The major role of the nursing profession is to provide high-quality health services. The implementation of evidence-based practice (EBP) is one of the most important strategies to achieve this professional role. EBP refers to the contentious, judicial, and explicit use of the current empirical or scientific evidence in informing decision making processes to impact healthcare delivery (Longton, 2014) positively. Longton (2014) further explains that professional nurses are required to not only support research work but also develop and transform nursing science, support its use in practice, and most importantly, apply scientific knowledge in advancing professional skills and practice. In most cases, EBP relies on scientific information published in journals to inform decision-making processes. However, clinical expertise and patient values, beliefs, and opinions should be incorporated to influence such decisions. According to Longton (2014), EBP has three aspects to be considered in the delivery of care, which includes clinical expertise of the care provider, patient values, beliefs, and the best scientific evidence. Health professionals are always on the move to make sure that EBP is a success. Although nurses receive motivation to implement EBP, they equally face barriers, which are a significant threat.
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Motivation to Implement EBP
Many factors motivate nurses to execute EBP in their areas of practice. First, the desire to provide high-quality care compels most of these professionals to apply the best evidence in practice. Furthermore, the presence of EBP training programs has proven to be an effective motivator in incorporating research knowledge into clinical practice (Black, Balneaves, Garossino, Puyat, & Qian, 2015). Advancing nursing education further increases the knowledge of research in nurses, which further enhances the level of adopting EBP in care delivery. Also, healthcare organizations and their administrators motivate these professionals to execute EBP to achieve high-quality care, reducing costs of care, and increasing patient satisfaction levels (Black et al., 2015). Therefore, the internal desire to offer high-quality care and the external influence of managers and their institutions leave nurses with no option other than executing EBP in their workplaces.
Moreover, factors that increase access to scientific materials compel nurses to incorporate the best evidence into practice. For instance, healthy relationships and partnerships between schools of nursing and clinical settings expose nurse professionals to new scientific knowledge, which is adopted into practice. Increased access to research materials in physical and online libraries is another motivating factor. Wilkinson, Hough, and Hinchliffe (2016) explain that increasing access to both international and local scientific resources through the use of digital and physical resources motivates nurses to acquire and incorporate scientific evidence into care. Also, healthcare accreditation processes, which are common in healthcare organizations indirectly motivate these professionals to adopt EBP (DeBruyn, Ochoa-Marín, & Semenic, 2014). Therefore, nurses are motivated by many factors to execute EBP in clinical care settings.
Barriers to Implementing EBP
Barriers that impede the implementation of EBP in clinical care settings range from individual to organizational factors. In their study, Black et al. (2015) explain that barriers at the individual level include the lack of knowledge about the research process and how the research studies can be critiqued, as well as the lack of awareness of research and its negative impact on care delivery. Also, nurses feel inferior to other health professionals like doctors, and together with the lack of support from other care providers to incorporate research into practice, they are demoralized. Khammarnia et al. (2015) further explain that low levels of education are another barrier. Therefore, nurses are faced with serious barriers to the execution of EBP at the individual level.
Organizational barriers emanate from the external challenges these professionals face in their areas of practice. One of the significant barriers is the lack of time to access online and physical resources that contain scientific information including published research journals (Black et al., 2015). Such a thing denies these professionals time to acquire scientific evidence, which is necessary for EBP. The lack of adequate time is attributed to increased workload and burnout levels in nurses because of the rampant problem of health workforce shortages (Khammarnia et al., 2015). Black et al. (2015) report that the lack of time further hinders the implementation of new scientific knowledge. Moreover, the lack of knowledge in nursing informatics and the absence of technological equipment like computers and the internet in places of work prevent nurses from accessing online scientific materials that, in turn, hinders the implementation of EBP (Khammarnia et al., 2015). Additionally, resistance to EBP in other health professionals discourages nurses because health care delivery involves different professions. Longton (2014) explains that the concept of evidence-based medicine met resistance from physicians, especially in its infancy periods. Nurses are likely to resist this concept because they rely on doctors to provide high-quality care.
Although there are motivational factors for EBP, many barriers hinder nurses from implementing this concept. Some of the motivational factors include the presence of EBP training programs, support from health care organizations and their management, advancing nursing education, and healthy partnerships between education and clinical nursing systems. Individual desires to offer high-quality care is another motivator. The lack of professional independence, the resistance of EBP by different health professionals, and lack of time to access, retrieve, and implement scientific information prevent the implementation of EBP. Also, the lack of nursing informatics knowledge and technological resources are among many of the barriers.
Black, A. T., Balneaves, L. G., Garossino, C., Puyat, J. H., & Qian, H. (2015). Promoting evidence-based practice through a research training program for point-of-care clinicians. The Journal of Nursing Administration, 45(1), 14-20.
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DeBruyn, R. R., Ochoa-Marín, S. C., & Semenic, S. (2014). Barriers and facilitators to evidence-based nursing in Colombia: Perspectives of nurse educators, nurse researchers, and graduate students. Investigacióny Educación en Enfermería, 32(1), 9-21.
Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to implementation of evidence-based practice in Zahedan teaching hospitals, Iran, 2014. Nursing Research and Practice, 2015, 1-5.
Longton, S. (2014). Utilizing evidence-based practice for patient safety. Nephrology Nursing Journal, 41(4), 343-344.
Wilkinson, S. A., Hough, J., & Hinchliffe, F. (2016). An evidence-based approach to influencing evidence-based practice in allied health. Journal of Allied Health, 45(1), 41-48.