Project BEAN: Building evidence based practice capacity across the nation

Project Background

Quality, safety, and patient outcomes depends on Evidence Based Practice. This scholarly project explored interventions designed to build evidence-based practice capacity (EBPC) for the subject matter experts (SMEs) of a national task force that developed evidence-based ambulatory care nursing procedures. The concepts of Albert Bandura’s Self-Efficacy theory and Icek Ajzen’s Theory of Planned Behavior conceptualized variables to examine if, and how, the SMEs built EBPC and any influencing factors that promoted belief in their success.

Project Purpose

The project used the concepts of Albert Bandura’s Self-Efficacy theory and Icek Ajzen’s Theory of Planned Behavior to define the components of EBPC, as well as to identify the individual characteristics of the SME and the leader that impacted the SME’s EBPC building.

The specific aims of this project were to:
1) Explore the theoretical variables (perseverance, verbal persuasion, vicarious experience and physiological arousal) that influenced self- efficacy (self-belief in EBP knowledge and skills, the ability to succeed and the confidence to risk creating the procedure)
2) Evaluate the individual characteristics (behavioral, control and normative beliefs) that influenced intention
3) Explore what variables helped build EBPC (behavior completion, achievement of learning, self-efficacy and confidence)
4) Explore what factors influenced the perceived success for procedure writing for the SMEs

Project Methods

The theoretical framework guided construction of the semi-structured interview, using a convenience sample of 12 national SMEs. Thematic analysis identified themes and sub themes using the Atlas ti. Version 8.0 software.

Project Outcomes

Three themes emerged. The first theme was self-efficacy (performance of the correct behavior) with sub themes of self-fulfillment (learning achievement and satisfaction), commitment and ownership (accountability to self and others), and confidence. The second theme was behavioral beliefs (success is probable and failure remote) with sub themes of physiologic arousal (open, honest, non-punitive, and supportive interactions); control beliefs (readily available assistance and ample resources); and verbal persuasion (perceived success from interactions and encouragement). The third theme was mutual trust between the SME and chairperson from the verbal communication during orientation. These findings created an EBPC framework, and support the use of a structured orientation for national task forces. The EBPC model will help trainers and leaders understand the characteristics of the participant, the leader, and the resources needed to advance educational programming to build EBPC.