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Reframing evidence-based practice competence in nursing: insights from a concept analysis using Walker and Avant's method
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This study refines the concept of evidence-based practice (EBP) competence in nursing by providing an updated operational definition grounded in contemporary educational and clinical contexts. A comprehensive literature review (2013-2023) was conducted across PubMed, CINAHL, Web of Science, and MEDLINE, supplemented by grey literature and regulatory documents, yielding 39 included publications. Using Walker and Avant's concept analysis method, key defining attributes were identified: a spirit of inquiry; the ability to formulate structured clinical questions; skills in searching for, appraising, and integrating evidence; the capacity to evaluate outcomes; and competence in disseminating findings. Antecedents included research literacy, professional experience, and organisational support, while consequences encompassed improved decision-making, professional development, and enhanced team communication. Model, borderline, and contrary cases were developed to illustrate application across clinical contexts. The refined operational definition conceptualises EBP competence as the attitudes, knowledge, and skills that enable nurses to question practice, acquire and critically appraise evidence, integrate it with clinical expertise and patient preferences, evaluate outcomes, and disseminate learning. This analysis offers a conceptual foundation to inform assessment tool development and support alignment of nursing curricula with core EBP competencies, strengthening conditions that facilitate EBP implementation across healthcare settings.
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Competence Concept analysis Evidence-based nursing Evidence-based practice Nursing