Barriers and Facilitators to the Use of Evidence-Based Best Practices

Abstract

The continued use of healthcare interventions without an evidence base increases healthcare costs without positively impacting patient care outcomes. Reports disseminated by bodies such as the Institute of Medicine and initiatives such as the Institute for Health Care Improvement's 5 Million Lives Campaign have increased emphasis on improving outcomes. Results of a descriptive correlational study indicated that 64% of the nurses surveyed read 7 or more specialty journals, 53% read 1 or more general nursing journal, 20% did not regularly read any professional journal, and none of the nurses surveyed read a journal that was primarily dedicated to the publication of original research. Almost half of the nurses indicated that the hospital library was the nearest location to conduct searches, and 34% indicated that they did not know what literature-searching capabilities were available to them. Although knowledge in itself is not sufficient for behavior change, it is an essential prerequisite. Regular reading of journals either through personal subscriptions or access through facility libraries can encourage the adoption of new evidence through lifelong learning. Modeling and skill building in use of readily available Internet resources can serve as a mechanism to increase awareness of and skill in accessing current information. Evidence-based changes can then be empirically examined, implemented, and evaluated in examining nursing's contribution to the daily operation of the healthcare organization.

What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review

“…Empirical literature needs to be available, if not at the point of care, then at the very least in a easily accessible designated area within each department (Brown et al, 2009;Chau et al, 2008;Chummun & Tiran, 2008;Gale & Schaffer, 2009;Green & Ruff, 2005;Leasure et al, 2008;McKenna et al, 2004b;Sams et al, 2004). For the resources to be properly utilised, staff need to know how to access them and interpret them.…”

“…If employees have the knowledge that they can improve patient outcomes through changes in their clinical practices developed by themselves or their colleague, it is more likely to motivate them to use EBP (Fink et al, 2005;Reavy & Tavernier, 2008). The use of EBP needs to become a recognised core skill in health care (Golenko et al, 2012;Leasure et al, 2008), with staff given the opportunity to be involved in activities which directly influence tangible workplace and patient outcomes (Kenny et al, 2010). If staff feel empowered to apply EBP principles, this will facilitate KT.…”

“…Again it is the senior staff and organisational policies leading from the front and the top that can help create a working environment open to innovation, revitalisation and positive change (Gerrish & Clayton, 2004;Plath, 2013). Workplace guidelines and protocols should be based on up-to-date, best evidence, with the background literature available to staff (Gerrish & Clayton, 2004;Leasure et al, 2008). Policies should also have input from staff working groups and be reflective of each working group's needs and ideas, which may help align professional and organisational goals Ogiehor-Enoma et al, 2010;Santos, 2012;Smith & Donze, 2010).…”

“…Individual experiences, bias and attitudes alongside professional, organisational and workplace factors can act as hurdles or barriers to the translation of empirical knowledge into practice and as such this process can take many years (Brady & Lewin, 2007;Fineout-Overholt et al, 2005;Newman et al, 1998;Retsas, 2000). For individuals to effectively implement EBP, they need to be both motivated and competent (Newman et al, 1998); motivated in that they have a desire to seek out the information that best serves the needs of their patients; and competent in that they need to have the necessary skills and resources available to them to seek out, critically analyse and interpret the data they require (Kajermo et al, 2010;Leasure et al, 2008;Ploeg et al, 2007). In short, health care professionals need to be skilled and informed consumers of EBP findings.…”

Promoting Evidence-Based Practice Through a Research Training Program for Point-of-Care Clinicians

“…[5][6][7][8] Organizational barriers identified include insufficient time to implement new ideas, lack of access to research, and lack of awareness of available educational tools related to research. [5][6][7][9][10][11] Research demonstrates that the most important factor related to nurses' EBP is support from their employing organizations to use and conduct research. 7,9 Other facilitators include the presence in the clinical setting of advanced practice nurses, research mentors, and educators knowledgeable about research [12][13][14][15][16] ; nursing research internships 17 ; and designated nurseresearchers.…”