Influence Of Critical Appraisal Skills On Evidence-Based Nursing Practice Among The Clinial Nurses

Objective:To explore the status and the influencing factors of critical appraisal skills of evidence-based nursing among clinical nurses, to confirm the effect of critical appraisal skills on evidence-based practice, and to analysis the critical appraisal skills training demand aiming to develop the critical appraisal skills interventions among clinical nurses.Methods:Clinical nurses were selected as subjects in the present study from three level-A hospital s in Jilin Province. General characteristic questionnaire,GSES, EBPQ, evidence-based nursing prac tice intention questionnaire, critical appraisal skills training demand questionnaire and critical appr aisal skills assessment tool. T test and ANOVA were deformed toanalyses for critical appraisal skill s,andevidence-based nursing practice.Pearson correlation analysis was used between to examineto fcritical appraisal skills,self-efficacy,evidence-based nursing practice intention,and evidence-base d nursing practice.The regression was conducted to explore of critical appraisal skills, self-efficac y, evidence-based nursing practice intention on evidence-based nursing practice.Results:(1) The average score of critical appraisal skills awong the subjects were (10.55±2.03), There were no significances between different age group, working life, positional titles, and duties of clinical nurses. And the differences between varied departments, whether received evidence-based nursing training experience(t=43.353,p=0.000)andevidence-based nursing experience (t=32.543,p=0.000).(2) The average score of evidence-based nursing practice was(4.22±0.91). The univariate analyses showed that, there were no significant differevce of evidence-based nursing practice between different age group, working life, and departments of clinical nurses. And the differences between whether received evidence-based nursing training experience(t=25.138, p=0.000) or evidence-based nursing experience(t=22.323,p=0.000).(3) The interaction effect between evidence-based nursing training experience and evidence-based nursing experience had negative effect on critical appraisal skills(Beta=-6.510, p=0.000). Self-efficacy had positive effect on critical appraisal skills and the above two factors could explain7.0% of critical appraisal skills.(4) Stratified regression amalyes showed that, Self-efficacy(Beta=8.013,p=0.000), evidence-based nursing practice intention(Beta= 12.453, p=0.000), and critical appraisal skills (Beta=6.823, p=0.000) were signifcant prodictors of evidence-based nursing practice.(5) There was 83.6% clinical nurseswho demand the critical appraisal skills training, and 8.6% of them showed more intensely demand. The Logistics regression ofshowed that, critical appraisal skills(Beta=6.823,p=0.000) was significant predictor training demand(OR=1.151,P=0.047).(6) The top demand training contents of the clinical nurses were the production of evidence was in the top place critical appraisal skills of case-control studies, the comprehension evaluation of evidence, the critical appraisal skills of descriptive studies, and the level of evidence. In the present study, about 449 clinical nurses selected workshop as the first favor style, while no more than half of the subjects selected the internet way. The most favorite training site was in the hospital(40.6%), in the department(22.5%) and a national training(11.8%). There were one third clinical nurses who selected 3 to 5 days, and 1/3 of tiem selected 6 to 9 days as the favorite training time.Conclusion:(1) The critical appraisal skill status and the evidence-based nursing practice of clinical nurses were not satisfied.(2) The interaction effect between evidence-based nursing training experience and evidence-based nursing experience had significand effect critical appraisal skills.(3) EBN practice intention and critical appraisal skillswere the important predutors ofEBN practice of the clinical nurses.(4)The demands of critical appraisal skill training demand among clinical nurses was high, and the training about RCT in the future. The training program can combine the using of internet. And in the early stage, the training should be carried out for most of the clinical nurses and in the progress stage the training should focus on national high-quality training.