Implementation competence for evidence-based practice among vascular access specialist team nurses: a mixed-method...

Evidence-based practice (EBP) is central to high-quality nursing care and patient safety, yet its effective adoption and sustainability depend on nurses' capability to translate evidence into routine practice. Vascular access specialist teams (VASTs) play a key role in implementing evidence-based interventions to reduce complications associated with intravenous therapy, but little is known about their capability to enact and sustain EBP in complex organisational contexts. This study aimed to assess implementation competencies for EBP among VAST nurses in Spain.

A two-stage, mixed-methods study was conducted in 2023. The quantitative stage involved a national cross-sectional survey of VAST nurses using an adapted questionnaire informed by behavioural frameworks relevant to EBP adoption. The qualitative stage consisted of in-depth semi-structured interviews with a purposive sample of participants. Quantitative data were analysed using descriptive and multivariate methods, and qualitative data through thematic analysis and integrated using triangulation.

Fifty-one VAST nurses completed the questionnaire, reporting high self-perceived competence in domains such as social/professional role and identity (mean 4.7/5), knowledge (4.3), and collective context (4.2) for EBP. Lower scores were observed in contextual and organisational domains (mean 3.9), reflecting structural barriers to sustained EBP. Knowledge correlated positively with beliefs about capabilities (ρ = 0.574), and behavioural regulation (ρ = 0.591). Qualitative findings revealed five themes: expanded professional roles, experiential learning of implementation skills, context-sensitive strategies, organisational barriers, and enabling conditions. Participants described intuitive engagement with EBP despite lacking formal training, highlighting a gap between individual motivation and organisational support.

VAST nurses in Spain show strong intrinsic motivation and emerging capability to lead and support EBP, but limited formal training and weak organisational infrastructure restrict their ability to enact and sustain implementation activities. Strengthening nurses' EBP capability through structured implementation training, alongside organisational strategies that formalise and support the VAST role, may improve the adoption and sustainability of evidence-based vascular access care.