Evidence-based practice competence among nurses in acute and critical care settings: a national cross-sectional study in Spain – The #Evidencer Project

OBJECTIVES: This study assessed EBP competence among critical care nurses in Spain and identified significant factors affecting the integration of EBP into clinical practice. METHODS: A multicenter cross-sectional study involved nurses in emergency departments, pre-hospital emergency services, and intensive care units throughout Spain. Competence was assessed through self-report using the validated EBP-COQ Prof© questionnaire, comprising 35 items divided into four dimensions: attitude, knowledge, skills, and utilization. Descriptive, bivariate, and multivariate regression analyses were conducted to identify the predictors of EBP competence. RESULTS: The sample comprised 847 nurses (78.5% female; mean age 39.89 years, SD = 9.13). The average total EBP competence score was 130.6 (SD = 17.29). Scores across dimensions were highest for attitude (37.1/40) and knowledge (38.0/55), while skills (23.0/30) and utilization (32.6/50) were lower. Key predictors of higher competence included EBP training (p < 0.001), regular reading of scientific articles (p < 0.001), postgraduate education (p < 0.001), mentorship roles (p = 0.018), and employment at Best Practice Spotlight Organization® (BPSO) centers (p = 0.001). Competence declined slightly with increasing professional experience (p = 0.037). CONCLUSIONS: Spanish critical care nurses exhibit moderate to high competence in evidence-based practice (EBP), showcasing solid attitudes and knowledge but lacking practical application. Healthcare institutions should emphasize organized EBP training to close this gap, encourage research involvement, and cultivate supportive environments by implementing initiatives such as BPSO programs. Tackling these elements can bolster EBP implementation and enhance patient outcomes in critical care environments. IMPLICATIONS FOR CLINICAL PRACTICE: These findings emphasize the need for strategies to improve evidence-based practice (EBP) in critical care. Healthcare organizations should focus on structured EBP education, regular access to scientific literature, and mentorship, including BPSO® programs. Enhancing EBP skills among experienced nurses can boost decision-making, patient safety, and care quality in high-acuity settings environments.