	11	3.24±0.68	4.94	3.03±0.30	15.75	2.04±0.59	24.77	2.95±0.43	12.36
	Only know name^b	80	3.47±0.47	(.008)	3.25±0.38	(＜.001)	2.32±0.55	(＜.001)	3.24±0.52	(＜.001)
	Know a little & all^c	93	3.65±0.50	a＜c	3.52±0.39	a, b＜c	2.90±0.65	a, b＜c	3.54±0.46	a, b＜c
EBP education in hospital	Yes	38	3.83±0.37	4.97	3.61±0.33	3.99	2.98±0.55	4.12	3.69±0.39	5.17
EBP education in hospital	No	146	3.47±0.52	(＜.001)	3.32±0.41	(＜.001)	2.50±0.67	(＜.001)	3.29±0.20	(＜.001)

Table 4.

Correlation between Knowledge Management, EBP Beliefs & Competence, Evidence-based Decision Making (N=184)

Variables	Knowledge management	EBP Beliefs	EBP competence
Variables	r (p)	r (p)	r (p)
EBP beliefs	.49 (＜.001)
EBP competence	.29 (＜.001)	.53 (＜.001)
Evidence-based decision making	.50 (＜.001)	.55 (＜.001)	.57 (＜.001)

Table 5.

Factors Related to Evidence-based Decision Making. (N=184)

Variables		Model 1	1		Model	2		Model 3	3		Mod	del 4
Variables	b	β	p	b	β	p	b	β	p	b	β	p	VIF
Level of education	.10	0.09	.307	.03	0.03	.755	-.05	-0.04	.577	-.01	-0.01	1 .929	2.02
Position	.02	0.01	.871	.05	0.04	.604	.05	0.04	.570	-.03	-0.02	2 .716	1.52
Research experience	.09	0.09	.274	.07	0.07	.325	.03	0.02	.715	-.01	-0.01	.851	1.47
Membership of academic society	.10	0.08	.294	.08	0.06	.351	.09	0.07	.276	.04	0.03	3 .630	1.28
Awareness of EBP	.20	0.16	.037	.13	0.10	.151	.16	0.12	.062	.11	0.08	.194	1.35
Knowledge of EBP	.13	0.13	.117	.05	0.04	.554	-.03	-0.03	.705	00	0.00	0 .946	1.61
EBP education	.23	0.18	.017	.14	0.11	.103	.11	0.08	.196	.08	0.06	6 .327	1.28
EBP beliefs				.53	0.42	＜.001	.37	0.29	＜.001	.22	0.18	8 .016	1.78
EBP competence							.28	0.37	＜.001	.29	0.37	7 ＜.001	1.73
Knowledge management										.28	0.27	7 ＜.001	1.56
R² (⊿R²)	.219			.361 (.141)			.438 (.077)				.486 (.048)
F (p)	7.07 (＜.001)			12.35 (＜.001)			15.09 (＜.001)				16.35 (＜.001)

Model 1: General·EBP Characteristics; Model 2: General·EBP Characteristics, EBP beliefs; Model 3: General·EBP Characteristics, EBP beliefs, EBP competence; Model 4: General·EBP Characteristics, EBP beliefs, EBP competence, Knowledge management.

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