Barriers to Implementation of Evidence-Based Practice in Clinical Areas

Running head: ESSAY
Evidence-based nursing
Name of the Student
Name of the University
Author Note

1ESSAY
Introduction- Evidence-based practice (EBP) is a term that defines the conscientious
usage of present finest evidences, with the aim of making critical decisions realted to patient
care. In other words, EBP is a systematic approach that encompasses the critical analysis of
most relevant and useful evidences for answering a clinical question that is under
investigation. This process of EBP provides practitioners the ability to analyse and evaluate
the research question, and other clinical guidelines that emphasise on high quality findings.
These results are then applied to the medical practice (Hall & Roussel, 2016). Thus, the
primary benefit of EBP is related to the fact that it entails decision making related to
promotion of patient health, through the delivery of care services that integrate practitioner
expertise and relevant findings. Owing to its potential in enhancing the health status among
patients, EBP has recently been identified as a matter of priority in healthcare systems
(Townsend & Morgan, 2017). Barriers to EBP generally occur at two levels namely,
individual and organisational. While individual barriers encompass inadequate knowledge
and lack of time management skills, organisational barriers are made up of patient factors,
limited access to health facilities, leadership qualities, and updated technology. The thesis
statement for the essay is:
There are several barriers that govern implementation of evidence-based practice in
clinical areas.
Barriers to EBP- EBP has been found to be greatly dependant on a range of factors,
apart from finding the evidence. These factors are responsible for influencing the extent to
which the evidence gets translated directly into healthcare practice. Some of the barriers to
the implementation of EBP are namely, (1) the ability to access and evaluate the collected
evidences, (2) workplace culture, (3) Human Resources and Finances, (4) Clinical skills, (5)
Values, expectations and concerns of the patient, and (6) Local environment (Laska, Gurman
& Wampold, 2014). Introduction of EBP to clinical practice is largely dependent on the

2ESSAY
individuals who are in possession of the unique ability to locate and analyse the information
that is relevant to the clinical question. Furthermore, introduction of EBP involves a great
deal of change (Scurlock-Evans, Upton & Upton, 2014). There are a plethora of enables and
barriers that are encountered on a regular basis, while attempts are taken for changing
healthcare practice.
Individual barriers- Effective utilisation of evidence-based practice for healthcare
related decision making is crucial in implementation of delivering care services that have
already been proved effective by a thorough and rigorous appraisal of research results
(Schmidt & Brown, 2014). However, the individual proficiency of the nursing professional is
a major barrier in this process. Research findings have confirmed the fact that nursing
professionals spent most of their time in activities that are related to direct or indirect patient
care (Tucker, 2017). Hence, most nursing staff do not have adequate time to go to libraries
and search for relevant evidences that can be implemented in practice. This can be attributed
to the fact the boundaries of nursing practice are often blurred and are open to different
interpretations in a range of circumstances (Gray et al., 2013). Thus, utilisation of EBP and
its effective implementation by all staff nurses are a challenging task. Individual barriers also
comprise of poor attitude and negative beliefs. Furthermore, a lack of awareness on research
makes it difficult for the nursing professionals to gain a sound understanding of statistical
terms, thereby creating difficulty in adjudging the quality of the research articles (Sadeghi‐
Bazargani, Tabrizi & Azami‐Aghdash, 2014).
Inadequate degree of familiarity of nurses with EBP also impedes the process of
correctly defining the process (Khammarnia et al., 2015). There is mounting evidence for the
fact that individual perceptions that all nursing staff hold for EBP play a crucial role in
governing their clinical decision-making skills. Majority of the nurses have been found to
report that they believe more on what they had been taught during the training programs and

3ESSAY
often trusted on traditional nursing practices, rather than EBP (Rodríguez-Soto et al., 2015).
Frequency of the nurses in assessing relevant information is another barrier. Most of them
access clinical evidences on an occasional basis, thus failing to effectively implement them.
Additionally, lack of computer literacy, level of educational attainment and proficiency in
English act as other individual barriers to EBP implementation.
Organisational barriers- In spite of the fact that nursing professionals form a major
part of the clinical workforce, and are imperative in the delivery of healthcare services, there
are a range of organisational factors that are perceived by the nurses as barriers to EBP
implementation. Lack of authority for changing practice and unsupportive management and
staff are some of the major organisational barriers (Lizarondo & McArthur, 2017).
Management priority plays an essential role in governing the EBP owing to the fact that it
considers several issues related to staffing, cost pressures, complaint responses, estate
management, and meeting the targets of the Department of Health and the purchasers. EBP is
an interdisciplinary practice. From the perspective of the operational management, the team
members often get frustrated due to the continuous pressure imposed on them. Owing to the
fact that the practice management groups (PMGs) are headed by non-nursing clinicians, the
nursing staff are most commonly excluded from the clinical decision making process (Légaré
& Witteman, 2013). There exist a lack of appropriate system to enhance personal and
professional growth and development. Haphazard appraisals of the nursing staff in terms of
quality and quantity also prevents them from participating in continuous education programs,
thus creating major barriers in the application of EBP (Farokhzadian, Khajouei & Ahmadian,
2015). Leadership skills have also been identified as a critical element of EBP application.
Absence of strong nursing leadership prevents the staff from drawing on best
evidences for disease prevention and health promotion. Thus, nursing administrators are the
prime personnel who can facilitate a culture of EBP in a healthcare setting (Tacia et al.,