Factors Associated With Nurses' Knowledge of and Perceived Value in Evidence-Based Practices.

Background: Little is known about how the education and specialty certification of intensive care unit nurses influence patients' outcomes.

Objective: To examine the relationships between critical care nurses' education level and specialty certification, their individual psychosocial beliefs about their place on the intensive care unit team (in relation to 3 factors: professional identity, self-efficacy, and role clarity), and their perceptions of evidence-based practices used in the intensive care unit.

Methods: A cross-sectional survey was emailed to nurses in 12 adult intensive care units within 6 hospitals in a single, integrated health care system.

Results: Of 268 respondents, 180 (71%) had a bachelor of science degree or higher, and 71 (26%) had critical care certification. Compared with noncertified nurses, certified nurses reported greater knowledge of spontaneous breathing trials (4.6 vs 4.4 on a 5-point scale, P = .03) and lung-protective ventilation (4.2 vs 3.9, P = .05). Certified nurses reported significantly higher self-efficacy (4.5 vs 4.3 on a 5-point scale, P = .001) and role clarity (4.4 vs 4.2, P = .05) than noncertified nurses. Certification was also associated with greater perceived value in specific practices (daily interruption of sedation: adjusted odds ratio 2.5 [95% CI, 1.0-6.3], P = .05; lung-protective ventilation: adjusted odds ratio, 1.9 [95% CI, 1.1-3.3], P = .03). Education level was not associated with greater knowledge of or perceived value in evidence-based practices.

Conclusions: Nursing specialty certification was associated with nurses' individual psychosocial beliefs and their perceptions of evidence-based practices in the intensive care unit, whereas education level was not. Supporting nurses in obtaining specialty certification could assist with the adoption of evidence-based practices as a means to improve quality of care in the intensive care unit.