title: Evidence-based practice beliefs and implementation before and after an initiative to promote evidence-based nursing in an ambulatory oncology setting.
abstract: BACKGROUND
  The purpose of evidence-based practice (EBP) in nursing is to improve patient outcomes, providing the best and most up-to-date care practices. In 2011, a nurse-led committee convened to develop an institute-wide initiative to promote EBP with oncology nurses at the Dana-Farber Cancer Institute.
  
  
  OBJECTIVE
  Compare and describe oncology nurse beliefs and perceived implementation of EBP and explore beliefs and implementation before and after implementing an institutional EBP initiative.
  
  
  METHODS
  Based on the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBP-B) and Implementation (EBP-I) scales were distributed to all Dana-Farber Cancer Institute registered and advanced practice nurses through an online survey in 2011 (T1) and again in 2013 (T2) after the implementation of an institute-wide nursing EBP initiative (orientation, poster presentations, education). Descriptive and correlation statistics were completed on total scores and demographics. Differences in beliefs and implementation scores based on demographics were analyzed with Mann-Whitney U tests. Open-ended item responses at each time point (T) were summarized for EBP barriers and promoters.
  
  
  RESULTS
  Thirty-two percent (n = 112 at T1; n = 113 at T2) of 350 nurses began the survey. A history of formal EBP education and nurse role were associated with higher EBP-B and EBP-I scores (p < .05). Highest level of education was significantly correlated with both EBP-B (r = .25; p = .03) and EBP-I (r = .32; p = .01). Narrative responses to open-ended questions described perceived personal and environmental barriers to engaging in EBP.
  
  
  CONCLUSIONS
  Although no significant differences were noted in beliefs and implementation after the EBP initiative, nurses reported valuing EBP. Respondents acknowledged a lack of full preparation in the EBP process to engage in and implement EBP consistently. Nurse role, formal EBP education, and highest level of education were associated with perceptions of EBP beliefs and implementation. Nurses should be provided the mentorship and support to obtain continuing education about how to engage in EBP and about implementing EBP change.
authors.affiliation: Nurse Scientist and Instructor, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA; Instructor, Harvard Medical School, Boston, MA, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Underhill
authors.forename: Kristin
authors.initials: K
authors.lastname: Roper
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Siefert
authors.forename: Jean
authors.initials: J
authors.lastname: Boucher
authors.forename: Donna
authors.initials: D
authors.lastname: Berry
mesh_terms: D001291:Attitude of Health Personnel; D004509:Education, Nursing, Continuing; D055318:Evidence-Based Nursing; D055317:Evidence-Based Practice / Q000193:education; D006801:Humans; D016522:Oncology Service, Hospital; D011795:Surveys and Questionnaires
keywords: cancer care; evidence-based practice; nursing