Evidence-based practice in obstetric care: perspectives, experiences, and readiness of obstetric nurses in Sri Lanka

Evidence-based practice (EBP) is essential for improving the quality, safety, and effectiveness of healthcare delivery. In obstetric care, the integration of EBP is particularly important for optimizing maternal and neonatal outcomes. However, implementation remains challenging, especially in low-resource settings such as Sri Lanka, where limited evidence exists regarding obstetric nurses’ perspectives, experiences, and readiness toward EBP. This study aimed to explore the perspectives, experiences, and readiness of obstetric nurses within the Sri Lankan state health system toward evidence-based practice in providing obstetric care. A qualitative study design was employed, and purposive sampling was used to recruit 33 participants (nurses, nurse managers, policymakers, and an obstetrician) across three tertiary hospitals. Data were collected via three focus group discussions (FGDs) and six in-depth interviews IDIs and analyzed using Braun and Clarke’s reflexive thematic analysis to identify key patterns and themes related to EBP. Participants were selected using purposive sampling from three tertiary care hospitals in Sri Lanka. Trustworthiness was ensured using credibility, dependability, confirmability, and transferability strategies, and reporting followed COREQ guidelines. Five key themes were generated: (1) knowledge and understanding of EBP, (2) practices of EBP, (3) beliefs and attitudes toward EBP, (4) barriers and facilitators to EBP implementation, and (5) readiness for EBP. Participants demonstrated varying levels of understanding, with many equating EBP with adherence to protocols rather than integration of research evidence and clinical judgment. Practice was largely protocol-driven and influenced by experiential knowledge and hierarchical decision-making. Although participants expressed positive attitudes toward EBP and recognized its value in improving care quality and patient safety, implementation was hindered by organizational constraints, workload pressures, limited training, and restricted autonomy. Supportive leadership, teamwork, and access to guidelines were identified as key facilitators. Readiness for EBP varied and was influenced by both individual motivation and organizational capacity. Obstetric nurses in Sri Lanka demonstrate positive attitudes toward EBP but face significant individual, organizational, and systemic barriers to its implementation. Strengthening EBP requires improvements in education, clinical training, leadership support, and institutional policies. Enhancing organizational readiness and empowering nurses may promote effective integration of evidence-based care in obstetric settings, ultimately improving maternal and neonatal health outcomes.