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Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals

In-Sook Jang, Myonghwa Park
Korean Journal of Adult Nursing 2016;28(1):83-94.
Published online: February 29, 2016

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Corresponding author: Park, Myonghwa College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-580-8328, Fax: +82-42-580-8309, E-mail: mhpark@cnu.ac.kr
• Received: November 10, 2015   • Accepted: February 13, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to explore how knowledge management of hospital and nurses’ beliefs and competences on evidence-based practice can affect evidence-based decision making.
  • Methods
    In this descriptive study, a total of 184 nurses who were working in the five general hospitals participated. The data were collected through a self-administered questionnaire in September, 2014. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and step-wise multiple regression with SPSS/WIN Statistics 21.0 program.
  • Results
    Evidence-based decision making was correlated with EBP beliefs (r=.55, p<.001), EBP competence (r=.57, p<.001), and knowledge management (r=.50, p<.001). Hierarchical regression analysis showed that EBP beliefs (β=.18, p=.005), EBP competence (β=.37, p<.001), organizational knowledge management (β=.27, p<.001) explained 48.6% of evidence based decision making (p<.001).
  • Conclusion
    The study results indicated that evidence-based practice competences, organizational knowledge management, and evidence-based practice beliefs were important factors on evidence-based decision making. In order to improve evidence-based practice among nurses through organizational knowledge management, EBP beliefs and competence at individual level need to be considered and incorporated into any systemic training of EBP.
  • Key Words: Evidence-based practice; Knowledge management; Decision making; Beliefs; Competence
Table 1.
General·EBP Characteristics of Subjects (N=184)
Variables Categories n (%) M±SD Range
Age (year) 21~30 86 (46.7) 33.62±8.87 23~60
31~40 59 (32.1)
≥41 39 (21.2)
Level of education College 38 (20.7)
BSN 69 (37.5)
MSN & PhD 77 (41.8)
Clinical experience (year) ≤5 59 (32.1) 10.98±8.79 1~37.75
＞5~≤10 45 (24.5)
＞10~≤20 48 (26.1)
＞20 32 (17.4)
Position Staff nurse 146 (79.3)
Charge & unit manager 38 (20.7)
Research experience Yes 90 (48.9)
No 94 (51.1)
Membership of academic society Yes 34 (18.5)
No 150 (81.5)
Have you heard EBP? Yes 146 (79.3)
No 38 (20.7)
Route to know EBP?† School 75 (40.8)
Hospital 72 (39.1)
Academic society 34 (18.5)
Article 25 (13.6)
Colleague 15 (8.2)
Web site 12 (6.5)
Had EBP education before? Yes 62 (33.7)
No 122 (66.3)
Know EBP? Not at all 11 (6.0)
Only know name 80 (43.5)
Know a little & know all 93 (50.5)
Do you feel the need for research evidence? Yes 163 (88.6)
No 21 (11.4)
When do you feel the need for evidence?† When teaching other nurse 80 (43.5)
To be a competent professional 82 (44.6)
To know exactly about the nursing procedure 78 (42.4)
When an error occurs in nursing practice 52 (28.3)
When problem occurs 59 (32.1)
What do you do when a you have problem in clinical situation?† Browse resources 119 (64.7)
We ask colleagues Ask the experts 76 (41.3) 33 (17.9)
Ignore 1 (0.5)
Have EBP education in hospital? Yes 38 (20.7)
No/do not know 146 (79.3)

EBP=evidence-based practice;

†Multiple response.

Table 2.
Scores of Knowledge Management, EBP Beliefs, EBP Competence, Evidence-based Decision Making (N=184)
Variables M±SD
Knowledge Management 3.55±0.04
Knowledge-sharing organizational culture 3.70±0.04
Knowledge management system 3.31±0.05
in nursing department  
Innovative leadership 3.56±0.05
Organizational learning 3.67±0.04
EBP beliefs 3.38±0.03
EBP competence 2.60±0.68
Evidence-based decision-making 3.38±0.52
Practice based evidence 3.43±0.55
Patient based evidence 3.53±0.57
Research based evidence 3.23±0.67
Resource based evidence 3.31±0.65

EBP=evidence-based practice.

Table 3.
Knowledge Management, EBP Beliefs & EBP Competence, Evidence-based Decision Making by Characteristics (N=184)
Variables Categories n Knowledge management EBP beliefs EBP competency Evidence-based decision making
M±SD F or t (p) Scheffé M±SD F or t (p) Scheffé M±SD F F or t (p) Scheffé M±SD F or t (p) Scheffé
Age (year) 　 21~30a 86 3.43±0.49 9.02 3.34±0.37 1.62 2.45±0.60 6.29 3.31±0.47 1.84
31~40b 59 3.53±0.51 (＜.001) 3.36±0.47 (.201) 2.61±0.75 (.002) 3.38±0.59 (.161)
＞41c 39 3.55±0.51 a, b＜c 3.48±0.41   2.90±0.65 a＜c 3.51±0.49  
Level of education 　 Collegea 38 3.41±0.47 6.07 3.26±0.38 10.91 2.30±0.61 23.28 3.23±0.44 10.30
BSNb 69 3.45±0.47 (.003) 3.26±0.34 (＜.001) 2.36±0.56 (＜.001) 3.24±0.52 (＜.001)
MSN & PhDc 77 3.55±0.51 a, b＜c 3.54±0.44 a, b＜c 2.96±0.64 a, b＜c 3.57±0.49 a, b＜c
Clinical experience (year) 　 ≤5a 59 3.43±0.50 11.07 3.34±0.34 1.60 2.45±0.58 4.63 3.30±0.50 1.90
＞5~10b 45 3.45±0.49 (＜.001) 3.40±0.43 (.191) 2.47±0.73 (.004) 3.35±0.52 (.132)
＞10~20c 48 3.55±0.48 a a, b, c＜d 3.31±0.48   2.66±0.72 a, b＜d 3.37±0.56  
≥20d 32 3.90±0.45   3.50±0.38   2.95±0.60   3.56±0.48  
Position Staff nurse 146 3.47±0.50 -4.25 3.35±0.41 -2.06 2.51±0.67 -3.41 3.32±0.52 -2.78
Charge & unit 38 3.85±0.44 (＜.001) 3.50±0.39 (.041) 2.92±0.59 (.001) 3.58±0.49 (.006)
manager                  
Research experience Yes 90 3.70±0.47 4.23 3.48±0.40 3.49 2.85±0.65 5.40 3.53±0.49 4.00
No 94 3.40±0.50 (＜.001) 3.28±0.40 (.001) 2.35±0.61 (＜.001) 3.23±0.52 (＜.001)
Membership of academic society Yes 34 3.80±0.47 3.30 3.51±0.42 2.15 2.83±0.69 2.28 3.59±0.48 2.69
No 150 3.49±0.50 (.001) 3.35±0.41 (.033) 2.54±0.67 (.024) 3.33±0.52 (.008)
Awareness of EBP Yes 146 3.63±0.49 4.42 3.44±0.41 4.40 2.68±0.68 3.34 3.46±0.50 4.58
No 38 3.24±0.46 (＜.001) 3.13±0.34 (＜.001) 2.28±0.96 (.001) 3.05±0.46 (＜.001)
Knowledge of EBP Not at alla 11 3.24±0.68 4.94 3.03±0.30 15.75 2.04±0.59 24.77 2.95±0.43 12.36
Only know nameb 80 3.47±0.47 (.008) 3.25±0.38 (＜.001) 2.32±0.55 (＜.001) 3.24±0.52 (＜.001)
Know a little & allc 93 3.65±0.50 a＜c 3.52±0.39 a, b＜c 2.90±0.65 a, b＜c 3.54±0.46 a, b＜c
EBP education in hospital Yes 38 3.83±0.37 4.97 3.61±0.33 3.99 2.98±0.55 4.12 3.69±0.39 5.17
No 146 3.47±0.52 (＜.001) 3.32±0.41 (＜.001) 2.50±0.67 (＜.001) 3.29±0.20 (＜.001)
Table 4.
Correlation between Knowledge Management, EBP Beliefs & Competence, Evidence-based Decision Making (N=184)
Variables Knowledge management EBP Beliefs EBP competence
r (p) r (p) r (p)
EBP beliefs .49 (＜.001)    
EBP competence .29 (＜.001) .53 (＜.001)  
Evidence-based decision making .50 (＜.001) .55 (＜.001) .57 (＜.001)
Table 5.
Factors Related to Evidence-based Decision Making. (N=184)
Variables   Model 1 1   Model 2   Model 3 3   Mod del 4  
b β p b β p b β p b β p VIF
Level of education .10 0.09 .307 .03 0.03 .755 -.05 -0.04 .577 -.01 -0.01 1 .929 2.02
Position .02 0.01 .871 .05 0.04 .604 .05 0.04 .570 -.03 -0.02 2 .716 1.52
Research experience .09 0.09 .274 .07 0.07 .325 .03 0.02 .715 -.01 -0.01 .851 1.47
Membership of academic society .10 0.08 .294 .08 0.06 .351 .09 0.07 .276 .04 0.03 3 .630 1.28
Awareness of EBP .20 0.16 .037 .13 0.10 .151 .16 0.12 .062 .11 0.08 .194 1.35
Knowledge of EBP .13 0.13 .117 .05 0.04 .554 -.03 -0.03 .705 00 0.00 0 .946 1.61
EBP education .23 0.18 .017 .14 0.11 .103 .11 0.08 .196 .08 0.06 6 .327 1.28
EBP beliefs       .53 0.42 ＜.001 .37 0.29 ＜.001 .22 0.18 8 .016 1.78
EBP competence             .28 0.37 ＜.001 .29 0.37 7 ＜.001 1.73
Knowledge management                   .28 0.27 7 ＜.001 1.56
R2 (⊿R2) .219 .361 (.141) .438 (.077)   .486 (.048)  
F (p) 7.07 (＜.001) 12.35 (＜.001) 15.09 (＜.001)   16.35 (＜.001)  

Model 1: General·EBP Characteristics; Model 2: General·EBP Characteristics, EBP beliefs; Model 3: General·EBP Characteristics, EBP beliefs, EBP competence; Model 4: General·EBP Characteristics, EBP beliefs, EBP competence, Knowledge management.

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    Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals
    Korean J Adult Nurs. 2016;28(1):83-94.   Published online February 29, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.1.83
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    Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals
    Korean J Adult Nurs. 2016;28(1):83-94.   Published online February 29, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.1.83
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    Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals
    Knowledge Management, Beliefs, and Competence on Evidence-Based Practice, Evidence-Based Decision Making of Nurses in General Hospitals

    General·EBP Characteristics of Subjects (N=184)

    Variables Categories n (%) M±SD Range
    Age (year) 21~30 86 (46.7) 33.62±8.87 23~60
    31~40 59 (32.1)
    ≥41 39 (21.2)
    Level of education College 38 (20.7)
    BSN 69 (37.5)
    MSN & PhD 77 (41.8)
    Clinical experience (year) ≤5 59 (32.1) 10.98±8.79 1~37.75
    ＞5~≤10 45 (24.5)
    ＞10~≤20 48 (26.1)
    ＞20 32 (17.4)
    Position Staff nurse 146 (79.3)
    Charge & unit manager 38 (20.7)
    Research experience Yes 90 (48.9)
    No 94 (51.1)
    Membership of academic society Yes 34 (18.5)
    No 150 (81.5)
    Have you heard EBP? Yes 146 (79.3)
    No 38 (20.7)
    Route to know EBP?† School 75 (40.8)
    Hospital 72 (39.1)
    Academic society 34 (18.5)
    Article 25 (13.6)
    Colleague 15 (8.2)
    Web site 12 (6.5)
    Had EBP education before? Yes 62 (33.7)
    No 122 (66.3)
    Know EBP? Not at all 11 (6.0)
    Only know name 80 (43.5)
    Know a little & know all 93 (50.5)
    Do you feel the need for research evidence? Yes 163 (88.6)
    No 21 (11.4)
    When do you feel the need for evidence?† When teaching other nurse 80 (43.5)
    To be a competent professional 82 (44.6)
    To know exactly about the nursing procedure 78 (42.4)
    When an error occurs in nursing practice 52 (28.3)
    When problem occurs 59 (32.1)
    What do you do when a you have problem in clinical situation?† Browse resources 119 (64.7)
    We ask colleagues Ask the experts 76 (41.3) 33 (17.9)
    Ignore 1 (0.5)
    Have EBP education in hospital? Yes 38 (20.7)
    No/do not know 146 (79.3)

    EBP=evidence-based practice;

    †Multiple response.

    Scores of Knowledge Management, EBP Beliefs, EBP Competence, Evidence-based Decision Making (N=184)

    Variables M±SD
    Knowledge Management 3.55±0.04
    Knowledge-sharing organizational culture 3.70±0.04
    Knowledge management system 3.31±0.05
    in nursing department  
    Innovative leadership 3.56±0.05
    Organizational learning 3.67±0.04
    EBP beliefs 3.38±0.03
    EBP competence 2.60±0.68
    Evidence-based decision-making 3.38±0.52
    Practice based evidence 3.43±0.55
    Patient based evidence 3.53±0.57
    Research based evidence 3.23±0.67
    Resource based evidence 3.31±0.65

    EBP=evidence-based practice.

    Knowledge Management, EBP Beliefs & EBP Competence, Evidence-based Decision Making by Characteristics (N=184)

    Variables Categories n Knowledge management EBP beliefs EBP competency Evidence-based decision making
    M±SD F or t (p) Scheffé M±SD F or t (p) Scheffé M±SD F F or t (p) Scheffé M±SD F or t (p) Scheffé
    Age (year) 　 21~30a 86 3.43±0.49 9.02 3.34±0.37 1.62 2.45±0.60 6.29 3.31±0.47 1.84
    31~40b 59 3.53±0.51 (＜.001) 3.36±0.47 (.201) 2.61±0.75 (.002) 3.38±0.59 (.161)
    ＞41c 39 3.55±0.51 a, b＜c 3.48±0.41   2.90±0.65 a＜c 3.51±0.49  
    Level of education 　 Collegea 38 3.41±0.47 6.07 3.26±0.38 10.91 2.30±0.61 23.28 3.23±0.44 10.30
    BSNb 69 3.45±0.47 (.003) 3.26±0.34 (＜.001) 2.36±0.56 (＜.001) 3.24±0.52 (＜.001)
    MSN & PhDc 77 3.55±0.51 a, b＜c 3.54±0.44 a, b＜c 2.96±0.64 a, b＜c 3.57±0.49 a, b＜c
    Clinical experience (year) 　 ≤5a 59 3.43±0.50 11.07 3.34±0.34 1.60 2.45±0.58 4.63 3.30±0.50 1.90
    ＞5~10b 45 3.45±0.49 (＜.001) 3.40±0.43 (.191) 2.47±0.73 (.004) 3.35±0.52 (.132)
    ＞10~20c 48 3.55±0.48 a a, b, c＜d 3.31±0.48   2.66±0.72 a, b＜d 3.37±0.56  
    ≥20d 32 3.90±0.45   3.50±0.38   2.95±0.60   3.56±0.48  
    Position Staff nurse 146 3.47±0.50 -4.25 3.35±0.41 -2.06 2.51±0.67 -3.41 3.32±0.52 -2.78
    Charge & unit 38 3.85±0.44 (＜.001) 3.50±0.39 (.041) 2.92±0.59 (.001) 3.58±0.49 (.006)
    manager                  
    Research experience Yes 90 3.70±0.47 4.23 3.48±0.40 3.49 2.85±0.65 5.40 3.53±0.49 4.00
    No 94 3.40±0.50 (＜.001) 3.28±0.40 (.001) 2.35±0.61 (＜.001) 3.23±0.52 (＜.001)
    Membership of academic society Yes 34 3.80±0.47 3.30 3.51±0.42 2.15 2.83±0.69 2.28 3.59±0.48 2.69
    No 150 3.49±0.50 (.001) 3.35±0.41 (.033) 2.54±0.67 (.024) 3.33±0.52 (.008)
    Awareness of EBP Yes 146 3.63±0.49 4.42 3.44±0.41 4.40 2.68±0.68 3.34 3.46±0.50 4.58
    No 38 3.24±0.46 (＜.001) 3.13±0.34 (＜.001) 2.28±0.96 (.001) 3.05±0.46 (＜.001)
    Knowledge of EBP Not at alla 11 3.24±0.68 4.94 3.03±0.30 15.75 2.04±0.59 24.77 2.95±0.43 12.36
    Only know nameb 80 3.47±0.47 (.008) 3.25±0.38 (＜.001) 2.32±0.55 (＜.001) 3.24±0.52 (＜.001)
    Know a little & allc 93 3.65±0.50 a＜c 3.52±0.39 a, b＜c 2.90±0.65 a, b＜c 3.54±0.46 a, b＜c
    EBP education in hospital Yes 38 3.83±0.37 4.97 3.61±0.33 3.99 2.98±0.55 4.12 3.69±0.39 5.17
    No 146 3.47±0.52 (＜.001) 3.32±0.41 (＜.001) 2.50±0.67 (＜.001) 3.29±0.20 (＜.001)

    Correlation between Knowledge Management, EBP Beliefs & Competence, Evidence-based Decision Making (N=184)

    Variables Knowledge management EBP Beliefs EBP competence
    r (p) r (p) r (p)
    EBP beliefs .49 (＜.001)    
    EBP competence .29 (＜.001) .53 (＜.001)  
    Evidence-based decision making .50 (＜.001) .55 (＜.001) .57 (＜.001)

    Factors Related to Evidence-based Decision Making. (N=184)

    Variables   Model 1 1   Model 2   Model 3 3   Mod del 4  
    b β p b β p b β p b β p VIF
    Level of education .10 0.09 .307 .03 0.03 .755 -.05 -0.04 .577 -.01 -0.01 1 .929 2.02
    Position .02 0.01 .871 .05 0.04 .604 .05 0.04 .570 -.03 -0.02 2 .716 1.52
    Research experience .09 0.09 .274 .07 0.07 .325 .03 0.02 .715 -.01 -0.01 .851 1.47
    Membership of academic society .10 0.08 .294 .08 0.06 .351 .09 0.07 .276 .04 0.03 3 .630 1.28
    Awareness of EBP .20 0.16 .037 .13 0.10 .151 .16 0.12 .062 .11 0.08 .194 1.35
    Knowledge of EBP .13 0.13 .117 .05 0.04 .554 -.03 -0.03 .705 00 0.00 0 .946 1.61
    EBP education .23 0.18 .017 .14 0.11 .103 .11 0.08 .196 .08 0.06 6 .327 1.28
    EBP beliefs       .53 0.42 ＜.001 .37 0.29 ＜.001 .22 0.18 8 .016 1.78
    EBP competence             .28 0.37 ＜.001 .29 0.37 7 ＜.001 1.73
    Knowledge management                   .28 0.27 7 ＜.001 1.56
    R2 (⊿R2) .219 .361 (.141) .438 (.077)   .486 (.048)  
    F (p) 7.07 (＜.001) 12.35 (＜.001) 15.09 (＜.001)   16.35 (＜.001)  

    Model 1: General·EBP Characteristics; Model 2: General·EBP Characteristics, EBP beliefs; Model 3: General·EBP Characteristics, EBP beliefs, EBP competence; Model 4: General·EBP Characteristics, EBP beliefs, EBP competence, Knowledge management.
    Table 1. General·EBP Characteristics of Subjects (N=184)

    EBP=evidence-based practice;

    Multiple response.

    Table 2. Scores of Knowledge Management, EBP Beliefs, EBP Competence, Evidence-based Decision Making (N=184)

    EBP=evidence-based practice.

    Table 3. Knowledge Management, EBP Beliefs & EBP Competence, Evidence-based Decision Making by Characteristics (N=184)

    Table 4. Correlation between Knowledge Management, EBP Beliefs & Competence, Evidence-based Decision Making (N=184)

    Table 5. Factors Related to Evidence-based Decision Making. (N=184)

    Model 1: General·EBP Characteristics; Model 2: General·EBP Characteristics, EBP beliefs; Model 3: General·EBP Characteristics, EBP beliefs, EBP competence; Model 4: General·EBP Characteristics, EBP beliefs, EBP competence, Knowledge management.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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