The main objective of this study was to assess nurses and midwives’ awareness and perceptions regarding EBP. The findings showed that less than a half (46.2%) were aware of EBP. Most nurses and midwives (over 97%) possessed positive perceptions regarding EBP, however only 68% routinely practice EBP. Level of education attained, going back to school after first qualification, gender, access to learning resources and attendance of CME/CPD were significantly associated with awareness and perceptions.
Awareness of nurses and midwives with regards to EBP
From this study, less than half (46.2%) of the participants were aware of EBP. These findings were lower than that in the study done in Oman , Ethiopia , and Poland  where 63.3% v, 62.6% and 66.6% were aware of EBP, respectively. All these studies were conducted in teaching hospitals with specialized experience, which is similar to our study. This inconsistence in study findings may be due to the difference in participant’s characteristics, especially the levels of education attained. Most participants were bachelor’s degree holder whereas in our study, the majority were diploma and enrolled nurses and midwives. It may also be due to the numbers of exposure to the concept and implementation of EBP in Oman, Poland and Ethiopia, which is higher than here in Uganda.
The finding showed multiple sources of awareness on EBP, where over a half (60%) heard about EBP from CME and CPD attended. Another significant number heard about EBP from learning institution and reading professional textbooks. About the current sources of evidence for nursing and midwifery practice, the majority of participant rely their practice on personal expertise, review of literature and clinical guidelines. It is encouraging that some nurses and midwives are relying on scientific evidence, however the habit of try and error still exists in nursing and midwifery practice. Early studies done in United Kingdom, Australia and Iran found similar findings and the majority of nurses and midwives are progressively adopting evidence from disciplined research other than traditional sources [17, 27, 28].
The findings from this study also revealed some factors which could preventing nurses and midwives to be aware of EBP. These factors include the level of education attained, going back to school after first qualification, gender and access to learning resources. Prior study found that nurses and midwives who has a bachelor’s degree and above were more familiar with the concept of EBP[29, 30]. In Uganda, the concept of EBP is included in the curriculum of undergraduate nursing and midwifery studies. Moreover, some health facilities provide specific trainings about EBP, which can be beneficial to those who did not attain bachelor’s degree. Furthermore, the studies done in USA, Kenya and Egypt found that limited access to learning resources prevent nurses and midwives from knowing and implementing EBP [30-32]. This highlight the need of interventions of availing accepted learning materials available at their place of work such as libraries, standard operating procedures (SOPs) and printed guidelines.
Perceptions with regards to EBP among nurses and midwives
Nurses and midwives expressed positive perception about EBP in Nursing and Midwifery practices where most participants agreed that EBP is highly important (97.0%), it is necessary to provide care based on evidence (97.7%) and it is an obligation for every nurse and midwife to provide evidence-based care (96.3%). However 68.0% routinely practice EBP. This means that if nurses and midwives are given opportunity to know much about EBP, they will implement it in their practice. These findings from this study were consistent with the studies done among nurses and midwives from Oman, Iran, USA and Australia[16, 19, 33]. These studies found that nurses and midwives’ perceptions and beliefs were strong and positive. Across the world, nurses and midwives expressed strong and positive perceptions regarding EBP [10, 27, 34], although their knowledge regarding it remains low leading to inconsistence in implementation of EBP in nursing and midwifery practices[12, 35]. In this study, attendance of CME/CPD was a major factor associated with nurses and midwives perceptions. It is therefore recommended that opportunities toward CME/CPD should be extended to nurses and midwives during their clinical practice.
Since the study participants were selected by Use of consecutive sampling method, there is a possibility of selection bias. However, this sampling method was the best considering the nature of the study. Secondly, the study used self-administered questionnaire, which reduced the response rate to 78.9%, however this response rate is accepted and sufficient in quantitative research.