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A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence‐Based Practice and Shortcomings in Hospital Performance Metrics Across the United States
Author(s) -
Melnyk Bernadette Mazurek,
GallagherFord Lynn,
Thomas Bindu Koshy,
Troseth Michelle,
Wyngarden Kathy,
Szalacha Laura
Publication year - 2016
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12133
Subject(s) - scale (ratio) , medicaid , health care , quality (philosophy) , organizational culture , nursing , prioritization , acute care , evidence based practice , business , medicine , psychology , public relations , political science , process management , geography , philosophy , cartography , alternative medicine , epistemology , pathology , law
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. Aims 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. Linking Evidence to Action 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.

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