Barriers to Implementing Evidence-Based Practice in Nursing

Running head: EVIDENCE-BASED PRACTICE
EVIDENCE-BASED PRACTICE
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Introduction:
Nowadays, the delivery of high-quality care is a big challenge in the health care
setting. An evidence-based approach is a problem-solving approach to person centred care
which only focuses on best suitable and valid evidence that is available (Williams, Perillo &
Brown, 2015). Traditional care approach method is use by the nurses and the healthcare
professional that does not allow the nurses to deliver best quality of care to the patient.
Hence, in order to enhance the care practice different techniques of evidence based practice
in included and implemented in the nursing profession that would enable the nurses to
enhance their quality and care and patient health outcome (Malik, McKenna & Plummer,
2015). While researchers have shown the evidence of the reduced cost of health care
expenditure, enhanced quality of care, improved health outcome and high patient satisfaction,
the evidence-based of practice is difficult to implement in the clinical setting (Khammarnia et
al., 2015). The nurses are the largest group of health care providers and have a key role in
ensuring accurate practice by following the evidence-based practice. The evidence-based
practice not only improves the quality of care but also fundamental to professional practice,
responsibility. As discussed by Malik, McKenna, and Plummer (2015), a considerate
number of nurses are incompetent to practice according to evidence based practice because of
lack of adequate literacy of nursing practice, lack of adequate time to practice standard
guideline, heavy workload and in sufficient proficiency in the languages. The several studies
have identified which are human and organization factors are responsible for hindrance
towards the implementation of evidence-based practical. This paper aimed to determine the
barriers that inhibit the implementation of factors that impede the application of existing
research or evidence to nursing practice with the assistance to the existing literature that will
allow the nurses to adopt better method of practice that aim to deliver high quality of care to
the patient improving the health outcome of the patient.

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Literature Review:
Different researcher aimed to perform a literature review that would focus on the
factors inhibiting the implementation of evidence-based practice. Friesen‐Storms et al.
(2015), were aimed to determine the barriers to implementation of evidence-based practice
among nurses. The researchers have undertaken a participatory action design to conduct the
research. The participants were rural nurses of lung care unit, the data was collected using
observation, reflection, planning and acting phases. The time spent was 2010 to 2012 and
data was analysed using a comparative approach. The result suggested that lack of English
proficiency and little knowledge regarding the evidence based practice which hinders the
implementation of the practice. Hence, in this facilitators such as innovation and initiative of
nurses to involve in training, the opportunity of empowerment and involvement in clinical
decision making can be used as the strategy to overcome these barriers. The limitation of the
study is that the study lack numerical data to validate the study. Khammarnia et al. (2015)
were aimed to determine the barriers to implementation of evidence-based practice among
nurses. Researchers have undertaken a cross-sectional study of 280 nurses from six teaching
hospital. The participants of the study were the nurses who were working in the hospital
during the data analysis. The researchers used questionnaire to identify the barriers to
implement evidence-based practice and data was analysed using chi-square and STAT 11.
The result suggested that the lack of human resources and shortage of nurses, lack of
internet access at the work, heavy work load, lack time to work with the literature and lack of
proficiency in English is the prime reasons behind hindrance of implementing the practice.
While nurses show a positive attitude and beliefs towards evidence-based practice, because of
factors mentioned above the nurses failed to implement the evidence based practice in their
research. The limitation of the study is that the study only conducted in the Iran highlighting
the cultural homogeneity of the result. Kristensen Nyman and Konradsen, (2015), focused on

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the contributing factors behind hindrance in implementing evidence‐based practice. The
researchers highlighted that because of lack of evidence based practice the nurses failed to
provide a high quality of care to the patient. A descriptive qualitative design was chosen by
researchers in order to gain the perception of the health care professionals regarding
evidence-based practice. The participants of the study were healthcare professionals working
in two different medical wards and the data was collected in the spring of 2014 through 12
semi-structured interviews were conducted in all medical hall. The interview was guided by a
theoretical framework proposed by Klein and Knight. The result obtain suggested that apart
from inadequate knowledge of nurses regarding evidence-based practice, the policies to
implement research result, the lack of availability of the financial resource, inadequate
learning orientations are contributing factors behind lack of appropriate evidence based
practice. The researchers highlighted a lack of comprehensive assessment and role and
responsibility for transferring the research into practice. Hence, in order to implement the
evidence-based practice incorporation of stakeholders, the availability of resources would
facilitate the implementation of evidence-based research (EBP). The limitation of the
research is a limited number of participant to conduct the study. Malik, Mckenna and
Plummer (2015), emphasized how knowledge and belief of health professionals such as nurse
educators, clinical coaches as well as nurse specialist affect this implantation of evidence
based practice in nursing practice. To identify the factors that affect the implementation of
evidence-based practice, researchers have undertaken a mixed method such as the
quantitative and small amount of qualitative study. The researchers used quantitative
questionnaire and a small number of qualitative questions in order to collect data from a
nursing specialist, nurse educator, and clinical coach. The questionnaire was distributed to
approximately a total of 435 people. However, out of 435 people, 135 people only
participated in the study. The result suggested the majority of the health professionals are