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Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Participant Invitation Letter Dear Prospective Participant, Thank you for your consideration in completing this survey. The following survey is being conducted for an Applied Research Project (ARP) in partial fulfillment of the requirements for the Doctor of Health Sciences degree at A.T. Still University. The purpose of this study is to identify perceived barriers that prevent staff nurses from contributing to evidence-based practice (EBP). This study is of high importance because without identifying the specific barriers, there is no way to address the problem. You have been chosen for this survey because you are a provider of direct patient care, and have knowledge and insight into the best outcomes for the patient. This survey is completely anonymous and your honesty is extremely valuable to this research study. There are no personal identifiers collected within the survey. The completion of this survey should not take much of your time, since it can be completed in approximately 10-15 minutes. If you are a nurse who performs bedside care to patients you are eligible to participate in this survey. The survey is intended for staff nurses only; educators, managers, and administration are excluded from this survey. Thank you in advance for your time and participation with this research study. Your responses will make a great contribution to EBP and nursing practice. Please click on the following link to access the survey https://www.surveymonkey.com/s/Barrier2EBP Thank you again for your time and participation, Aimee Nabor Ortiz, MSN, RN Doctorate of Health Sciences Student A.T. Still University College of Graduate Health Studies Arizona Campus 5850 E. Still Circle Mesa, AZ 85206 (480) 219-6000

Perceived Barriers to Staff Nurse Contributions to Evidence-Based Practice Being involved with and contributing to evidence-based practice (EBP) can be a requirement for nurses in a leadership or educational role. However, staff nurses should also contribute to EBP. Staff nurses may only identify their role as practicing EBP but not initiating EBP. The goal is to identify the current barriers that are preventing staff nurses from contributing to the EBP process. The Institute of Medicine has set a goal for 2020 to increase evidence-based clinical decision-making (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). An additional significant factor derives from the perceived minimal participation in research from staff nurses. The nursing profession and care is guided by evidence-based research (EBR) and EBP. Identification of the barriers is needed to make efforts to correct the issue. Patient care and nursing practice are guided by the research that supports the best practices for optimal patient outcomes. According to Fitzsimons and Cooper (2012), the benefits of EBP include an increase in patient safety, higher patient satisfaction scores, and improved cost-effectiveness. The practice standards set forth in policies and protocols are based on evidence of benefits to the patients and their health status. With the goal of the Institute of Medicine, it is an expectation that nurses contribute to EBP (Yoder et al., 2014). Nurses at all levels should be at the forefront of this process to implement the practice, contributing to the development of new practices and standards of care. Loke, Larenson, and Lee (2012) stated that despite efforts to increase awareness, there is still a lack of contribution from nurses. Having the staff nurse contribute to EBP will ensure that the front line nurses are also included in the development and process of EBP. Increasing the number of staff nurses that contribute to EBP, will also benefit the nursing profession. There is an obligation for nurses to be actively involved with health care policies (ANA, 2001). With the goal set forth by the Institute of Medicine, increasing the number of nurses that contribute to EBP can assist with the transition by 2020 (Yoder et al., 2014). The question does not presume staff nurses should, or must, take part in this process alone. Mentorship and guidance is plays a key role in increasing participation in EBP. References: American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Nursebooks.org Fitzsimons, E. & Cooper, J. (2012). Embedding a culture of evidence-based practice. Nursing Management, 19(7), 14-19. An Error Occurred Setting Your User Cookie Loke, J. C., Laurenson, M.C., & Lee, K. W. (2014). Embracing a culture in conducting research requires more than nurses’ enthusiasm. Nurse Education Today, 34(1), 132-37. http://dx.doi.org/10.1016/j.nedt.2012.09.006 Melnyk, B. M.,, Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. The Journal of Nursing Administration, 42(9), 410-417. Blackboard Learn Yoder, L. H., Kirkley, D., McFall, D. C., Kirksey, K. M., Stalbaum, A. L., & Sellers, D. (2014). Staff nurses’ use of research to facilitate evidence-based practice. American Journal of Nursing, 114(9), 26-37. Blackboard Learn