title: Implementation of evidence-based practice: outside the box, throughout the hospital.
abstract: BACKGROUND
  Evidence-based practice (EBP) is a generally accepted means to improve healthcare quality. However, not all healthcare professionals and managers apply EBP in daily practice. We investigated EBP attitudes, knowledge and the perceived barriers and facilitators to practising EBP , to define tailor-made interventions for improving evidence-based behaviour.
  
  
  METHODS
  In this cross-sectional survey, doctors and nurses from five major specialities of a university hospital were invited to complete the McColl and Barriers questionnaires.
  
  
  RESULTS
  Response rates were 70% (305÷435) for doctors and 74% (396÷537) for nurses. They were welcoming towards EBP, but considered time constraints, knowledge gaps and poor availability of evidence as major barriers to implement EBP . They also mentioned contradicting results (75%) and flawed methodology (69%), while nurses frequently mentioned unawareness of (75%), or difficulty in reading and interpreting research papers (70%). Regarding EBP knowledge, 6/8 common EBP terms could be explained by 54% of doctors but by only 15% of nurses. Facilitating factors among doctors concerned the availability and accessibility of high-level evidence and communication of evidence during various clinical meetings and handovers for clinical decision making. Among nurses, promoting factors involved more teaching and instances to incorporate EBP in clinical practice. Both groups desired more managerial support in terms of motivation and opportunities.
  
  
  CONCLUSIONS
  Doctors and nurses have embraced the EBP paradigm as an important means to improve quality of clinical patient care, but its application is still cumbersome. This paper offers a tailored programme for implementation and managerial role-models.sustainment of EBP, corroborated by professional and managerial role-models.
authors.affiliation: Department of Quality Assurance & Process Innovation, University of Amsterdam, the Netherlands. d.ubbink@amc.nl
authors.forename: D T
authors.initials: DT
authors.lastname: Ubbink
authors.forename: H
authors.initials: H
authors.lastname: Vermeulen
authors.forename: A M
authors.initials: AM
authors.lastname: Knops
authors.forename: D A
authors.initials: DA
authors.lastname: Legemate
authors.forename: K
authors.initials: K
authors.lastname: Oude Rengerink
authors.forename: M J
authors.initials: MJ
authors.lastname: Heineman
authors.forename: Y B
authors.initials: YB
authors.lastname: Roos
authors.forename: C J
authors.initials: CJ
authors.lastname: Fijnvandraat
authors.forename: H S
authors.initials: HS
authors.lastname: Heymans
authors.forename: R
authors.initials: R
authors.lastname: Simons
authors.forename: M
authors.initials: M
authors.lastname: Levi
mesh_terms: D001291:Attitude of Health Personnel; D003197:Computer Literacy; D003430:Cross-Sectional Studies; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D055317:Evidence-Based Practice; D005260:Female; D019538:Health Care Surveys; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000592:standards; D009426:Netherlands; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods; D000078329:Workforce