INTRODUCTION

Background of the Study

Nursing like other health occupations moving towards to establishing

itself and a profession has expressed concerns about the development of

her services orientation. The continual growth of a scientific base care

which her members practice and evolution of a fairly distinct body of

knowledge that separates nursing from other professions (Fajemilehin

1993).

Human being experiences be it physical chemical biological social and

psychological forces are complex affair defying total comprehension. In

peoples daily private lives and work they strive to make sense of their

experience understand regularities and so predict future circumstances.

Hence human knowledge has many roots some of it is derived from

scientific research but much of it comes from traditional authorities

experience trial and error as well as logical reasoning.

Nursing during the pre-nightingale era was distinguished as a

community service which was based on related strong instinct to

preserve and protect the family (Donaline 1995).

The desire to keep people healthy provide comfort and care for the sick

were the initial focus of nursing. this practice has been modified as a

result of societal influence and changing needs medicine was practiced

without nursing in the era of Hypocrates while in the middle ages

nursing was practiced without medicine (Royle J. A. et al 1996).

In the ancient cultures religious leaders assumed the responsibility for

health and medical care because causation of illness was tied to myths

and religion. Hence nurses were seen to be below religious leaders.

During the Florence Nightingale era (1820-1910) she instituted a major

reforms in nursing practice she was a proficient bedside nurse with a

great concern for the soldiers. Her ward round at night with the lamp

earned her the title “The Lady with the Lamp”.

Organized nursing began in the mid 1800s before her era nursing care

was done by paupers and persons unfit for any type of work.

Following the Crimean war in 1854 Florence Nightingale initiated and

sustained a campaign for nurses all over the world to have an organized

formal training. This later had a positive influence in Africa sub region

most especially in Nigeria which was at that time a British colony. By

1930 formal apprenticeship training started in Nigeria in both missions

and government hospitals.

In 1960 the western region government of Nigeria sent qualified nurses

to train as nurse tutors while the technical aids afforded some of the

opportunity to have diploma and degree. The return of these few staff

paved way for the commencement of degree programme in nursing in

the Nigerian universities. Nursing profession took a significant leads in

Nigeria with the establishment of the Department of Nursing in the

University of Ibadan in 1965 with the mandate to produce teachers and

administrators for the African sub-region. This programme improved

nursing and also transforms the education and practice of the

profession.

The Schools of Nursing till the present day neither affiliates to

Polytechnics nor Universities. This is the reason why the nursing

certificate cannot be said to be a pre-requisite for admission into any

other school. Also in terms of practice there is uncertainty over

professional nurses capability to cope with local and global emerging

trends in nursing practice. Twentieth century nurses were witnesses to

the technological explosion in the health care work-place for example

the digital thermometer that replaced the glass mercury ones and the

intensive care unit were established and many nurses began combining

their learned high-tech skill with the new technology. The need for

traditional trolleys for procedures during observations (that is setting of

vital signs tray) may soon become obsolete and irrelevant.

In a study of health agencies in Ontario Canada Mitchell et al (1995)

found that only 35% of small hospitals (less than 250 beds) had nursing

research journals in their libraries; 38% of health agencies based make

changes in nursing practice based on the research process; 15%

implemented research utilization programmes for staff nurses and 97%

wanted assistance in teaching their nursing staff about research

utilization.

Sackett et al (1996) defined evidence based practice as the

conscientious explicit and judicious use of current best evidence in

making decisions about the care of individual patients.

According to Filana et al (2002) evidence based practice is a method of

problem solving searching the literature evaluating the research

evidence and deciding on the intervention.

Hicks (1997) suggested that account should be taken of all valid

relevant information when making decisions that affect the care of

patients. Thus best evidence might be defined as that which is valid

and relevant to the patient’s problems.

The best available evidence moderated by patient circumstances and

preferences will be applied to improve the quality of clinical judgments.

Evidence based practice is about finding out something whose absence

may affect our informed decision. It is also about finding out a missing

link and providing solution to the identified missing links. Many

authorities agreed that evidence based practice mostly concerned with

the application of scientific method to problem solving. It involves

careful observations orderly co-variations among measurable

phenomena objective interpretation of facts and validation of accepted

theories or their revision in the light of new facts or evidence (Obono

2005).

As stated by Obono et al (2005) nursing research aimed at validating

nursing care practices keeping nurses abreast with theories laws

scientific principles that will give impetus for nurses to act appropriately.

Nursing research is generally aimed at enhancing the social relevance of

nursing education achieving effective nursing administration for the

achievement of professional status.

The knowledge generated through nursing research will be used to

develop evidence based practice improve the quality of care and

maximise health outcome intervention.

Chambless & Hollon (1988) stated that empirically supported treatment

(ESTs) are defined as “clearly specified psychological treatments shown

to be efficacious in controlled research with a delineated population.

Evidence base practice movement in mental health attempts to identify

implement and disseminate treatments that have been proven

demonstrably effective in line with the empirical evidence (Norcross et

al 2006).

According to Mercer et al (2007) classifying a research report as strong

or weak evidence for a treatment is necessary to evaluate the quality of

the research as well as the reported outcome.

Gortner et al (1976) lamented lack of research evidence in many areas

of nursing practice. Evidence-based practice is not new; most of the

past 20 years has focused on the identification of the barriers to

evidence-based practice and the consideration of strategies to overcome

these barriers.

According to the International Council for Nurses (2000) the main goal

of nursing research is to improve care outcomes by advancing nursing

knowledge practice and informed health policy. She also facilitates and

promote the conduct dissemination and utilization of research related to

nursing health and health care system. There are ever expanding

conceptual and practical challenges in health care in the world today

and nurses in Nigeria are not exempted. There is a need to transform

nursing in Nigeria through purposeful reinforcement of nursing training

to suite the current practices in line with global standards.

Statement of the Problem

Despite the introduction of nursing process seminars workshops

attended by the nurses in ECWA Hospital and General Hospital Egbe the

researcher observed over the years that nurses working at the bedside

practice were not making use of the new technological methods

knowledge and skills acquired through seminars or workshops which

could have helped them to give quality nursing care. Such knowledge

and skills such as the use of aseptic technique wearing of masks while

dressing wounds frequent washing of hands after each procedure to

prevent infection most especially in a surgical ward.

In 2005 there were reported cases of broken down post-operative

wounds as a result of infections in the surgical wards of ECWA Hospital

Egbe. As a result surgeries were temporarily suspended while affected

patients referred to University of Ilorin Teaching Hospital for better

management. Ever since reported cases of post-operative wound

infection/breakdown in the hospital still persist despite efforts by the

nurses to maintain good aseptic and asepsis techniques in the operating

theatre and in the central sterile supply department of the hospital. Due

to lack of evidence based practice by the nurses the researcher intend

to find out the nurses level of knowledge about evidence based practice

in ECWA Hospital and General Hospital Egbe Kogi State.

Purpose/Objective of the Study

This study will be guided by the following objectives:

1. To find out nurses knowledge about research and evidence based

practice.

2. To identify nurses interest on evidence based theories for clinical

nursing practice.

3. To access the problems encountered while utilizing evidence based

practice in Egbe Hospital.

4. To suggest ways evidence based practice can be effectively utilized

in clinical nursing practice.

Research Questions

1. What is nurses level of knowledge about evidence based practice

in Egbe Hospital?

2. Do nurses have interest in evidence based care in Egbe hospital?

3. What are the problems encountered while utilizing evidence based

practice during clinical nursing practice?

4. How can evidence based practice be effectively utilize by nurses in

Egbe Hospital?

Significant of the Study

This study will be of benefit to the nurses and clients it will enable

nurses to apply the knowledge of various theories in the management of

patients. It is also believed that the knowledge of evidence based

practice will greatly reduce morbidity and mortality rate in the society; it

will also assist the nursing institution and regulatory organisation to

come up with recommendations that will enrich the existing curriculum.

The study will also broaden nurses’ knowledge of scientific management

of patients thereby uplifting the professional status of nurses and

midwives. Evidence based practice will assist the government and

non-governmental organisation to plan for better health care it will also

improve the budgetary allocation to health care.

The knowledge of evidence base practice will create confidence in the

mind of nurses about the care rendered to their clients and the

significant others.

Scope of the Study

The researcher wish to limit the study to nurses and midwives working

in ECWA Hospital Egbe and General Hospital Egbe in Yagba West local

government bearing in mind its accessibility cost and time available to

carry out the study.

Operational Definition of Terms

Role: This is individual ability to fulfill or perform his or her

responsibility to meet societal expectations.

Qualitative: This is concerned with quality about a kind of

experience.

Nursing: The desire to care for people and provide comfort for

the society.

Care: Act of receiving an individualized holistic evidence based

services.

Data: Information in the course of investigation which come out

pure and not adulterated.

Research: A process of finding out or seeking solution to a

problem.

Evidence: Anything that provides material or information based

an indications.