Evidence-Based Practice and Associated Factors among Healthcare Providers Working in Public Hospitals, Northwest Ethiopia, 2017

Abstract Purpose Despite the fact that evidence-based practice (EBP) is thought to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia, is not evidence-based. Understanding the extent of, and barriers to, EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia. Therefore, this study aimed to assess reported level of EBP and associated factors among healthcare providers working in public hospitals in Northwest Ethiopia. Method A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire, which was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP implementation scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation. Results The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research; and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β= -0.10, p Conclusion Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia.