Evidence-based practice among Danish cardiac nurses: a national survey

Aims. This paper presents a survey of evidence-based practice among cardiac nurses exploring nurses' attitudes towards evidence-based practice and the types of knowledge they employ in clinical practice. Background. Research utilization and evidence-based practice are required at hospitals around the world, although the definition of evidence-based practice is still unclear. An ongoing debate exists about the sources of knowledge and the hierarchy of research evidence in clinical practice, and nursing research has been threatened by the dominance of randomized controlled trials. Evidence-based practice has been described as a new paradigm, which promotes patient-centred care by integrating external evidence and patient preferences. Methods. The study was a cross-sectional survey with a descriptive and comparative design, using self-administered postal questionnaires. The questionnaires were sent to 33 head nurses and 51 bedside nurses representing one or two units in each cardiac department in Denmark (n = 28). The final response rate was 81%. The study was carried out in 2004. Results. Respondents had a positive attitude towards evidence-based practice, although they relied upon personal clinical experience. Head nurses were statistically significantly more familiar with the concept of evidence-based practice than bedside nurses, and read scientific journals more frequently. Introductory courses to evidence-based practice are rare and seldom mandatory, and the data suggest that respondents lacked knowledge of the finer points of evidence-based practice and equated the concept with research utilization. Conclusion. Barriers to evidence-based practice are inadequate education, unfamiliarity with English, and low organizational position. Facilitators include the implementation of guidelines, provision of continuing education, and an increase in the accountability of bedside nurses.