Homework Lance
The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020. We are currently at approximately 15%. Discuss two barriers that might hold nursing practice from achieving this goal. In your responses to course colleagues, suggest ways in which identified barriers may be addressed.
Multiple barriers to conducting and implementing evidence-based practice exist and contribute to the constraint of advanced practice in the field. Haynes & Haines (1998) suggest hindrances that may impede the conduction of evidence-based practice exist on the clinical practice level. Sometimes once guidelines have been set to administer care to a patient it ends up being a “hurry up and wait” game. New standards of care for CPR may be implemented but in many places, CPR is not administered on a daily basis. Waiting for the perfect time, place, and person to test a theory on takes time and patience. Age, gender, and specifics of condition may also contribute to the slowing of research.
Another barrier to conducting EBP research pointed out by Stevens (2013), is the implementation of new practices on the clinical level. Integrating change, even for the sake of research, is difficult and can require tiresome efforts of those in leadership positions to get everyone on board. Simply put, change is hard for people to accept and apply. When we’ve been doing things the same way for so long, it becomes routine and comfortable. Often nurses may feel stressed out by their workload, patient ratios, or duties in general. Then new information, a new way of giving care, and having to learn a new task may add to the pressures and stress of an already busy nurse. Research is halted or slowed for hospitals whose staff may be reluctant to apply new practice.
Reference:
Haynes, B. & Haines, A. (1998). Barriers and bridges to evidence based clinical practice. BMJ: British Medical Journal, 317(7153), 273-276.
Stevens, K.R. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 2(18).
ANSWER 2
Ross (2010) found that nurses face research and clinician barriers that include not having the time, skills and knowledge to critically critique and/or synthesis research literature, unable to effectively use and search databases electronically, hold negative views toward research and feel research is too complex, aswell 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 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 EBP procedures and theory (Eizenberg, 2011). It is therefore imperative to implements these processes for good result. Great Job Kiley.
References
Ross, J. (2010). Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice. Journal of PeriAnesthesia Nursing, 25(2), 64-70. DOI: 10.1016/j.jopan.2010.01.007
Eizenberg, M. M. (2011). Implementation of evidence-based nursing practice: nurses’ personal and professional factors? Journal of Advanced Nursing,67(1), 33-42. DOI: 10.1111/j.1365-2648.2010.05488.x
ANSWER 3
Evidence-Based Practice (EBP) is the forefront of healthcare and helps improve clinical decision making. By implementing EBP, a practice can become stronger and have a higher standard of care.
One of the main barriers I see in implementing EBP is resistance. I think that people are naturally resistant to change. People like what they know and how they do things, so change can be difficult. “If nurse executives/leaders are not engaging in EBP, serving as role models, and facilitating evidence-based care, it follows that their staff will not engage in evidence-based care as the behaviors of nurse executives and managers influence staff behaviors” (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan. 2012). With that being said, nursing is constantly changing and therfore if the staff is not interested in change, then they are going to be stuck where they are and never improve. EBP can be difficult to implement if it is a completely new procedure that not many people are familiar with and I think that resistance is a main barrier to implementation.
Another barrier is lack of information. I think that EBP is great but sometimes it can be hard to find initially. According to a study “Barriers not frequently cited in previous literature that were noted by this sample of nurses included the lack of available information (55 respondents, 8%) and evidence (15 respondents, 2%) to support EBP efforts” (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan. 2012). I think one must know who to turn to and where to look for this information in order for it to be implemented. An EBP mentor would be a good starting point for information on EBP. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The
REFERENCES
State of Evidence-Based Practice in US Nurses. JONA: The Journal of Nursing Administration, 42(9), 410-417. doi:10.1097/nna.0b013e3182664e0a
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