The Role of Evidence-Based Practice in Improving Patient Care in Nursing
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Background: Evidence-based practice (EBP) is recognised as a core element of high-quality nursing care, yet its implementation in low- and middle-income countries remains inconsistent due to structural, organisational and educational constraints. Objective: To examine the association between nurses’ EBP competency and patient care outcomes at a tertiary hospital in Pakistan and to explore contextual barriers and facilitators influencing EBP implementation. Methods: A convergent mixed-methods study was conducted among 200 registered nurses providing inpatient care in medical, surgical and intensive care units at Memorial Christian Hospital. Quantitative data were collected using a structured, validated questionnaire assessing EBP competency, departmental support and a composite patient outcome index. Descriptive statistics, Pearson correlations and multivariable linear regression were used for analysis. Qualitative data from 14 semi-structured interviews and two focus groups (16 nurses) were analysed using inductive thematic analysis. Results: Nurses showed moderate EBP competency (mean 68.4, SD 12.1) and high patient outcome scores (mean 82.5, SD 8.3). EBP competency correlated strongly with patient outcomes (r = 0.68, p < 0.001). In multivariable analysis, EBP competency (β = 0.35, p < 0.001), years of experience (β = 0.28, p = 0.006) and departmental support (β = 0.22, p = 0.015) jointly explained 52% of the variance in patient outcomes. Qualitative themes highlighted access to information, training and competency, organisational culture, time constraints and perceived benefits as key influences on EBP use. Conclusion: Higher EBP competency among nurses is independently associated with better patient outcomes in this resource-constrained setting, and its translation into practice is critically mediated by organisational support, digital infrastructure, education and workload.
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