Evidence-based practice (EBP) is not consistently implemented within healthcare settings; although many organizations claim it is how they deliver care in the 21st century. In a review of the literature, multiple intrapersonal variables were found to impact the inconsistency with which EBP is applied and the success of its implementation within nursing practice. Organizational culture and perceived stress can influence the uptake of EBP beliefs and can affect EBP implementation. Clinicians who have more confidence in their EBP knowledge and skills are expected to implement best practices. Underpinned by Social Cognitive Theory, a model was developed to guide study design and interpretation of results as well as the expected relationships among study variables. A correlational predictive study design was used to explore the modeled relationships. A convenience sample of 208 point-of-care registered nurses was recruited to complete an online questionnaire including demographics and measures of the study variables. Online data collection took place over eight weeks. Path analysis was used to explore the modeled relationships. The Evidence Implementation in Practice Model was a good fit for the sample data (Chi-sq. = 7.49, p < .112). All paths within the model were statistically significant (p < .05). The work environment predictor variables of organizational culture and readiness for EBP and perceived stress accounted for 21% of the variance in the intrapersonal predictor variable self-efficacy. These upstream variables explained 37% of the variance in EBP beliefs. All upstream variables explained 17% of the variance in EBP implementation.

Date of publication

Fall 12-4-2019

Document Type




Persistent identifier


Committee members

Dr. Ellen Fineout-Overholt, Dr. Jenifer Chilton, Dr. Sara Breckenridge-Sproat


PhD Nursing

Available for download on Saturday, December 04, 2021

Included in

Nursing Commons