Competencies, barriers, and facilitators in the implementation of evidence-based practice among nurses in a central hospital in Ho Chi Minh City, Vietnam

Abstract

Background: Evidence-based practice (EBP) is a core nursing competency essential for safe care. Despite its recognized value, EBP adoption among Vietnamese nurses is limited due to multiple barriers. Aim: To assess EBP competencies, barriers, and facilitators among nurses in a central hospital in Vietnam, and to examine the relationships among these factors. Design: Descriptive correlational research design. Methods: Stratified random sampling recruited 388 nurses from a central hospital. Data were collected using the Vietnamese version of the Evidence-Based Practice Competency Questionnaire, the Barriers Scale, and the Research Factor Questionnaire. Data were analyzed using descriptive statistics, Pearson’s correlation, and mediation analysis. Results: Nurses demonstrated high competency in skills (M = 3.83, SD = 0.47), utilization (M = 3.87, SD = 0.48), and knowledge (M = 3.65, SD = 0.56), with very high scores in attitudes (M = 4.29, SD = 0.44). Barriers were reported at a moderate level (M = 3.10, SD = 0.65), with the strongest obstacles being lack of authority, insufficient time to implement new ideas, and inadequate skills for research appraisal. Facilitators were rated highly (M = 3.65, SD = 0.53), especially managerial support, advanced education, and access to resources. Correlation analysis revealed a positive association between barriers and facilitators (r = 0.307, p < 0.001). Mediation analysis showed that attitude had both a direct effect on facilitators (β = 0.220, p < 0.001) and an indirect effect through barriers (β = –0.050, p = 0.011). Conclusion: Attitude is central to shaping supportive conditions for EBP implementation. Strengthening facilitators can offset barriers, suggesting that organizational interventions should target both structural and motivational aspects to enhance EBP adoption