Advanced practice nurses' evidence-based healthcare competence and associated factors: A systematic review

BackgroundEvidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC.AimTo identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors.DesignA systematic review.Data SourcesCINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar.MethodsDatabases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis.ResultsThe review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies.ConclusionThe development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs.Implications for the ProfessionWe should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice.Registration, and Reporting ChecklistThe review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist.Patient/Public ContributionNone.