Evidence-Based Practice Implementation Scale

Instrument Author:

Melnyk, B. M

Source title:

The evidence‐based practice beliefs and implementation scales: psychometric properties of two new instruments

Source:

Melnyk, B. M., Fineout‐Overholt, E., & Mays, M. Z. (2008). The evidence‐based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews on Evidence‐Based
Nursing, 5(4), 208‐216.

Source Author:

Melnyk, B. M., Fineout‐Overholt, E., Mays, M. Z.

Journal Name:

Worldviews on Evidence‐Based Nursing

Volume:

5

Issue/Part:

4

Year:

2008

Pagination:

208-216

Abstract:

BACKGROUND: Implementation of evidence‐based practice (EBP) by health professionals is a key strategy for improving health care quality and patient outcomes as well as increasing professional role satisfaction.
Improvement Science Research Network www.ISRN.net However, it is estimated that only a small percentage of nurses and other health care providers are consistently using this approach to clinical practice. AIM: The aim of this study was to report on the development and psychometric properties of two new scales: (1) the 16‐item EBP Beliefs Scale that allows measurement of a person's beliefs about the value of EBP and the ability to implement it, and (2) the 18‐item EBP Implementation Scale that allows measurement of the extent to which EBP is implemented. METHODS: Nurses (N= 394) attending continuing education workshops volunteered to complete the scales. Data were analyzed to evaluate reliability and validity of both instruments. RESULTS: Cronbach's alpha was > .90 for each scale. Principal components analysis indicated that each scale allowed measurement of a unidimensional construct. Strength of EBP beliefs and the extent of EBP implementation increased as educational level increased (p < .001) and as responsibility in the workplace increased (p < .001). CONCLUSION: In this study, initial evidence was provided to support the reliability and validity of the EBP Beliefs and Implementation
Scales in a heterogeneous sample of practicing nurses. EVIDENCE TO ACTION: Use of the scales in future research could generate evidence to guide EBP implementation strategies in practice and education. Results
could establish the extent to which EBP is being implemented and its effect on clinician satisfaction and patient outcomes.

Descriptors:

Number of questions:

18 Items

Response Options:

5-point frequency scale

Validity:

Face and Content Validity were assessed in early drafts of the instruments. The article describes construct and
criterion validity. Researchers should review article for full details of psychometric properties estimates.

Reliability:

Internal Consistency Reliability showed a Cronbach alpha that exceeded 0.85 for each of the scales.

Subscale/Factors:

n/a

Sample Descriptors:

Adult

Nurses

Sample Items:

Shared evidence from a research study with a multidisciplinary team member.

Measure Descriptors:

Implementation of EBP.

References:   

1. American Association of Critical Care Nurses. (2004). Position statement on nursing research. Retrieved May 28, 2008, from http://www.aacn.nche.edu/Publications/ positions/NsgRes.htm.
2. Arora N.K., Avanian J.Z. & Guadagnoli E. (2005). Examining the relationship of patients’ attitudes and beliefs with their self‐reported level of participation in medical decision‐making. Medical Care, 43(9), 865–872.
3. Balas E.A. & Boren S.A. (2000). Managing clinical knowledge for healthcare improvements. In V. Schattauer (Ed.), Yearbook of medical informatics (pp. 65–70). New York: Stuttgart.
4. Carver C.S. & Scheier M.F. (1982). Control theory: A useful conceptual framework for personality‐social, clinical, and health psychology. Psychological Bulletin, 92, 111–135.
5. Carver C.S. & Scheier M.F. (1998). On the self‐regulation of behavior. Cambridge, UK: Cambridge University Press. Ciliska D. (2005). Educating for evidence‐based practice. Journal of Professional Nursing, 21(6), 345–350.
6. Ciliska D., Chambers L., Hayward S., James M. & Underwood J. (1996). Increasing evidence‐based decisions about public health interventions. Canadian Journal of Public Health, 87(6), 376, 410.
7. Eccles M., Grimshaw J., Walker A., Johnston M. & Pitts N. (2005). Changing the behavior of healthcare professionals: The use of theory in promoting the uptake of research findings. Journal of Clinical Epidemiology, 58(2), 113–116.
8. Fineout‐Overholt E., Melnyk B.M. & Schultz A. (2005). Transforming health care fromthe inside out: Advancing evidence‐based practice in the 21st century. Journal of Professional Nursing, 21(6), 335–344.
9. Goodwin L.D. (2002). Changing conceptions of measurement validity: An update on the new standards. Journal of Nursing Education, 41, 100–106.
10. Greiner A. & Knebel E. (2003). Health professions education: A bridge to quality.Washington, DC: National Academic Press.
11. Grimshaw J., Eccles M., Thomas R., MacLennan G., Ramsay C., Fraser C. & Vale L. (2006). Toward evidencebased quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. Journal of General Internal Medicine, 21(Suppl. 2), S14–S20.
12. Hakstian A.R., Rogers W.D. & Cattell R.B. (1982). The behavior of numbers of factors rules with simulated data. Multivariate Behavioral Research, 17, 193–219.
13. Heater B., Becker A. & Olsen R. (1988). Nursing interventions and patient outcomes: A meta‐analysis of studies. Nursing Research, 37, 303–307.
14. Hutchinson A.M. & Johnston L. (2006). Beyond the barriers scale: Commonly reported barriers to research use. Journal of Nursing Administration, 36(4), 189–199.
15. Kajermo K.N., Nordstrom G., Krusebrant A. & Bjorvell H. (2000). Perceptions of research utilization: Comparisons between health care professionals, nursing students and a reference group of nurse clinicians. Journal of Advanced Nursing, 31(1), 99–109.
16. Larrabee J.H., Janney M.A., Ostrow C.L., Withrow M.L., Hobbs G.R. Jr. & Burant C. (2003). Predicting registered nurse job satisfaction and intent to leave. Journal of Nursing Administration, 33, 271–283.
17. Levin R., Vetter M.J., Fineout‐Overholt E., Melnyk B.M. & Barnes M. (2007). Advancing research and clinical practice through close collaboration (ARCC): A pilot test of an intervention to improve evidence‐based care and patient outcomes in a community health setting. Paper presented at the 8th Annual National/International Evidence‐Based Practice Conference, Translating Research into Best Practice with Vulnerable Populations. Phoenix, Arizona, February 23.
18. R.L. (1968). A Monte Carlo approach to the number of factors problem. Psychometrika, 33, 37–71.
19. Maljanian R., Caramanica L., Taylor S.K., MacRae J.B. & Beland D.K. (2002). Evidence‐based nursing practice, Part 2: Building skills through research roundtables. Journal of Nursing Administration, 32(2), 85–90.
20. Melnyk B.M. (1994). Coping with unplanned childhood hospitalization: Effects of interventions on mothers and children. Nursing Research, 43(1), 50–55.
21. Melnyk B.M. (1995). Coping with unplanned childhood hospitalization: The mediating functions of parental beliefs. Journal of Pediatric Psychology, 20(3), 299–312.
22. Melnyk B.M. (2007). The evidence‐based practice mentor. A promising strategy for implementing and sustaining EBP in healthcare systems.Worldviews on Evidence‐Based Nursing, 4(3), 123–125.
23. Melnyk B.M.&Feinstein N.F. (2001). Mediating functions of maternal anxiety and participation in care on young children’s posthospital adjustment. Research in Nursing & Health, 24, 18–26.
24. Melnyk B.&Fineout‐Overholt E. (2002). Putting research into practice. Reflections on Nursing Leadership, 28, 22–25.
25. Melnyk B.M. & Fineout‐Overholt E. (2005a). Evidencebased practice in nursing & healthcare. A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.
26. Melnyk B.M. & Fineout‐Overholt E. (2005b). Outcomes and implementation strategies from the first U.S. Evidence‐Based Practice Leadership Summit. Worldviews on Evidence‐based Nursing, 2, 185–193.
27. Melnyk B.M., Alpert‐Gillis L.J., Hensel P.B., Cable‐Billing R.C.&Rubenstein J. (1997). Helping mothers cope with a critically ill child:Apilot test of theCOPEIntervention. Research in Nursing and Health, 20, 3–14.
28. Melnyk B.M., Alpert‐Gillis L., Feinstein N.F., Fairbanks E., Schultz‐Czarniak J., Hust D., Sherman L., LeMoine C., Moldenhauer Z., Small L., Bender N. & Sinkin R.A. (2001). Improving cognitive development of LBW premature infants with the COPE program: A pilot study of the benefit of early NICU intervention with mothers. Research in Nursing and Health, 24, 373– 389.
29. Melnyk B.M., Alpert‐Gillis L., Feinstein N.F., Crean H., Johnson J., Fairbanks E., Small L., Rubenstein J., Slota M. & Corbo‐Richert B. (2004a). Creating opportunities for parent empowerment (COPE): Program effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics, 113(6). Accessed December 17, 2004, from http://www.pediatrics.org/cgi/content/full/113/6/e597‐e607.
30. Melnyk B.M., Fineout‐Overholt E., Feinstein N., Li H., Small L., Wilcox L. & Kraus R. (2004b). Nurses’ perceived knowledge, beliefs, skills, and needs regarding evidence‐based practice: Implications for accelerating the paradigm shift. Worldviews on Evidence‐based Nursing, 1, 185–193.
31. Melnyk B.M., Fineout‐Overholt E., Stetler C. & Allan J. (2005). Outcomes and Implementation Strategies from the First U.S. EBP Leadership Summit. Worldviews on Evidence‐Based Nursing 2(3), 113–121.
32. Melnyk B.M., Feinstein N.F., Alpert‐Gillis L., Fairbanks E., Crean H.F., Sinkin R., Stone P.W., Small L., Tu X.&Gross S.J. (2006). Reducing premature infants length of stay and improving parents’ mental health outcomes with the COPE NICU program: A randomized clinical trial. Pediatrics, 118(5), 1414–1427.
33. Nunnally J.C.&Bernstein I.H. (1994). Psychometric theory (3rd Ed.). New York: McGraw‐Hill.
34. Parahoo K. (2000). Barriers to, and facilitators of, research utilization among nurses in Northern Ireland. Journal of Advanced Nursing, 31(1), 89–98.
35. Pravikoff D.S., Pierce S.T. & Tanner A. (2005). Evidencebased practice readiness study supported by academy nursing informatics expert panel. Nursing Outlook, 53, 49–50.
36. Prochaska J.O. & VelicerW.F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38–48.
37. Prochaska J.M., Prochaska J.O. & Levesque D.A. (2001). A transtheoretical approach to changing organizations. Administration and Policy in Mental Health, 28(4), 247– 261.
38. Retsas A. (2000). Barriers to using research evidence in nursing practice. Journal of Advanced Nursing, 31(3), 599–606.
39. Reynolds K.E. & Magnan M.A. (2005). Nursing attitudes and beliefs toward human sexuality: Collaborative research promoting evidence‐based practice. ClinicalNurse Specialist, 19(5), 255–259.
40. Rhodes R.E. & Plotnikoff R.C. (2006). Understanding action control: Predicting physical activity intentionbehavior profiles across 6 months in a Canadian sample. Health Psychology, 25(6), 292–299.
41. Sackett D.L., Straus S.E., Richardson W.S., Rosenberg W. & Hayes R.B. (2000). Evidence‐based medicine: How to practice and teach EBM. London: Churchill Livingstone. Steger M.F. (2006). An illustration of issues in factor extraction and identification of dimensionality in psychological assessment data. Journal of Personality Assessment, 86(3), 263–272.
42. Strout T.D. (2005). Curiosity and reflective thinking: Renewal of the spirit. Excellence in Nursing Knowledge. Indianapolis, IN: Sigma Theta Tau International.
43. U.S. General Accounting Office. (2001). Nursing workforce: Emerging nurse shortages due to multiple factors. Report to the Chairman, Subcommittee on Health, Committee on Way and Means, House of Representatives [GAO‐01–944]. Washington, DC: Author.
44. Vahey D.C., Aiken L.H., Sloane D.M., Clarke S.P. & Vargas D. (2004), Medical Care, 42(2 Suppl): II 57–66. Worthington R.L. & Whitaker T.A. (2006). Scale development research a content analysis and recommendations for best practices. The Counseling Psychologist, 34(6), 806–838

Readability Index:

n/a

Instrument Availability:

Contact author: Bernadette.Melnyk@asu.edu

Article Availability:

http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=19076922

Acronym:

EBP

DOI:

n/a

ISBN:

n/a

ISSN:

1545-102X