Uptake of evidence-based practice and its predictors among nurses in Ethiopia: a systematic review and meta-analysis

Abstract

Background: While evidence-based practice has demonstrated its capacity to enhance healthcare quality and bolster clinical outcomes, the translation of research into clinical practice encounters persistent challenges. In Ethiopia, there remains a dearth of comprehensive and nationally representative data concerning the extent of Evidence-based practice adoption among nurses. Thus, this systematic review and meta-analysis endeavors to assess the overall prevalence of Evidence-based practice implementation and delve into its determinants among Ethiopian nurses. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines. In order to identify pertinent studies, a search was conducted across PubMed, Scopus, Google Scholar, and EMBASE databases. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence. Cochrane's Q-test and I² statistics were calculated to assess heterogeneity among studies. Funnel plots and Egger's test were utilized to evaluate publication bias. Pooled implementation rates and meta-regression analysis were carried out using STATA 17. Results: Of the total 1,590 retrieved articles, twelve studies including 4,933 nurses were included in the final analysis. The pooled prevalence of Evidence-based practice uptake among nurses in Ethiopia is 53% (95% CI: 46%-60%). Having knowledge about Evidence-based practice (AOR = 2.29; 95% CI: 1.90, 2.69; I² = 70.95%), holding a favorable attitude towards Evidence-based practice (AOR = 2.56; 95% CI: 1.63, 3.49; I² = 88.39%), occupying a head nurse position (AOR = 3.15; 95% CI: 1.85, 4.46; I² = 87.42%), possessing effective communication skills (AOR = 4.99; 95% CI: 1.47, 8.51; I² = 99.86%), and having access to Evidence-based practice guidelines (AOR = 1.90; 95% CI: 1.55, 2.24; I² = 57.24%) were identified as predictors of the uptake of Evidence-based practice. Conclusion: Only half of Ethiopia's nurses exhibit a strong embrace of Evidence-Based Practice within clinical settings, underscoring the urgent necessity for coordinated endeavors to cultivate this essential practice. Possessing knowledge, effective communication skills, access to updated guidelines, maintaining a positive attitude towards Evidence-Based Practice, and holding a position as head nurse emerged as predictors of successful implementation of Evidence-Based Practice. Hence, policymakers must prioritize capacity-building initiatives, disseminate the latest EBP guidelines widely, and strengthen mentorship roles for head nurses. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CRD42023488943.

Keywords: Ethiopia; evidence based practice; meta-analysis; nurses; predictors; systemic review; uptakes.

FIGURE 1

Study selection for systemic review and meta-analysis of evidence-based practice uptake and associated factors among nurses in Ethiopia, 2024.

FIGURE 2

Pooled magnitude of uptake of EBP among nurses in Ethiopia, 2024.

FIGURE 3

Egger test for analysis of publication bias for EBP uptake among nurses in Ethiopia, 2024.

FIGURE 4

Doi plot for Reporting bias and certainty of evidence for EBP uptake among nurses in Ethiopia, 2024.

FIGURE 5

Sensitivity analysis for EBP implementation among nurses in Ethiopia, 2024.