Construction Of Evidence-Based Nursing Training Program For Clinical Nurses With Master’s Degree Based On Gagne’s "Nine And Five Matrix" Model

ObjectiveTo investigate the status quo of knowledge,attitude and practice(KAP)of evidence-based nursing(EBN)in clinical nurses with master degree,to identify the weak links and to explore the influencing factors of EBN practice.Based on questionnaire survey,literature review and Gagne ’s "nine-five matrix" model,this paper constructs an evidence-based nursing training program for clinical nurses with master’ s degree to provide reference for managers to carry out targeted evidence-based nursing training.Methods1.Questionnaire survey:This study selected 200 clinical nurses with master degree from 6 general hospitals in Shandong Province by convenience sampling method.The status quo and influencing factors of evidence-based nursing of clinical nurses with master degree were analyzed by general information questionnaire,Evidence-Based Practice Knowledge,Attitude and Behavior Questionnaire(EBPQ)and EvidenceBased Practice Barriers Scale,descriptive statistics,t-test,ANOVA,Pearson correlation analysis and multiple linear regression analysis.2.Literature research: system retrieves evidence-based nursing training related literature published at home and abroad,to include induction,analysis of literature,refining the key content of evidence-based nursing training,provide the basis for establishing training scheme.3.Delphi expert enquiry method: according to the inclusion criteria selected topic related two rounds of expert enquiry for 15 experts,combined index selection criteria,revision,for each entry to form the final version of the master’s degree in clinical evidence-based nursing training programs.Results1.Questionnaire survey: 210 questionnaires were sent out and 200 effective questionnaires were recovered,the effective recovery rate of questionnaire was 95%.The total score of the scale of evidence-based nursing knowledge,attitude and practice of 200 clinical nurses with master’s degree was(109.63±9.72)points,and the total score was(4.56±0.41)points,which was in the middle level.Scores of each dimension:Evidence-based practice behavior(4.24±0.55),evidence-based practice attitude(5.90±0.55),evidence-based knowledge and skills(4.21±0.47).The total score of EBP scale for master degree nurses was(92.33±9.54),and the average total score was(3.08±0.32).The scores of each dimension from high to low are as follows: The scores of timeliness and systematicness of research report,resource condition of evidence-based nursing,quality of scientific literature and subjective attitude and ability of nurses to implement evidence-based nursing were(3.58±0.44),(3.52±0.48),(2.82±0.58)and(2.37±0.59)respectively.Pearson linear correlation analysis showed that the knowledge,attitude and practice of evidence-based nursing and its dimensions were negatively correlated with the obstacles of evidence-based practice and its dimensions.Univariate analysis showed that total working years,first educational background,degree type,training mode,English grade,medical statistic level,whether have studied evidence-based nursing courses,received evidence-based nursing training,carried out evidence-based nursing projects,applied for successful scientific research projects,necessity of carrying out evidence-based nursing in clinical practice,number of English literatures read per month are that main factors influencing evidence-based practical knowledge,attitude,The influencing factors of behavior(P<0.05).Multiple linear regression analysis showed that the main influencing factors of EBP knowledge,attitude and behavior of clinical nurses with master’s degree were training mode,necessity of developing EBP in clinical nursing,having studied EBP courses,having applied for scientific research projects successfully,timeliness and systematicness of research reports,subjective attitude and ability of nurses to EBP(P<0.05).2.Into 21 articles in this research,inductive analysis after extracting evidence-based nursing training programs of the six elements and content: training objectives(three themes,item 9),the training object(three themes,item 4),the training content(22)and seven modules,item(3),training teachers,training method(item 6),training effect evaluation(two themes,item 6).3.Delphi method: 15 experts participated in the two rounds of expert consultation.The effective response rate of questionnaire was 88.24% and 100%,the expert opinion rate was 86.67% and 26.67%,the expert authority coefficient was 0.92,the Kendall coefficient of harmony(W)was 0.240～0.508 in the first round and 0.351～0.533 in the second round(P<0.001).Finally,the evidence-based nursing training program for clinical nurses with master’s degree was formed,which covered six modules: training objectives,training objects,training process and content,training cycle,training teachers and training forms,including 6 first-level indicators,21 second-level indicators and 62third-level indicators.Conclusions1.The total score of the clinical nurses with master’s degree in this study was in the middle level,and the attitude towards EBN was positive,but the level of EBN knowledge,skills and practice should be improved.It was suggested that nursing managers should pay attention to the training of clinical nurses with master’s degree,encourage nurses to actively carry out evidence-based nursing practice and promote the development of evidence-based nursing.2.Based on Gagne’s “nine-five matrix” model,this study constructed a training program of evidence-based nursing for clinical nurses with master’s degree through questionnaire,literature review and Delphi method,which included six parts: training objectives,training objects,training process and content,training period,training teachers and training forms.The results are scientific,reliable and practical,and can provide reference for the hospital to carry out evidence-based nursing training for clinical nurses with master’s degree.