WHAT ARE SOME OF THE OBSTACLES OR BARRIERS TO IPMLEMENTING EVIDENCE-BASED PRACTICE(EBP) IN NURSING? NUR 590
What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Explain how at least one of the obstacles you have described could impact the implementation for your EBP project.
Barriers to evidence-based practice research can prevent research from reaching potential. Barriers that involve resource management, interdisciplinary involvement and lack of support are common in evidence-based practice research in varying levels depending on the research setting or question being explored. Building research within a medical center has its benefits as well as its barriers to obtaining research goals for health outcomes. Health related education especially can sometimes take a back seat to patient care interventions in terms of implementation of research (Swindle, Johnson, Davenport, Whiteside-Mansell, Thirunavukarasu, Sadavsin & Curran, 2019)
One barrier that I would predict would interfere with the implementation process deals with interdisciplinary communication for educational purposes. Although using education can be used to disseminate information to health care providers and the public, interdisciplinary information and coordination may make this difficult. This would impact my project because coordinating with nutrition and educational departments will become very important to the research outcomes and the amount of involvement or coordination may revolve around the ability to utilize these connections with other disciplines (Shayan, Kiwanuka & Nakaye, 2019).
Swindle, T., Johnson, S. L., Davenport, K., Whiteside-Mansell, L., Thirunavukarasu, T., Sadasavin, G., & Curran, G. M. (2019). A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start. Journal of Nutrition Education and Behavior, 51(9), 1067–1079. https://doi-org.lopes.idm.oclc.org/10.1016/j.jneb.2019.06.019
Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers Associated With Evidence‐Based Practice Among Nurses in Low‐ and Middle‐Income Countries: A Systematic Review. Worldviews on Evidence-Based Nursing, 16(1), 12–20. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12337
Mathieson and Brooke reported “barriers (to EPB) frequently reported include lack of time, staff shortage, heavy patient caseload, family commitments, limited knowledge of EBP and negative beliefs toward it, and limited academic skills” (Mathieson et at., 2019). Staff shortages with heavy caseloads are not new to nursing, but are intensely felt with nurse burnout and ethical conundrums. As a life-long learner with an ADN, BS Biology, and eventual MSN, I feel intense pressure to continue gaining knowledge and desire to increase nursing knowledge However, lack of time makes a war between my family, work rand educational responsibilities.
Lack of time is a one barrier to implementation of my EBP project. Several members of the EBP team, like the floor nurse and CNAs, have limited time during a shift. While a note in the EHR documentation may only take a moment, it can be hard to find those extra minutes on a busy and understaffed floor. Lack of time may be a barrier for the participants who will be completing educational modules. The participants, informal/family caregivers, may be busy or not give the education priority enough to finish. If team-members and participants don’t have the time to complete their needed responsibilities to the project, the data will be biased.
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488
There will always be barriers when implementing change. A study written by Mathieson, et al, in 2019 explored the barriers to implementing EBP in nursing. It was found that organizational changes – restructuring and the decentralization of services – had a negative impact upon implementation. I think the biggest barrier to change is timing. If the unit or hospital is not fully invested or there are other priorities then the EBP changes will suffer. The timing of implementation is crucial to the success of a project. For example, for my EBP proposal I think there will be obstacles because of our staffing issues. The lack of proper staff takes priority and it can be difficult to train and implement a new process when there is constant turnover of nurses. I am hopeful with a recent change in leadership, there will be better staffing models and my unit can return to focusing on improving nursing practice instead of staffing shortages.
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20 doi:http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488
The process of evidence-based practice (EBP) begins with a clinical query and then moves on to seeking and critically evaluating the evidence. When implementing evidence-based practice in nursing, there will be obstacles and barriers that will affect health care practices. Barriers can come in various forms on an organizational level or personal level. Examples of organizational level include the lack of human resources, shortage of internet service at work, and high workload were all issues at the organizational level (Khammarnia et al., 2017). Personal barriers examples included a lack of time to study literature, a lack of computer skills, and a poor command of the English language. Resistance is another barrier to healthcare when trying to implement evidence-based practice. Resistance is an obstacle that would impact the evidence-paste project; culture can be seen as a significant challenge on Hospital units (Ginex, 2019). It takes more than one person to alter a practice, which is why establishing a culture that promotes a spirit of inquiry and an evidence-based approach to treatment is crucial. When there is resistance in a unit towards change, it inhibits the progression of quality improvement.
Ginex, P. (2019). Overcome barriers to applying an evidence-based process for practice change. ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change
Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2017). Barriers to implementation of evidence-based practice in zahedan teaching hospitals, iran, 2016. Nursing Research and Practice, 2017, 1–5. https://doi.org/10.1155/2015/357140