Competencies, barriers, and facilitators in the implementation of evidence-based practice among nurses in a central hospital in Ho Chi Minh City, Vietnam

Tạp chí Khoa học Điều dưỡng - Tập 8 Số 05 - Trang 162-172 - 2025
Thi Nhat Le Vuong1, D. Estioko Edreck2
2Trinity University of Asia, Philippines

Tóm tắt

Background: Evidence-based practice (EBP) is a core nursing competency essential for safe care. Despite its recognized value, EBP adoption among Vietnamese nurses is limited due to multiple barriers. Aim: To assess EBP competencies, barriers, and facilitators among nurses in a central hospital in Vietnam, and to examine the relationships among these factors. Design: Descriptive correlational research design. Methods: Stratified random sampling recruited 388 nurses from a central hospital. Data were collected using the Vietnamese version of the Evidence-Based Practice Competency Questionnaire, the Barriers Scale, and the Research Factor Questionnaire. Data were analyzed using descriptive statistics, Pearson’s correlation, and mediation analysis. Results: Nurses demonstrated high competency in skills (M = 3.83, SD = 0.47), utilization (M = 3.87, SD = 0.48), and knowledge (M = 3.65, SD = 0.56), with very high scores in attitudes (M = 4.29, SD = 0.44). Barriers were reported at a moderate level (M = 3.10, SD = 0.65), with the strongest obstacles being lack of authority, insufficient time to implement new ideas, and inadequate skills for research appraisal. Facilitators were rated highly (M = 3.65, SD = 0.53), especially managerial support, advanced education, and access to resources. Correlation analysis revealed a positive association between barriers and facilitators (r = 0.307, p < 0.001). Mediation analysis showed that attitude had both a direct effect on facilitators (β = 0.220, p < 0.001) and an indirect effect through barriers (β = –0.050, p = 0.011). Conclusion: Attitude is central to shaping supportive conditions for EBP implementation. Strengthening facilitators can offset barriers, suggesting that organizational interventions should target both structural and motivational aspects to enhance EBP adoption.

Từ khóa

#evidence-based practice #nursing competency #barriers #facilitators #Vietnam

Tài liệu tham khảo

Dang D, Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. 2022.

Portela Dos Santos O, Melly P, Hilfiker R, Giacomino K, Perruchoud E, Verloo H, Pereira F. Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review. Healthcare (Basel). Nov 2 2022;10(11)doi:10.3390/healthcare10112204

McArthur C, Bai Y, Hewston P, Giangregorio L, Straus S, Papaioannou A. Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis. Implementation Science. 2021;16:1-25. doi: 10.1186/s13012-021-01140-0.

Nguyen Thi Bich Tram, Tran Thi Hoang Oanh. Perception of evidence-based practice among nurses. Journal of Nursing Science, Vol. 3 No. 5 (2020):148-157.

Adamakidou T, Ntempeli E, Galanis P, et al. Factors related to evidence-based practice among community nurses in Greece: a cross-sectional study. MDPI; 2023:3071. doi: 10.3390/healthcare11233071.

Smith-Miller CA. Implementing evidence informed practice changes: barriers, facilitators, and work environments. JONA: The Journal of Nursing Administration. 2022;52(4):203-210. doi: 10.1097/NNA.0000000000001132.

Chu Thi Nguyet, Nguyen Thi Bich Nguyet. Perception of evidence – based practice of nurses at Vinh city general hospital in 2022. Tạp chí Y học Việt Nam. 2023;530(1). https://doi.org/10.51298/vmj.v530i1.6626.

Nguyen Trong Thu, et al. Knowledge - skills, attitudes, and practices regarding evidence-based practice of nursing at Le Van Thinh hospital: A cross-sectional survey study. Vietnam Medical Journal. 2023;530(1B). https://doi.org/10.51298/vmj.v530i1B.6718

Ngo Thi Dung, Hawks M, Ruzafa-Martinez M, et al. Cross-cultural adaptation and psychometric validation of the Vietnamese version of the evidence-based practice competency questionnaire for registered nurses (EBP-COQ Prof©). Nursing Practice Today. 2023. DOI:10.18502/npt.v10i3.13435.

Ruzafa-Martínez M, Fernández-Salazar S, Leal-Costa C, Ramos-Morcillo AJ. Questionnaire to Evaluate the Competency in Evidence-Based Practice of Registered Nurses (EBP-COQ Prof©): Development and Psychometric Validation. Worldviews Evid Based Nurs. Oct 2020;17(5):366-375. doi:10.1111/wvn.12464

Schetaki S, Patelarou E, Giakoumidakis K, Kleisiaris C, Patelarou A. Evidence-Based Practice Competency of Registered Nurses in the Greek National Health Service. Nurs Rep. Sep 9 2023;13(3):1225-1235. doi:10.3390/nursrep13030105

Dagne AH, Beshah MH, Kassa BG, Dagnaw EH. Implementation of evidence-based practice and associated factors among nurses and midwives working in Amhara Region government hospitals: a cross-sectional study. Reprod Health. Feb 12 2021;18(1):36. doi:10.1186/s12978-021-01096-w

Alatawi M, Aljuhani E, Alsufiany F, Aleid K, Rawah R, Aljanabi S, Banakhar M. Barriers of implementing evidence-based practice in nursing profession: A literature review. American Journal of Nursing Science. 2020;9(1):35-42. DOI: 10.11648/j.ajns.20200901.16

Almalki MSS. Barriers to and facilitators of research utilisation among nurses in Saudi Arabia. RMIT University; 2017.

Pitsillidou M, Roupa Z, Farmakas A, Noula M. Factors Affecting the Application and Implementation of Evidence-based Practice in Nursing. Acta Inform Med. Dec 2021;29(4):281-287. doi:10.5455/aim.2021.29.281-287

Ayoubian A, Nasiripour AA, Tabibi SJ, Bahadori M. Evaluation of Facilitators and Barriers to Implementing Evidence-Based Practice in the Health Services: A Systematic Review. Galen Med J. 2020;9:e1645. doi:10.31661/gmj.v9i0.1645

Atalla ADG, El-Ashry AM, Mohamed SMS. The relationship between evidence-based practices’ facilitators and barriers among nurses and their competencies: self-efficacy as a mediator. BMC Nursing. 2025/04/25 2025;24(1):458. doi:10.1186/s12912-025-02896-2

Nwe HM, Akkadechanunt T, Abhicharttibutra K, Sripusanapan A. Individual and social system factors influencing evidence-based practices among nurses in general hospitals: A cross-sectional multi-institutional study. Journal of clinical nursing. 2025;34(3):894-905. doi: 10.1111/jocn.17083.

Rooney C. Attitudes of Emergency Nurses to Evidence Based Practice in the Emergency Department of a Multi-Specialty Hospital. Royal College of Surgeons in Ireland; 2021.

Al Anazi E, Alassaf RN, Alanazi AM, et al. Barriers to Implementing Evidence-Based Practice among Nurses in Saudi Arabia: A Systematic Review. Saudi Journal of Health Systems Research. 2025:145-154. doi:10.1159/000545235

Dabak Z, Toqan D, Malak MZ, Al-Amer R, Ayed A. Knowledge, attitudes, practice, and perceived barriers toward evidence-based practice among Palestinian nurses in intensive care units. BMC Nursing. 2024/12/23 2024;23(1):950. doi:10.1186/s12912-024-02646-w

Li S, Cao M, Zhu X. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine. 2019;98(39):e17209. doi:10.1097/md.0000000000017209

Melnyk BM, Zellefrow C, Tan A, Hsieh AP. Differences between Magnet and non-Magnet-designated hospitals in nurses’ evidence-based practice knowledge, competencies, mentoring, and culture. Worldviews on Evidence-Based Nursing. 2020;17(5):337-347. doi: 10.1111/wvn.12467.

Thông tin
Thông tin xuất bản

Tạp chí Khoa học Điều dưỡng

Tập 8 Số 05

162-172

Thông tin tác giả