In 2024, the Nursing Research Advisory & Networking Team (A.N.T.) of the Colorado Nurses Association (CNA) conducted a brief online evidence-based practice (EBP) needs assessment of Colorado nurses. EBP is defined as the application of research findings and other types of evidence into nursing practice. The goal was to evaluate the EBP values and priorities of nurses as a means of identifying potential focal areas for the Research A.N.T. Brief assessments such as this help to ensure that CNA initiatives align with the needs of Colorado nurses. The purpose of this report is to disseminate the procedures and results of the needs assessment accompanied by professional EBP recommendations from the Research A.N.T.

Needs Assessment Procedures

An invitation to participate in the assessment was issued to all CNA members, as well as non-members, via email, the CNA website, and social media in June 2024. A reminder was sent two weeks later. The Nursing Evidence-Based Practice Survey^© (NEPBS) from University of Iowa Health Care was selected as the data collection instrument and used with permission. This reliable and valid instrument assesses perceptions of EBP culture in the workplace across 29 items using a Likert scale ranging from strongly disagree (1) to strongly agree (4). Higher scores indicate a stronger EBP culture. The Research A.N.T. reduced the Likert scale from 5 to 4 points in anticipation of a small sample size and to reduce variability. In addition to basic demographic questions, a question about ranking EBP priorities in Colorado and two open-ended questions about facilitators and barriers to EBP were developed by the team and included at the end of the survey. The survey was open for a period of 28 days. Basic descriptive analyses of the demographic and NEPBS data were completed using Qualtrics Survey Software. Analyses of open-text responses were conducted by the Research A.N.T using basic content analysis procedures.

Findings

Out of 58 participants, 52 were practicing nurses in Colorado and completed the survey. Most worked in outpatient care, community/public health, nursing education, or acute care. Nearly 70% had a master’s degree or higher, and 33% were advanced practice nurses. Participants averaged 26 years of experience, with a range of 5 to 53 years.

Most participants agreed or strongly agreed with the majority of the NEBPS statements about valuing EBP including recognizing it as being important to their work, having a willingness to try out new innovations, and knowing where to find new evidence. While just over half of participants (51%) reported that they participated in data collection for research, larger numbers participated in data collection for quality improvement (70%) and EBP projects (58%). Over 80% of participants indicated that having someone to assist with literature searches and obtain research articles would increase the effectiveness of their EBP. Another 74% agreed or strongly agreed that having a journal club at their place of employment to discuss nursing research findings would be helpful. Overall, participants reported feeling mostly confident in their ability to interpret and evaluate research reports but were less sure about how to implement EBP into their practice and organizational protocols (see Table 1 for complete NEBPS results).

Participants were then asked “Based on your experience as a nurse in Colorado, what areas of nursing practice do you feel would benefit the most from evidence-based practice efforts? Select your top three priorities.” The results are displayed below:

What areas of nursing practice do you feel would benefit the most from evidence-based practice efforts

Safe staffing and nurse-to-patient ratios were selected as being a top priority for 44% of participants. A similar percentage (42%) of nurses identified healthcare disparities/inequities as being a priority followed by burnout/moral distress/compassion fatigue and nurse retention/satisfaction. Participants were also given the opportunity to suggest other priorities. Four areas were identified: (1) public health nursing, (2) scope of practice issues for CNAs and LPNs in acute care, (3) the need for specialty/affinity nursing groups, and (4) generative AI in nursing practice.

Lastly, participants were asked to provide brief open-text responses to describe the barriers and facilitators to EBP being successful in their workplace. The most identified barriers were:

• Lack of time to investigate, implement, and evaluate EBP given the typical nursing workload.
• Lack of support (both logistical and financial) from leadership/administration to implement EBP.
• Limited access to EBP journals and other resources.
• Resistance to change from either individual colleagues or at the organizational level.

The biggest facilitators to the successful integration of EBP into the workplaces of participants were:

• Having strong nursing leadership with advanced degrees or specialty training in EBP.
• Access to current evidence and support from leadership/administration to instigate change.
• Sustaining motivation by clearly linking EBP with improvements to patient outcomes and safety.
• Building an EBP culture of inquiry and lifelong learning within the unit or organization.

Recommendations

Based on these needs assessment findings, the Research A.N.T. recommends the following to CNA and all other healthcare organizations to increase EBP implementation support for Colorado nurses:

Offer in-person and virtual workshops on EBP topics tailored to the requests of nursing units or organizations.

Develop training for nurse leaders on the benefits of supporting EBP among their nursing staff as well as effective strategies for creating a culture of inquiry and lifelong learning.

Facilitate a monthly online journal club open to nurses across Colorado accompanied by collective brainstorming on how to implement best practices into their setting.

Offer EBP participation certificates from CNA to encourage attendance and enhance nurses’ and nurse leaders’ professional record.

Conclusion

Although the sample size for this needs assessment was small and does not reflect the complete needs and priorities for the approximately 81,000 nurses in Colorado, it provides a glimpse into some of the current EBP issues in practice. The survey findings suggest that Colorado nurses understand the value of EBP and want to utilize evidence to improve outcomes for both the profession and the patients, families, and communities we serve. Although nurses can largely interpret published evidence, access may be limited and the time it takes to investigate, implement, and sustain EBP is often restricted by organizations and workload demands. Some nurses and organizations may be resistant to change, while others find EBP to be motivating and rewarding. The survey findings suggest that Colorado nurses are acutely aware of complex issues such as staffing ratios and health inequity that can be addressed using EBP approaches.

Authors

Natalie Pool, PhD, RN, CNE | University of Northern Colorado, School of Nursing
Kenneth Oja, PhD, RN | University of Colorado, College of Nursing & Denver Health, Nursing Education and Research Department
Mona Hebeshy, PhD, RN | University of Northern Colorado, School of Nursing