This study employed convenience sampling to select 120 clinical nurses from a tertiary hospital in Wuhan for investigation. Taking the clinical nurses of a large tertiary grade A hospital in the Wuhan area as the target population, the research subjects were determined by using the method of stratified cluster sampling. In the first stage, the targets were divided into five layers according to the ward and department settings: internal medicine, surgery, obstetrics and gynecology, pediatrics, and others. In the second stage, following the principle of convenient investigation, a certain number of departments were randomly selected from each layer, and all the clinical nurses in these selected departments were the subjects of this study [5]. Inclusion Criteria: Nurses with at least one year of clinical nursing experience; hospital employees; possessing normal language comprehension without history of mental disorders; voluntarily participating in this survey. Exclusion Criteria: Nurses with less than one year of nursing experience; those with severe physical illnesses; individuals with mental disorders or cognitive impairments; clinical nurses not voluntarily participating in this study.

The survey questionnaire consists of three sections: a general information form, the Clinical Nurse Evidence-Based Core Competencies Survey developed by Wang et al. [6], and the Chinese version of the Evidence-Based Nursing Practice Barriers Scale [7]. 1) General Information Form: It includes the clinical nurse’s department, age, gender, years of experience, professional title, position, educational background, and whether pursuing a degree. 2) Evidence-Based Nursing Practice Core Competency Questionnaire for Nursing Staff: This section comprises four dimensions—evidence-based knowledge, evidence-based skills, evidence-based attitudes, and evidence-based behaviors—totaling 64 items. Each item is scored on a scale of 0 to 5 points, yielding a total score range of 0 to 320 points. Higher scores indicate stronger competency within that dimension. The total evidence-based competency score and each dimension’s score are converted to a percentage scale. Scores ≤25, 26 - 50, 51 - 75, and >75 are classified into four levels: very poor, slightly poor, adequate, and good. The Cronbach’s α coefficient for the entire scale was 0.928, with subscale coefficients of 0.927, 0.849, 0.701, and 0.712, respectively. All items showed significant correlations with their respective subscale totals (P < 0.01). 3) Chinese Evidence-Based Nursing Practice Barriers Scale: This 30-item scale comprises four dimensions—accessibility of research findings, quality of research reporting, resource conditions for implementing evidence-based nursing, and nurses’ understanding of evidence-based nursing. Each item is scored 0 - 5 points, yielding a total range of 0 - 150 points. Higher scores indicate stronger association with the factor and poorer quality. The total scale score and scores across the four dimensions were converted to a percentage scale. Scores were categorized into four levels: >75 points (severe impact), 51 - 75 points (moderate impact), 26 - 50 points (mild impact), and ≤25 points (minimal impact). The Cronbach’s α coefficient for the entire scale was 0.919, with dimension-specific coefficients of 0.825, 0.794, 0.815, and 0.729, respectively. All items showed significant correlations with their respective dimension totals (P < 0.01).

The survey team comprised mentors, nursing instructors, nursing administrators, and master’s degree candidates in nursing. Prior to the survey, investigators underwent standardized training and were deployed to clinical settings upon certification. Surveys were conducted one-on-one. Before distributing questionnaires, participants were briefed on the study’s objectives, significance, and completion guidelines, while also being assured of the survey’s anonymity and confidentiality. Respondents completed the questionnaires independently, with completion typically taking approximately 15 minutes. Completed questionnaires were collected immediately upon completion.

A total of 120 questionnaires were distributed, with 120 returned, achieving a 100% response rate.

Data were analyzed using the SPSS 21.0 statistical software package. Descriptive statistics, univariate correlation analysis, and multiple linear regression analysis were performed. The significance level was set at α = 0.05.

The clinical nurses surveyed ranged in age from 19 to 54 years, with a mean age of (31.46 ± 7.37) years. Their years of service ranged from 1 to 42 years, with a mean of (11.18 ± 8.60) years. Internal medicine: 50 (41.7%); Surgery: 34 (28.3%); Obstetrics and Gynecology: 3 (2.5%); Pediatrics: 7 (5.8%); Other departments: 26 (21.7%); Female: 116 (96.7%); Male: 4 (3.3%); 45 nurses (37.5%), 47 registered nurses (39.2%), 25 senior registered nurses (20.8%), 3 deputy chief nurses or above (2.5%); 112 general nurses (93.3%), 8 ward head nurses (6.7%); current educational levels: 35 secondary vocational school graduates (29.2%), 44 with associate degrees (36.7%), and 41 with bachelor’s degrees or higher (34.2%); 6 pursuing master’s degrees (5%), 20 pursuing bachelor’s degrees (16.7%), 6 pursuing associate degrees (5%), 2 pursuing other types of degrees (1.6%), and 86 not pursuing any degree (71.7%).

The total score for the Evidence-Based Nursing Competency Scale among clinical nurses was (135.92 ± 41.04) points, which converts to a percentage score of (42.48 ± 12.83), indicating a slightly inadequate level. Among the four dimensions, Evidence-Based Knowledge and Evidence-Based Practice scored the lowest, as shown in Table 1.

Table 1. Scores for evidence-based nursing competencies and their four dimensions among clinical nurses (n = 120).

Table 2. Barriers to evidence-based practice among clinical nurses and their scores across four dimensions (n = 120).

The total score on the Barriers to Evidence-Based Practice Scale for Clinical Nurses was (87.04 ± 20.89), which converts to a percentage score of (58.03 ± 13.93), indicating a moderate level of impact. Among the four dimensions, the availability of research findings and the resource conditions for implementing evidence-based nursing practice had the most significant impact, as shown in Table 2.

Using the total evidence-based competency score as the dependent variable, univariate correlation analysis was conducted with the following independent variables: department, age, years of service, professional title, position, current educational level, degree being pursued, and evidence-based nursing practice barriers score. Results indicate that clinical nurses with higher professional titles and educational levels demonstrate superior evidence-based competency, while those with higher evidence-based nursing practice barriers scores exhibit poorer competency. See Table 3.

Table 3. Univariate correlation analysis of evidence-based competencies among clinical nurses.

Note: P < 0.05.

Using the total actual score for evidence-based competency as the dependent variable, and department, age, years of service, professional title, position, current educational level, and evidence-based nursing competency scores as independent variables, a multiple linear regression analysis was conducted. Among the observed values set are the partial regression coefficient, the standard error, and the standard regression coefficient. The independent variable assignment table is shown in Table 4. Results indicated: r = 0.453, r² = 0.205, F = 9.973, P = 0.000. Nurses with higher professional titles and educational levels, along with lower scores on barriers to evidence-based practice, demonstrated superior evidence-based competency (see Table 5).

Table 4. Independent variable assignment table.

Table 5. Multiple regression analysis of evidence-based competencies among clinical nurses.

Note: P < 0.05.