Examining Bolivian Nurses Readiness to Engage in Evidence-based Practice
Repository Posting Date2019-03-08T20:28:40Z
Author(s)Garcia, Daisy S.
Author DetailsDaisy S. Garcia, PhD, MSN, BSN
Lead Author Sigma AffliationAlpha Epsilon
Lead Author AffliationSeattle University School of Nursing
Level of EvidenceOther
Research ApproachMixed/Multi Method Research
KeywordsEvidence-based Practice; Readiness for Best Practice; Preparedness for Research Utilization; Bolivian Nurses
CINAHL HeadingsProfessional Practice, Evidence-Based -- Bolivia; Nursing Knowledge -- Bolivia; Nursing Knowledge -- Evaluation -- Bolivia; Bolivia; Professional Practice, Evidence-Based; Nursing Knowledge; Nursing Knowledge -- Evaluation
Evidence-based nursing practice can promote sustainable health care and contribute to reducing health inequities in underprivileged countries such as Bolivia. Bolivia’s health care service utilization among the poorest is 30% compared with 70% for the wealthier. The evidence-based practice (EBP) movement in Bolivia is nascent; and the influential factors for implementing EBP in nursing are unknown. A mixed methods study was conducted to investigate Bolivian nurses’ readiness for engaging in EBP and the challenges they face for implementing EBP in acute and outpatient care settings in La Paz, one of the Bolivia’s largest urban areas. A sequential explanatory mixed methods approach was used to first examine statistical trends on data gathered from nurse clinicians, educators, and leaders on their values and beliefs about EBP as well as barriers to its implementation. One hundred seventy nurses with baccalaureate or higher education from three hospitals and a health network with five community centers were surveyed using the EBP Beliefs, EBP Implementation, and BARRIERS to EBP scales, which were translated and validated into Spanish. After, an in-depth interview data was gathered in a focus group of nine key informants to further explain the survey findings. The quantitative results showed that nurses’ beliefs on engaging in EBP can improve their clinical practice and that conducting research is not time-consuming or difficult. However, their EBP implementation behaviors were found to be infrequent. Further, nurses obtaining or who have enrolled in graduate education or have research experience were associated with knowing how they can improve patients’ care using EBP (p = 0.04). Organizational setting characteristics and lack of support from physicians, who occupy most of the leadership positions, scored high as barriers for nurses to engage in EBP. The qualitative data analysis confirmed the survey results and revealed underlying factors for limiting improvements to nurses’ clinical practice such as “feeling undervalued” by other providers or by the nurses “themselves,” which lead to “frustration” and “lack of motivation.” Efforts to develop strategies for nurses to stay current on their EBP skills and to create a progressive EBP culture are needed. Collaborative work between educators, nursing societies, and local and international organizations can guide initiatives for implementing EBP based on the Bolivian health profile and benefit the health care of underserved Bolivians.
Funder(s)Sigma Theta Tau International
NotesThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
Dr. Garcia was the 2016-2017 recipient of the SigmaI/Council for Advancement of Nursing Science Grant
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