From leadership research to district action: Nurses experiences of adopting evidence-based practice in Saudi healthcare: organizational, educational, and cultural influences from qualitative focus groups

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Background Evidence-based practice (EBP) is expected in nursing, and its implementation is still limited by workload, evidence access, and organizational culture. In Saudi settings, nurses report mixed readiness for EBP and recurring constraints related to resources, autonomy, and change processes in daily care. This exploratory study aimed to examine the perspectives of postgraduate nursing students (Master’s and doctoral level) on barriers and facilitators to EBP in the Saudi healthcare context, using the Johns Hopkins Practice Evidence Translation (PET) model as the analytic framework. Methods A framework-guided thematic analysis of recorded focus group transcripts used deductive coding to PET domains (Practice, Evidence, Translation) with dual coding across two purposively sampled focus groups: Master’s-level nursing students (FG1; n = 5) and doctoral-level nursing students (FG2; n = 5), yielding N = 10 participants. Results In Practice participants framed EBP as “not personal preference,” integrating research evidence, clinical experience, and patient preferences, and described adapting tools and protocols locally. Key practice barriers include bedside resistance when EBP steps were viewed as extra work and hierarchical norms that constrained nursing autonomy. In Evidence, participants reported variable EBP education and research literacy and inconsistent organizational access to journals and databases. In Translation, facilitators included leadership support and capacity-building, while barriers included multi-level resistance and slow approval processes. Conclusion PET mapping highlights priorities to protect time for EBP work, build research skills, ensure reliable evidence access, and streamline translation pathways. Keywords: Evidence-based practice, Nursing, Johns Hopkins PET model, Framework-guided thematic analysis, Barriers, Facilitators, Knowledge translation, Organizational culture, Saudi Arabia

Study methods

Purposive sampling was implemented to recruit the sample. Special concern was given to direct experience of EBP implementation in Saudi healthcare settings. Eligibility criteria include registered nurses or nursing faculty currently employed in a clinical or academic institution in Saudi Arabia, with at least 1 year of experience. Recruitment itself was conducted through professional networks and institutional contacts. Both focus groups were conducted at King Saud University, Riyadh, Saudi Arabia 2025. Participants in focus group1 were Master’s-level nursing students enrolled in the nursing program at King Saud University (n = 5). Participants in focus group 2 were doctoral-level nursing students at the same institution (n = 5). While all participants were enrolled at King Saud University, they have diverse clinical and academic backgrounds. Their work experience ranged from tertiary hospitals, primary healthcare centres, and university settings across Saudi Arabia (Table 1).

Limitations

A number of limitations should be considered when interpreting these findings. First, the sample comprised N = 10 postgraduate nursing students enrolled at King Saud University (Master’s-level, FG1, n = 5; doctoral-level, FG2, n = 5), all within an academic setting and without frontline clinical nurses. These findings should not be generalised to frontline clinical nurses without postgraduate enrolment, or nurses in other Saudi institutions or regions. Participants’ perspectives, shaped by academic training, may differ from those of nurses working in clinical settings. Findings should therefore be interpreted as exploratory and contextually specific to this nursing population.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Amira Suliman AlAnizi; Seham Mansour Alyousef; Sami Abdulrahman Alhamidi. Nurses experiences of adopting evidence-based practice in Saudi healthcare: organizational, educational, and cultural influences from qualitative focus groups. BMC Nursing (2026-05-19). https://doi.org/10.1186/s12912-026-04768-9

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.