{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:45:56Z","timestamp":1792518356796,"version":"4.5.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n The use of the best available research evidence in clinical decision-making through the incorporation of clinical experience and patient preferences into the delivery of professional patient care is known as evidence-based practice. The best way to provide high-quality care that is secure and has positive results is through evidence-based practice. To use evidence-based practice. Despite the anticipated advantages of evidence-based practice, nurses have found it challenging to implement.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To assess the implementation of evidence-based practice and related factors among nurses working in public hospitals in the Siltie Zone in South Central Ethiopia in 2023.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An institution-based cross-sectional study was conducted from March 6 to April 5, 2023, to assess the implementation of evidence-based practice. A sample size was 337 nurses working in Siltie Zone public hospitals; a self-administered, semi-structured questionnaire was used for data collection. Data was cleaned, coded, and entered into EpiData version 4.6 before being exported and analyzed in SPSS (version 26). To ascertain the relationship between the outcome variable and the predictors, binary logistic regression was performed, and those with a p-value of < 0.25 were entered into multivariate analysis. In multivariate analysis, a p-value\u2009<\u20090.05 was considered statistically significant. The Adjusted Odds Ratio (AOR) was calculated to determine the association between the dependent and independent variables at a 95% confidence interval (CI).<\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n According to this study, 147 (45.5%) of nurses have good evidence-based practice implementation, and 176 (54.5%) of nurses were found to have poor evidence-based practice implementation. Factors significantly associated with implementation of evidence-based practice were age between 26 and 30 (AOR\u2009=\u20095.247, 95% CI: 1.249, 22.047); educational level, BSc (AOR\u2009=\u20091.956, 95% CI: 1.035, 3.698) and masters (AOR\u2009=\u20094.149, 95% CI: 1.088, 15.817); working unit like emergency (AOR\u2009=\u20093.935, 95% CI: 1.300, 11.914) and inpatient (AOR\u2009=\u20094.684, 95% CI: 1.633, 13.435); ability to formulate a question (AOR\u2009=\u20091.844, 95% CI: 1.062, 3.201); and not relevant to the nursing profession (AOR\u2009=\u20090.459, 95% CI:\u2009\u2009.236,\u2009\u2009.878).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study showed that the majority of nurses implement evidence-based practice ineffectively. Age, educational level, working unit, question formulation, and the applicability of evidence-based practice to nursing professions were the main causes of inadequate implementation of evidence-based practice. Therefore, multi-stakeholder approaches are required to address the main contributing variables and promote the implementation of evidence-based practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0357626","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:21:56Z","timestamp":1792516916000},"page":"e0357626","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence-based practice implementation and associated factors among nurses employed at public hospitals in Siltie Zone, South Central Ethiopia: A cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"given":"Sadik Seid","family":"Ahmed","sequence":"first","affiliation":[{"name":"Saint Paul\u2019s Hospital Millennium Medical College School of Nursing Department of Medical-Surgical Nursing","place":["Addis Ababa, 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AlibakhshiKenari","year":"2015","journal-title":"Int J Nurs Didact"},{"key":"pone.0357626.ref014","doi-asserted-by":"crossref","DOI":"10.1046\/j.1365-2648.2003.02705.x","volume-title":"Clinical experience as evidence in evidence-based practice","author":"C Thompson","year":"2003"},{"key":"pone.0357626.ref015","doi-asserted-by":"crossref","unstructured":"Haynes RB, Devereaux PJ, Guyatt GH. Physicians\u2019 and patients\u2019 choices in evidence based practice: evidence does not make decisions, people do. BMJ. 2002;324(7350):1350.","DOI":"10.1136\/bmj.324.7350.1350"},{"issue":"21","key":"pone.0357626.ref016","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1001\/jama.2008.730","article-title":"Incorporating patient preferences in evidence-based medicine","volume":"300","author":"MH Murad","year":"2008","journal-title":"JAMA"},{"key":"pone.0357626.ref017","doi-asserted-by":"crossref","unstructured":"Robinson B, Hart AM, Whitney FW. Linking evidence-based nursing practice and patient-centered care through patient preferences. Nurs Adm Q. 2013;37(3):231\u201341.","DOI":"10.1097\/NAQ.0b013e318295ed6b"},{"key":"pone.0357626.ref018","unstructured":"Anbessa T, Hospital S, Ababa A, Hadgu G, Almaz S, Tsehay S. Assessment of Nurses \u2019 Perceptions and Barriers on Evidence Based Practice in Assessment of Nurses \u2019 Perceptions and Barriers on Evidence Based Practice in Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia. 2017."},{"issue":"2","key":"pone.0357626.ref019","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/1319-6308.142347","article-title":"Plantar fasciitis: a\u00a0review of literature","volume":"14","author":"S Nuhmani","year":"2014","journal-title":"Saudi J Sports Med"},{"key":"pone.0357626.ref020","article-title":"Epidemiological assessment of nurses\u2019 knowledge and utilization of evidence based practice and its associated factors in specialist hospital Bauchi state, Nigeria","author":"AS Aliyu","journal-title":"ARC J Public Health and Commun Medicine"},{"key":"pone.0357626.ref021","doi-asserted-by":"crossref","unstructured":"Khammarnia M, Mohammadi MH, Amani Z, Rezaeian S, Setoodehzadeh F. Barriers to Implementation of Evidence Based Practice in Zahedan Teaching Hospitals, Iran, 2014. 2015;2015.","DOI":"10.1155\/2015\/357140"},{"key":"pone.0357626.ref022","unstructured":"Dessie Ayalew G, Jara D, Alem G, Mulugeta H, Zewdu T. Evidence-based practice and associated factors among health care providers working in public hospitals. 2017."},{"key":"pone.0357626.ref023","volume-title":"Cycle Audit Tool Clinical Service Directorate","author":"CA Tool","year":"2022"},{"issue":"2","key":"pone.0357626.ref024","doi-asserted-by":"crossref","DOI":"10.2196\/28739","article-title":"Knowledge and attitude toward evidence-based medicine and associated factors among medical interns in amhara regional state teaching hospitals, northwest ethiopia: cross-sectional study","volume":"7","author":"D Emwodew","year":"2021","journal-title":"JMIR Med Educ"},{"key":"pone.0357626.ref025","first-page":"51","article-title":"Knowledge and utilization of evidence-based nursing practice among nurses of Offa Specialist Hospital, Kwara State","volume":"4","author":"FE Oluwatoyin","year":"2016","journal-title":"IOSR J Nurs Health Sci"},{"issue":"1","key":"pone.0357626.ref026","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/wvn.12076","article-title":"Implementation of evidence-based practice in relation to a clinical nursing ladder system: a national survey in Taiwan","volume":"12","author":"Y-H Weng","year":"2015","journal-title":"Worldviews Evid Based Nurs"},{"key":"pone.0357626.ref027","doi-asserted-by":"crossref","unstructured":"Harper MG, Gallagher-Ford L, Warren JI, Troseth M, Sinnott LT, Thomas BK. Evidence-based practice and US healthcare outcomes: findings from a national survey with nursing professional development practitioners. 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