Models and Barriers in Evidence Based Practice: A Healthcare Report

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This report examines the implementation of Evidence-Based Practice (EBP) in healthcare settings. It begins by defining EBP and its significance in clinical decision-making. The report then delves into key EBP models, such as the ACE Star Model and the Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model, discussing their strengths and limitations. It highlights common barriers to EBP adoption, including lack of organizational support, limited access to resources, resistance to change, and the perception of EBP as time-consuming. The report suggests strategies for overcoming these barriers, such as staff training, quality audits, incorporating patient feedback, and integrating EBP into organizational policies. The author reflects on their experience as a nursing student and concludes by emphasizing the importance of considering patient and organizational factors, as well as traditional nursing values, when implementing EBP models. The report provides valuable insights into the practical challenges and potential solutions for promoting EBP in healthcare.
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Running head: MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
Name of the Student:
Name of the University:
Author note:
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1MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
Introduction
Evidence based practice (EBP) implies the act of engaging in clinical decision-making,
implementing clinical interventions and patient management strategies which are based on
scientific, valid and significant empirical evidence (Butler, Hall & Copnell, 2016). The following
paper will briefly discuss on the key models, barriers and strategies of overcoming barriers with
respect to the implementation of EBP across healthcare organizations.
Discussion
Models and Barriers
I was previously working as a nursing student at a local healthcare organization which
initially did not possess any specific model for EBP implementation. Some of the key barriers to
implementation of EBP, which were also prevalent in our organization, have been evidenced to
be: lack of prioritizing EBP as an organizational principle by the management, inadequate access
to evidence based research (EBR) and resources, resistance to change by the staff and
perceptions that EBP was time consuming. These issues prompted an organizational change and
the adoption of an EBP model – a strategy evidenced to be effective in guiding healthcare
professionals on EBP implementation (Labrague et al., 2019).
A model of EBP which was commonly used by my organization was the Academic
Center for Evidence-Based Practice Star Model (ACE Star Model), which provides a simple,
systematic approach for healthcare organizations to gradually adopt EBP practice via 5 methods.
These include: discovering and identifying relevant clinical research, summarizing essential
evidence from the same, translating the evidence to clinical guidelines, integrating the evidence
into organizational practice and screening effectiveness of these changes via process and
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2MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
outcome evaluation methods (Orta et al., 2016). While the simplicity and step-by-step guidelines
of this model is advantageous for healthcare professionals who are newly practicing EBP, it also
posed several limitations in our organization. Nurses like me, found it difficult to choose
between EBP and traditional nursing practice of patient-centered approaches since the latter is
not considered by the ACE Star Model. Indeed, overuse of EBP has been criticized to overlook
traditional nursing values of holistic patient care as well as organizational barriers to the same
(Fisher et al., 2016).
Overcoming Barriers
1. Inclusion of healthcare organizational staff to educational or training programs can assist
in overcoming resistance to organizational change in terms of EBP implementation.
2. Implementation of quality audits or group discussions involving stakeholders experienced
in EBP usage can assist in identification and mitigation of organizational barriers to EBP
implementation.
3. Inclusion of patient feedback results or EBP models emphasizing patient centeredness
can guide nurses on strategies with which patient centeredness can be integrated with
EBP simultaneously.
4. Inclusion of EBP as a part of an organization’s foundational policies and principles will
enhance organizational acceptance of EBP (McCluskey & Taylor, 2017).
EBP Model
A key EBP model which I believe will be useful in overcoming the barriers in my
institution is the Advancing Research and Clinical Practice through Close Collaboration (ARCC)
Model. This is because this model emphasizes the implementation of EBP interventions only
after identification of possible patient and organizational barriers as well as usage of factors like
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3MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
patient feedback, financial expenditures, staff intentions and staff turnover rates (Melnyk et al.,
2016).
Conclusion
This paper thus successfully discusses on key models as well as possible barriers which
are prevalently associated with the implementation of EBP across healthcare organizations. To
conclude, despite the effectiveness associated with EBP models, healthcare organizations and
nurses must consider patient and organizational factors as well as traditional nursing values prior
to their implementation.
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4MODELS AND BARRIERS IN EVIDENCE BASED PRACTICE
References
Butler, A., Hall, H., & Copnell, B. (2016). A guide to writing a qualitative systematic review
protocol to enhance evidencebased practice in nursing and health care. Worldviews on
Evidence
Based Nursing, 13(3), 241-249.
Fisher, C., Cusack, G., Cox, K., Feigenbaum, K., & Wallen, G. R. (2016). Developing
competency to sustain evidence-based practice. The Journal of nursing
administration, 46(11), 581.
Labrague, L. J., McEnroePetitte, D., D'Souza, M. S., Cecily, H. S. J., Fronda, D. C., Edet, O. B.,
... & Mirafuentes, E. C. (2019). A Multicountry Study on Nursing Students’ Self
Perceived Competence and Barriers to EvidenceBased Practice. Worldviews on
Evidence
Based Nursing, 16(3), 236-246.
McCluskey, A., & Taylor, R. R. (2017). Managing barriers to evidence-based practice: an
international imperative. Kielhofner's Research in Occupational Therapy: Methods of
Inquiry for Enhancing Practice, 59-68.
Melnyk, B. M., FineoutOverholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC©
Model improves implementation of evidencebased practice, healthcare culture, and
patient outcomes. Worldviews on Evidence
Based Nursing, 14(1), 5-9.
Orta, R., Messmer, P. R., Valdes, G. R., Turkel, M., Fields, S. D., & Wei, C. C. (2016).
Knowledge and competency of nursing faculty regarding evidence-based practice. The
Journal of Continuing Education in Nursing, 47(9), 409-419.
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