Impact of an Organizational Climate for Evidence-Based Practice on Evidence-Based Practice Behaviour among Nurses: Mediating Effects of Competence, Work Control, and Intention for Evidence-Based Practice Implementation

Abstract

Background: Despite the emphasis on the importance of implementing evidence-based practices, nurses did not adopt this approach as a standard. For those who have attempted to implement evidence-based practice in health care settings, the behaviour is rarely simple or straightforward. Therefore, exploring the mechanism that motivates nurses' evidence-based practice behaviour is essential to promote this practice.

Aims: The aim of this study was to investigate the effect of the organizational climate for evidence-based practice on evidence-based practice behaviour among nurses through the mediating role of evidence-based practice competence, work control, and the intention to implement evidence-based practice.

Methods: This study consisted of a cross-sectional design and convenience sampling to recruit 641 nurses employed in 6 hospitals in China. Five self-report instruments were used to collect the data. A structural equation model was adopted to verify the research hypotheses. IBM SPSS 26.0 and AMOS 24.0 were used for statistical analysis of the data.

Results: The organizational climate for evidence-based practice was significantly and positively related to the nurses' evidence-based practice behaviour (p < 0.01). Direct effects accounted for 45.93% of the total effect. Evidence-based practice competence, work control, and the intention to implement evidence-based practice partially mediated the association between the organizational climate and evidence-based practice behaviour. The indirect effect accounted for 54.07% of the total effect.

Conclusion: The organizational climate for evidence-based practice is critical for predicting and enhancing evidence-based practice behaviour. Evidence-based practice competence, work control, and the intention to implement evidence-based practice are intervening mechanisms that explain how the organizational climate promotes evidence-based practice behaviour. Implications for Nursing Management. Nursing managers should be aware of the interaction of individual and organizational factors that influence evidence-based practice behaviours among nurses. Administrators should improve the organizational climate by providing nurses with cultural and team support, mentoring, training projects, resource provisions, and more autonomy and authority at work, which are beneficial to the nurses' evidence-based practice competence, work control, and intentions to adopt evidence-based practices.

Figure 1

The hypothesized study model. This model presents hypothetical relationships among the variables. Note. “+” = positive correlation; EBP, evidence-based practice.

Figure 2

Mediation model. This model describes the paths between the variables and shows the standardized path coefficients. Note. EBP, evidence-based practice.