Knowledge, Attitudes, and Practices Toward Evidence-Based Care Among Emergency and Critical Care Nursing and Public Health Professionals: A Systematic Review and Meta-Analysis

Abstract

Evidence-based practice (EBP) is the foundation of safe, effective and high quality healthcare provision, especially in high-acuity healthcare settings like emergency departments and critical care units. Regardless of its acknowledged significance, it has major knowledge, attitudes, and clinical practice gaps that restrict its implementation among nursing and public health professionals worldwide. The aim of this systematic review and meta-analysis was to synthesize literature available on knowledge, attitudes, and practices (KAP) toward evidence-based care among nurses and professionals in emergency and critical care and within the context of the global population with public health in mind. One of the sources conducted a complete search of the largest electronic databases, such as PubMed, CINAHL, Scopus and Web of Science, with the scope of the search being 2018-2025 years of publication. Research that satisfied a set of predefined inclusion criteria were evaluated on the methodological quality and data pooled based on random-effects meta-analytic models. In the ultimate synthesis, 35 articles with 12,480 participants were incorporated. Combined findings showed that about 58.3% of the professionals portrayed sufficient understanding of EBP principles compared to 72.1% individuals who indicated a positive attitude towards its application. Nevertheless, those who maintained evidence-based practice in their everyday clinical practice were only 44.6% and a significant gap between knowledge and practice was indicated. Substantial heterogeneity was found among studies (I² = 76.4%), and educational level, years of experience, institutional support, and access to research resource were identified to be major moderating factors. These results highlight the acute necessity of formal EBP training, organizational empowerment measures, and culturally sensitive implementation models to provide the gap between current knowledge gaps in the emergency and acute care scenarios. The review offers practical information to nursing educators, clinical administrators, and the public health policymaker to improve evidence-based care on a significant scale.