The relationship between nursing unit culture and the use of evidence-based practice among nurses in hospitals
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Jin Jun, PhD, RN, Assistant Professor - The Ohio State University
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Evidence-based practice (EBP) has been the gold standard for clinical practice. However, the use of EBP by healthcare providers, including nurses, has remained at suboptimal rates. Though researchers have examined various factors that influence nurses’ use of EBP, studies of more complex organizational factors are limited. Nursing unit culture, which encompasses unique shared values, beliefs, and assumptions, may be one of the driving forces in determining nurses’ behavior, leading to variation in the use of EBP. The purpose of this study was to examine the association between nursing unit culture and the use of EBP among nurses in hospitals under the overarching theoretical frameworks of the Competing Values Framework and the Consolidated Framework for Implementation Research. A cross-sectional, correlation design was used. The sample was 242 staff nurses working in inpatient units at two large teaching hospitals in a metropolitan area. Excluded were nurses who worked in operating rooms and outpatient settings such as procedural and emergency departments. Also excluded were administrators, managers, advanced practice nurses, and nonclinical nurses including case managers or nurse educators. Most nurses were White/Caucasian women between the ages of 20 and 39. Of the nurses, 85.1% had a Bachelor of Science in Nursing as their first professional degree, and about half were either already back in school or planned to return to school within 1–5 years, with Masters of Science in Nursing being the most sought-after degree. The overall attitude of EBP was positive and the knowledge/skills of EBP was high. The practice of EBP, however, was lagging. The dominant nursing unit culture was a “Group” culture. Initially, an “Innovation” culture was positively associated with the practice of EBP while a “Market” culture was negatively associated with the practice of EBP. However, the associations became non-significant when controlled for individual, work, and educational characteristics. Similarly, the attitude toward EBP was negatively associated with a “Market” culture but the association became non-significant when controlled for individual, work, and educational characteristics. No significant association was found between the types of nursing unit culture and the knowledge/skills of EBP. Though no statistical significance was found between nursing unit culture and the use of EBP, organizational culture can still provide the background for nurses, nurse managers, and administrators to use in creating interventions to promote a supportive and encouraging work environment for nurses and their use of EBP. Qualitative or mixed methodology as well as the use of social cognitive theories such as the Theory of Planned Behavior also may be better suited for future research of organizational culture.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10792208; ProQuest document ID: 2039079655. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Cross-Sectional |
Research Approach | Quantitative Research |
Keywords | Organizational Culture; Evidence-Based Practice; Nursing Unit Culture; High-Quality Healthcare; Incorporating EBP into Practice |
Grantor | New York University |
Advisor | Kovner, Christine T.; Dickson, Victoria V. |
Level | PhD |
Year | 2018 |
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