Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review

Abstract

ObjectivesEvidence-based practice (EBP) may help improve healthcare quality. However, not all healthcare professionals and managers use EBP in their daily practice. We systematically reviewed the literature to summarise self-reported appreciation of EBP and organisational infrastructure solutions proposed to promote EBP.DesignSystematic review. Two investigators independently performed the systematic reviewing process.Information sourcesMEDLINE, EMBASE and Cochrane Library were searched for publications between 2000 and 2011.Eligibility criteria for included studiesReviews and surveys of EBP attitude, knowledge, awareness, skills, barriers and facilitators among managers, doctors and nurses in clinical settings.ResultsWe found 31 surveys of fairly good quality. General attitude towards EBP was welcoming. Respondents perceived several barriers, but also many facilitators for EBP implementation. Solutions were proposed at various organisational levels, including (inter)national associations and hospital management promoting EBP, pregraduate and postgraduate education, as well as individual support by EBP mentors on the wards to move EBP from the classroom to the bedside.ConclusionsMore than 20 years after its introduction, the EBP paradigm has been embraced by healthcare professionals as an important means to improve quality of patient care, but its implementation is still deficient. Policy exerted at microlevel , middlelevel and macrolevel, and supported by professional, educational and managerial role models, may further facilitate EBP.

Cross-cultural Comparison of Pharmacy Students’ Attitudes, Knowledge, Practice, and Barriers Regarding Evidence-based Medicine

“…The questionnaire was developed from a comprehensive literature review of prior literature and adapted from questionnaires in previous studies in this area. [19][20][21][22] Its face and content validity was confirmed with two EBM experts. The questionnaire was originally in English and was translated to Japanese by 2 native Japanese speakers with back translation to English.…”

“…This finding was consistent with studies conducted with other medical professionals and students. [8][9][10][11]22 There is increasing awareness and a perceived need to incorporate EBM into the pharmacy curriculum and to make it an integral part of pharmacy education in both countries. 12,…”

“…In a meta-analysis of physicians from 18 different countries, 83% of physicians indicated their understanding of NNT, 22 while studies show that 74-75% of pharmacists understand NNT in the US and Australia. 25,26 While common EBM terms have been penetrating the health profession lexicon around the world, American student pharmacists appear to have greater recognition than those in Japan.…”

“…For agreement questions, strongly agree, agree, disagree, or strongly disagree were used as response choices, for frequency questions, rarely, sometimes, usually, or always were used as response choices, and for terminology questions, can explain to others, know somewhat, want to know, and don't need to know were used as response choices. 22 Participants were invited to participate in the survey in their classrooms and were provided with a survey web-link via email or a paper-based survey.…”

“…Similar to other studies, we included a meaningless dummy term question in order to determine students' accuracy of self-assessed EBM knowledge and their interest in learning new terms. 22 To measure students' knowledge, attitudes and perceptions about EBM, we used either yes/no responses or a 4-point Likert Scale, with anchors tailored to the specific section. For agreement questions, strongly agree, agree, disagree, or strongly disagree were used as response choices, for frequency questions, rarely, sometimes, usually, or always were used as response choices, and for terminology questions, can explain to others, know somewhat, want to know, and don't need to know were used as response choices.…”