Perceptions of Factors Associated With Sustainability of Evidence-Based Nursing Practice: A Sequential Mixed Methods...

To improve the quality of nursing services and patient outcomes, the implementation of evidence-based nursing practice (EBNP) becomes increasingly important. Little is known about determinants to sustainability of EBNP.

To explore potential barriers and facilitators in the sustainability of EBNP from Chinese nurses' perspectives.

A cross-sectional survey and semistructured interviews were conducted among Chinese nurses participating in evidence-based practice (EBP) between May to June 2023 and June to July 2024. The interviews and answers to the open-ended questions were analyzed using content analysis. Based on the length of time that EBNP has been routinely applied in clinical settings, we divided the time into seven stages from not routinely used to greater than 5 years. Descriptive statistics evaluated barriers and facilitators influencing sustainability in different stages.

Of 406 nurses surveyed, 319 provided valid responses. Fifteen nurses participated in interviews. Among 48 constructs in updated Consolidated Framework for Implementation Research, participants reported 3 as barriers, 7 as facilitators, and 21 as both barriers and facilitators. The remaining 17 constructs were not mentioned by participants or were mentioned with insufficient frequency to be categorized as either barriers or facilitators. Major facilitators included benefits to patients and professionals, access to information technology infrastructure, commitment, competent leadership, team and leadership support, incentives, training, assessment of patients' and professionals' needs, regular tailoring of strategies, and quality control measures/supervision. Barriers across the sustainment phases included heavy workload, staffing shortages, limited leadership support, low compliance, and low enthusiasm among nurses, even after EBP had been sustained for over 5 years.

The findings enhance understanding of factors promoting the sustainability of EBP from nurses' perspectives. They highlight that dynamically identifying related barriers provides lessons for designing strategies and programs that promote the sustainability of EBNP in China.