Barriers, challenges, and strategies to implementing evidence-based nursing practice (EBNP)

Topics: Nursing, Nurse, Evidence-based medicine Pages: 7 (2122 words) Published: May 27, 2014
Most clinical health care workers are aware that achieving the paradigm of evidence-based practice (EBP) is the gold star standard that one strives for in his/her clinical practice. EBP is expected of healthcare clinicians and has become a synonym for quality care both by the institution of healthcare and its consumers (Brim & Schoonover, 2009). This essay will define EBP for nurses. The barriers, challenges and strategies to implementing evidence-based nursing practice (EBNP) will be discussed with reference to relevant and authoritative literature. As well, the relevance and the links that EBNP has with the clinical area of Intensive Care will be discussed. EBP is the integration, by clinicians, of clinical expertise which is meticulous, explicit and uses current clinically appraised professional knowledge (Eizenberg, 2011; Kenny, Richard, Ceniceros, & Blaize, 2010). EBP accommodates patient preferences, views and values; while also guiding, supporting, validating and answering health care workers clinical judgements, practices, and questions (Eizenberg, 2011; Kenny et al., 2010; Matula, 2005; Wolf, 2005). EBP is a process of asking a clinical question; searching for clinical evidence; critically appraising this evidence and then expertly integrating this evidence with patient’s values, views and preferences; evaluation of how the changes to practice have had on outcomes; and finally disseminating the results that the EBP or change had on patient outcomes (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010). The definition of EBP and EBNP and the implementation of EBNP appear to be straightforward and easily accomplished; however, EBNP implementation is far removed from being easy (Brim & Schoonover, 2009; Cullen, Titler, & Rempel, 2011; Eizenberg, 2011; Kenny et al., 2010; Tolson, Booth, & Lowndes, 2008). Nursing research has uncovered numerous challenges and barriers which the implementation of EBNP faces. These challenges and barriers can be classified as a research, a clinician, an organisational, a nursing professional barrier, and not least patient barriers (Fernandez, Davidson, & Griffiths, 2008; Gerrish et al., 2011; Hutchinson &Johnston, 2006; Ross, 2010). Eizenberg (2011), Gerrish et al. (2011), and Ross (2010) found that nurses face research and clinician barriers that include not having the time, skills and knowledge to critically critique and/or synthesise research literature, unable to effectively use and search databases electronically, hold negative views toward research and feel research is too complex, as well research at times is not clear on how to implement the findings and findings can be contradictory. Due to these barriers, nurses tend to rely on synthesised evidence such as evidence-based protocols, policies and procedures (Gerrish et al., 2011). Eizenberg (2011) and Gerrish et al. (2011) also found that nurses prefer to acquire information through third parties such as their colleagues, the workplace, through patient care experience, and the knowledge they received from their nursing education. Eizenberg (2011) found that the organisation is the greatest factor in successful EBNP implementation. The organisation controls access and the budget to and for evidence resources such as computers with internet access, a well-equipped library, and access to educational opportunities in EBNP procedures and theory (Eizenberg, 2011). The barrier of not having the authority to change a nursing practice also lies with the organisation – a nurse may have the necessary research knowledge and experience to effectively change practice but cannot implement practice change due to the organisation not giving him/her the authority to instill change (Eizenberg, 2011). Few nursing staff members are given the opportunity to participate in the development of evidence-based policies and procedures; therefore, most nurses are not engaged to support EBP. Ross (2010) further found organisational barriers such...

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