title: A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence-Based Practice and Shortcomings in Hospital Performance Metrics Across the United States.
abstract: BACKGROUND
  Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe.
  
  
  OBJECTIVE
  The purpose of this study was to describe: (a) the EBP beliefs and level of EBP implementation by chief nurse executives (CNEs), (b) CNEs' perception of their hospitals' EBP organizational culture, (c) CNEs' top priorities, (d) amount of budget invested in EBP, and (e) hospital performance metrics.
  
  
  METHODS
  A descriptive survey was conducted. Two-hundred-seventy-six CNEs across the United States participated in the survey. Valid and reliable measures included the EBP Beliefs scale, the EBP Implementation scale, and the Organizational Culture and Readiness scale for EBP. The Centers for Medicare and Medicaid Services Core Measures and the National Database of Nursing Quality Indicators (NDNQI) were also collected.
  
  
  RESULTS
  Data from this survey revealed that implementation of EBP in the practices of CNEs and their hospitals is relatively low. More than one-third of the hospitals are not meeting NDNQI performance metrics and almost one-third of the hospitals are above national core measures benchmarks, such as falls and pressure ulcers.
  
  
  CONCLUSIONS
  Although CNEs believe that EBP results in high-quality care, it is ranked as a low priority with little budget allocation. These findings provide a plausible explanation for shortcomings in key hospital performance metrics. To achieve higher healthcare quality and safety along with decreased costs, CNEs and hospital administrators need to invest in providing resources and an evidence-based culture so that clinicians can routinely implement EBP as the foundation of care.
authors.affiliation: Associate Vice President for Health Promotion, University Chief Wellness Officer, Dean and Professor, College of Nursing, Professor of Pediatrics and Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Bernadette Mazurek
authors.initials: BM
authors.lastname: Melnyk
authors.affiliation: Director, Center for Transdisciplinary Evidence-Based Practice, Clinical Associate Professor, The Ohio State University, College of Nursing, Columbus, OH, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Gallagher-Ford
authors.affiliation: Technology Coordinator, Center for Transdisciplinary Evidence-Based Practice, The Ohio State University, College of Nursing, Columbus, OH, USA.
authors.forename: Bindu Koshy
authors.initials: BK
authors.lastname: Thomas
authors.affiliation: Chief Professional Practice Officer, Elsevier Clinical Solutions, Grand Rapids, MI, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Troseth
authors.affiliation: Manager, Elsevier CPM Consortium, Elsevier Clinical Solutions, Grand Rapids, MI, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Wyngarden
authors.affiliation: Director of Research Methods and Statistics, University of Arizona College of Nursing, Tucson, AZ, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Szalacha
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000592:standards*; D055317:Evidence-Based Practice; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals / Q000592:standards*; D006801:Humans; D009718:Nurse Administrators; D015279:Organizational Culture; D011795:Surveys and Questionnaires; D014481:United States
keywords: chief nurse; evidence-based practice; health care; nurse executive; performance metrics