IMPLEMENTATION AND EVALUATION OF EVIDENCE BASED NURSING PROTOCOLS IN PUBLIC AND PRIVATE SECTOR HOSPITALS

Abstract

Background: Evidence-based nursing protocols help standardise clinical care, reduce preventable errors, improve patient safety, and support consistent nursing practice.

Objective: To compare the implementation, adherence, perceived effectiveness, and barriers related to evidence-based nursing protocols among nurses working in selected public- and private-sector hospitals.

Methods: A comparative cross-sectional study was conducted among 384 nurses, including 256 from the public-sector hospital and 128 from the private-sector hospital, selected through proportionate stratified random sampling. Data were collected using a structured and pretested questionnaire covering demographic characteristics, knowledge, readiness, institutional support, adherence to nursing protocols, perceived effectiveness, and implementation barriers.

Results: Private-sector nurses had significantly higher knowledge (75.9 ± 11.4% versus 67.8 ± 12.6%), readiness (73.6 ± 12.2% versus 64.1 ± 13.9%), institutional support (72.4 ± 13.8% versus 55.7 ± 15.2%), adherence (78.6 ± 12.5% versus 64.3 ± 14.8%), and perceived effectiveness scores (79.8 ± 11.6% versus 67.9 ± 13.7%) than public-sector nurses (all p<0.001). High adherence was reported by 63 (49.2%) private-sector nurses compared with 57 (22.3%) public-sector nurses.

Conclusion: Evidence-based nursing protocols were implemented more consistently in the private-sector hospital. Strengthening training, staffing, access to guidelines, availability of supplies, managerial support, and regular clinical audit may improve protocol adherence, particularly in public-sector hospitals.