Integrating Insights: A Mixed-Methods Approach to Nurses' Competencies in Evidence-Based Practice and Clinical Decision-Making

整合洞见:一种混合方法研究护士在循证实践和临床决策中的能力

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Abstract

AIM: To identify the factors influencing nurses' Evidence-based practices (EBP) competencies and clinical decision-making (CDM) levels. DESIGN: A convergent parallel mixed-methods study. METHODS: The quantitative data were collected from 387 nurses via the EBP Competence Questionnaire and the Clinical Decision-Making in Nursing Scale, while qualitative data were gathered from semi-structured interviews with 20 nurses. Quantitative data were analysed using descriptive statistics, ANOVA, and multiple linear regression, and qualitative data were subjected to thematic content analysis. RESULTS: Regression analysis revealed that higher education, research involvement, and following scientific publications positively influenced EBP competencies. Working in inpatient units and clinical nursing roles negatively affected EBP and CDM abilities. A significant positive correlation was found between EBP competence and CDM skills. Qualitative findings identified four themes: Implementation Areas of EBP, Competence in EBP, Impacts of EBP, and Facilitators and Barriers to EBP. CONCLUSION: Strengthening nurses' EBP competencies and CDM requires targeted strategies such as education, access to organizational resources and supportive policies. IMPLICATIONS FOR THE PROFESSION: Addressing barriers and fostering a culture of continuous learning can enhance patient care and nursing outcomes. IMPACT: By addressing gaps in EBP implementation and decision-making skills, the findings serve as a benchmark for policymakers, educators and healthcare administrators to create supportive infrastructures, promote continuous professional development, and foster a culture of evidence-based practice worldwide. REPORTING METHOD: The study was reported in accordance with the GRAMMS guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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