Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study

BACKGROUND Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. METHODS A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. RESULTS Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6-7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7-2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4-2.0). CONCLUSIONS To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.