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Segura López, Gabriel

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Segura López, Gabriel
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Subject: Evidence-based practice ×

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    Evidence-based practice competence among nurses in acute and critical care settings: a national cross-sectional study in Spain – The #Evidencer Project
    (Elsevier, 2026-05-12) Segura López, Gabriel; Cayuela Fuentes, Pedro Simón; Leal Costa, César; Vera Pérez, José Antonio; Ruzafa Martínez, María; Ramos Morcillo, Antonio Jesús; Enfermería; Facultades de la UMU
    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.
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    Assessing Evidence-Based Practice Competence in Nurse Leadership Roles in Spain
    (Wiley, 2026) Pedro Simón Cayuela-Fuentes; César Leál-Costa; Serafín Fernández-Salazar; José Antonio Vera-Pérez; Antonio Jesús Ramos-Morcillo; María Ruzafa-Martínez; Segura López, Gabriel; Cayuela Fuentes, Pedro Simón; Leal Costa, César; Vera Pérez, José Antonio; Ramos Morcillo, Antonio Jesús; Ruzafa Martínez, María; Enfermería; Facultades de la UMU
    ABSTRACT Objective: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments. Background: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. Material and methods: A cross-sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP-COQ Prof tool. The questionnaire assessed four competency domains—attitude, knowledge, skills, and utilization—using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational afiliation, were analyzed using multivariate linear regression. Results: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/ 50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. Conclusions: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. Implications for Nursing Management: Healthcare institutions should implement (1) training programs for addressing knowledge-to-practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP-competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence-based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.
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