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

In-Sook Jang; Myonghwa Park

doi:10.7469/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

In-Sook Jang, Myonghwa Park

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

DOI: https://doi.org/10.7469/kjan.2016.28.1.83

College of Nursing, Chungnam National University, Daejeon, Korea

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

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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Abstract
REFERENCES

Abstract

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)
Position	Charge & unit manager	38 (20.7)
Research experience	Yes	90 (48.9)
Research experience	No	94 (51.1)
Membership of academic society	Yes	34 (18.5)
Membership of academic society	No	150 (81.5)
Have you heard EBP?	Yes	146 (79.3)
Have you heard EBP?	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)
Had EBP education before?	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)
Do you feel the need for research evidence?	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)
Have EBP education in hospital?	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
Variables	Categories	n	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)	21~30^a	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
	31~40^b	59	3.53±0.51	(＜.001)	3.36±0.47	(.201)	2.61±0.75	(.002)	3.38±0.59	(.161)
	＞41^c	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	College^a	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
	BSN^b	69	3.45±0.47	(.003)	3.26±0.34	(＜.001)	2.36±0.56	(＜.001)	3.24±0.52	(＜.001)
	MSN & PhD^c	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)	≤5^a	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
	＞5~10^b	45	3.45±0.49	(＜.001)	3.40±0.43	(.191)	2.47±0.73	(.004)	3.35±0.52	(.132)
	＞10~20^c	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
	≥20^d	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
Research experience	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
Membership of academic society	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
Awareness of EBP	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 all^a	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 name^b	80	3.47±0.47	(.008)	3.25±0.38	(＜.001)	2.32±0.55	(＜.001)	3.24±0.52	(＜.001)
	Know a little & all^c	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
EBP education in hospital	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
Variables	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
Variables	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

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

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)
Position	Charge & unit manager	38 (20.7)
Research experience	Yes	90 (48.9)
Research experience	No	94 (51.1)
Membership of academic society	Yes	34 (18.5)
Membership of academic society	No	150 (81.5)
Have you heard EBP?	Yes	146 (79.3)
Have you heard EBP?	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)
Had EBP education before?	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)
Do you feel the need for research evidence?	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)
Have EBP education in hospital?	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
Variables	Categories	n	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)	21~30^a	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
	31~40^b	59	3.53±0.51	(＜.001)	3.36±0.47	(.201)	2.61±0.75	(.002)	3.38±0.59	(.161)
	＞41^c	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	College^a	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
	BSN^b	69	3.45±0.47	(.003)	3.26±0.34	(＜.001)	2.36±0.56	(＜.001)	3.24±0.52	(＜.001)
	MSN & PhD^c	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)	≤5^a	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
	＞5~10^b	45	3.45±0.49	(＜.001)	3.40±0.43	(.191)	2.47±0.73	(.004)	3.35±0.52	(.132)
	＞10~20^c	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
	≥20^d	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
Research experience	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
Membership of academic society	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
Awareness of EBP	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 all^a	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 name^b	80	3.47±0.47	(.008)	3.25±0.38	(＜.001)	2.32±0.55	(＜.001)	3.24±0.52	(＜.001)
	Know a little & all^c	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
EBP education in hospital	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
Variables	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
Variables	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)

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)

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