What Are The Barriers To The Use Of Evidence Based Practice

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).

doi:10.1037/cpb0000021 Melnyk, B.M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters

Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.

Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).

Another barrier is that organization does not provide the encouragement and acknowledgment to nurses who implement Evidence Based Practice (Cathy L. O’Nan, 2012). Major factors which prevent nurses from the implementation of Evidence Based Practices (EBP) are a lack of time to read articles, poor coordination with other members of health team and unavailability of nursing research articles. It was also concluded that nurses perceived the lack of managerial and organizational support to implement EBP (Ay, F., 2014).

The barriers to the implementation of the evidence-based practice (EBP) in nursing could occur either at the individual level or the organizational level. The individual level barriers include a lack of time and skill to work with the computer, age, level of education and the professional experience of the employees. (Khammarnia, Haj Mohammadi, Amani, Rezaeian, & Setoodehzadeh). Some people do not believe in this new approach, and they have a negative attitude towards research and EBP. It is hard for them to accept that the outcomes of EBP are better compared to the traditional methods. So they will continue to exert their pressure to follow the old practice. People think, it may take a lot of time to access the critical information from the

AJN, American Journal of Nursing, 110(1), 51-53. doi:10.1097/01.naj.0000366056.06605.d2 Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Asking the clinical question. AJN, American Journal of Nursing, 110(3), 58-61.

However the research study would have been better if they used qualitative methods to find out the nurse’s perceptions, knowledge and barriers towards evidence based practice in clinical decision making. Majid, et al. (2011) could have interviewed some of the participants to get detailed descriptions of how they feel about evidence based practice in clinical decision making. This would allow the researches to get an in-depth understanding making the study more valid (Saris and Gallhofer, 2007).

According to Lewis, Dirksen, Heitkemper & Bucher (2014), “Evidence-based practice is a problem-solving approach to clinical decision making. It involves the use of the best available evidence in combination with clinical expertise and patient preferences and values to achieve desired patient outcomes.” Using evidence based practice in nursing is extremely important, because evidence-based practice is the result of others trying a practice one way but needing to change some of the guidelines to make the practice safer and over all better for patients.

Evidence Based Practice is a principle that is centered on the improvement of patient care and outcomes, by introducing and researching current based evidence when making decisions for that patient. According to Johnston (2016), “Health-care practitioners are increasingly being encouraged to implement research evidence into practice in order to ensure optimal patient outcomes and provide safe, high-quality care”. Throughout the course of this class, whether it be from researching about Evidence Based Practice, or the implementation of nursing care delivery models, patient care and the way we treat our patients is at the forefront of change. We know that change is necessary, now it is just a matter of how to implement that change into the healthcare

This allows for a constantly growing pool of knowledge for clinicians to be able to get information from. Contributing not to only to the safety of clients, clinicians, and the efficacy of the medical procedures done. Evidence based practice encourages both old and new nurses to widen their knowledge and improve knowledge, competence and critical thinking skills (Belowska, Panczyk, & Gotlib, 2014). In a constantly growing and vast profession like nursing, it is imperative to constantly increase ones

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

Discovering new information applicable to the field of nursing begins by asking a focused clinical research question. According to Stone (2002), asking the appropriate question is essential for the research process that follows. Although there are countless nursing problems that are worth investigating, it is imperative to narrow the focus of the problems so they can be empirically tested (Adams, 2012). Personal clinical experience, professional literature, previous research, and current nursing theories are a few examples of sources where research questions can be identified (Adams, 2012). The purpose of this paper is to explain the connection between research and evidence-based practice, discuss how

Schmidt, N. A., & Brown, J. B. (2015). Evidence-Based Practice for Nurses (3rd edition). Burlington, MA: Jones & Barlett