1251: EFFECT OF EDUCATION AND CERTIFICATION ON BELIEFS ABOUT EVIDENCE-BASED PRACTICES AMONG ICU NURSES

Abstract

Learning Objectives: Nursing education and specialty certification are associated with improved patient outcomes in the ICU. However, the mechanism of this association is unknown. We sought to better understand this association by examining the relationship between nurses’ education level, nursing specialty certification, and perceptions of the use of ICU evidence-based practices (EBPs). We hypothesized that nurses with higher education levels and specialty, critical care certification would endorse greater knowledge and more value in the use of EBPs. Methods: We performed a cross-sectional e-mail survey of ICU nurses in 12 adult ICUs within 5 hospitals in a single integrated health care system in 2017. ICU nurses were asked about their demographic characteristics, educational background, and specialty certification, as well as their knowledge and attitudes toward EBPs in general and three specific EBPs: daily interruption of sedation (DIS), spontaneous breathing trials (SBTs), and lung-protective ventilation (LPV). Multivariate regression was performed to test the study hypotheses. Results: Of 268 respondents, 180 (71%) were prepared with a Bachelors of Science in Nursing (BSN) degree or higher, and 71 (26%) reported having critical care certification. Compared with no specialty certification, specialty certification was associated with significantly higher knowledge of SBTs (4.4 vs. 4.6 on a 5-point scale, mean difference 0.2, 95% CI 0.1-0.3, p=0.03) and LPV (3.9 vs. 4.2, mean difference 0.3, 95% CI 0.1-0.5, p=0.05). Specialty certification was not associated with improvement in perceptions of EBP in general; but was associated with greater value in specific EBPs (adjusted odds ratio for DIS: 2.7, 95% CI 1.16.8, p=0.03; SBT: 2.7, 95% CI 0.9-7.8, p=0.07; LPV: 2.1, 95% CI 1.2-3.8, p=0.01). Educational level was not associated with greater knowledge of or attitudes towards either general or specific EBPs. Conclusions: Nursing specialty certification was associated with self-reported knowledge of and value in EBP while BSN education was not. These data provide additional support for specialty certification of ICU nurse and could assist ICUs with adoption of EBP as a means to improve the quality of care. 1251