Evidence-based practice implementation among nurses in Siltie Zone hospitals

In a 2023 cross-sectional study of nurses employed at public hospitals in Ethiopia’s Siltie Zone, 54.5% were classified as having poor implementation of evidence-based practice, while 45.5% had good implementation. The study analyzed questionnaire responses from 337 nurses and identified several measured factors associated with implementation, including age, education, working unit, question-formulation ability, and perceived relevance of the approach to nursing.

Evidence-based practice uses the best available research evidence, clinical experience, and patient preferences in clinical decision-making. The researchers assessed its implementation among nurses in Siltie Zone, South Central Ethiopia, between March 6 and April 5, 2023. The institution-based study focused on nurses working in public hospitals within the zone rather than on clinical outcomes or patients receiving care.

Data were collected with a self-administered, semistructured questionnaire. Investigators cleaned and coded the responses in EpiData version 4.6, exported them to SPSS version 26, and used binary logistic regression to assess relationships between evidence-based practice implementation and candidate predictors. Variables with p-values below 0.25 entered the multivariable model, where p below 0.05 was considered statistically significant. Adjusted odds ratios and 95% confidence intervals quantified the associations remaining in that model.

Nurses aged 26 to 30 had higher odds of good implementation than the study’s reference group, with an adjusted odds ratio of 5.247 and a 95% confidence interval of 1.249 to 22.047. Educational level was also associated with the outcome. Compared with the reference category, nurses with a bachelor’s degree had an adjusted odds ratio of 1.956 (95% CI 1.035–3.698), while those with a master’s degree had an adjusted odds ratio of 4.149 (95% CI 1.088–15.817).

The study also found associations with working unit. Nurses in emergency units had higher odds of good implementation than the reference group, with an adjusted odds ratio of 3.935 (95% CI 1.300–11.914). Nurses assigned to inpatient units had an adjusted odds ratio of 4.684 (95% CI 1.633–13.435). These estimates describe differences between groups after adjustment for other variables included in the multivariable model; they do not show that assignment to either unit caused stronger implementation.

Question-formulation ability was associated with good implementation. Nurses able to formulate a question had an adjusted odds ratio of 1.844 (95% CI 1.062–3.201) for good implementation relative to the reference group. In contrast, nurses who considered evidence-based practice not relevant to the nursing profession had lower odds of good implementation, with an adjusted odds ratio of 0.459 (95% CI 0.236–0.878). The reported analysis did not establish why these associations occurred.

Confidence intervals for the age, master’s-degree, emergency-unit, and inpatient-unit estimates were relatively wide, indicating uncertainty around the adjusted odds ratios. The cross-sectional design also limited the study’s ability to establish temporal sequence or causation. Although the questionnaire assessed implementation, the supplied findings do not establish whether research evidence was applied in individual clinical decisions or whether implementation affected patient outcomes.

Overall, the results show that more than half of the participating nurses were classified as having poor evidence-based practice implementation in the sampled Siltie Zone public hospitals. The authors concluded that a multistakeholder approach is needed to address the identified contributing variables and promote implementation. The study itself did not test a multistakeholder intervention, professional-development program, or other proposed solution, so it does not establish which approach would improve implementation.

Subject of Research: Evidence-based practice implementation and associated factors among nurses in Siltie Zone public hospitals

Article Title: Evidence-based practice implementation and associated factors among nurses employed at public hospitals in Siltie Zone, South Central Ethiopia: A cross-sectional study

Article References: Ahmed, S. S., Gebresillassie, A. M., Bekele, T. T., & Mekonnen, H. A. (2026). Evidence-based practice implementation and associated factors among nurses employed at public hospitals in Siltie Zone, South Central Ethiopia: A cross-sectional study. PLOS One, 21(10), e0357626. https://doi.org/10.1371/journal.pone.0357626

Image Credits: AI Generated

DOI: 10.1371/journal.pone.0357626

Keywords: evidence-based practice, nurses, Ethiopia, Siltie Zone, public hospitals, cross-sectional study, nursing implementation, clinical decision-making, question formulation, adjusted odds ratios, Evidence-based, practice