Barriers to implementing evidence-based practice in a private intensive care unit in the Eastern Cape

Abstract

Background. Evidence-based practices (EBPs) have been promoted to enhance the delivery of patient care, reduce cost, increase patient and family satisfaction and contribute to professional development. Individual and organisational barriers can hamper the implementation of EBP, which can be detrimental to healthcare delivery. Objective. To determine the individual and organisational implementation barriers of EBP among nurses in a private intensive care unit (ICU). Methods. A quantitative research design was used to collect data from nurses in a private ICU in the Eastern Cape Province, South Africa. The structured questionnaire (Cronbach's alpha: 0.72) was administered to 70 respondents, with a response rate of 93%. Results. Barriers at individual level were identified, and include lack of familiarity with EBP, individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to organisational support, change and operations were identified. Conclusion. Although the findings were similar to other studies, this study showed that nurses younger than 40 years of age were more familiar with the concepts of EBP. Physicians were perceived as not being very supportive of EBP implementation. In order to enhance healthcare delivery in the ICUs, nurse managers need to take cognisance of the individual and organisational barriers that might hamper the implementation of EBP.

A multi‐institutional study of the perceived barriers and facilitators to implementing evidence‐based practice

“…A major barrier identified in this study was insufficient knowledge. These findings were consistent with those from other studies, which identified insufficient knowledge as main barrier to the uptake of EBP (Jordan et al., ; Kin et al., ; Koehn & Lehmen, ; Mallion & Brooke, ; McInerney & Suleman, ; Underhill et al., ; Wang, Jiang, Wang, Wang, & Bai, ). Another barrier to EBP that has been commonly identified in research studies is the perception of insufficient power to adjust patient care processes.…”

“…A review of the literature revealed that nurses from different countries and settings have consistently complained of experiencing similar barriers to the adoption of EBP, which include lack of time , perception of insufficient power to adjust patient care processes, inadequate organisational support, insufficient access to research journals and articles and insufficient knowledge and skills (Baird & Miller, ; Carroll et al., ; Funk et al., ; Gerrish & Cooke, ; Jordan, Bowers, & Morton, ; Kin et al., ; Mallion & Brooke, ; Mehrdad et al., ; Underhill, Roper, Siefert, Boucher, & Berry, ). In one study, Funk et al.…”

“…This study sought to uncover the barriers and facilitators of EBP that nurses in this population face in their provision of nursing care. 2 | LITERATURE REVIEW 2.1 | Nurses' perception of barriers to using evidence-based practice A review of the literature revealed that nurses from different countries and settings have consistently complained of experiencing similar barriers to the adoption of EBP, which include lack of time, perception of insufficient power to adjust patient care processes, inadequate organisational support, insufficient access to research journals and articles and insufficient knowledge and skills (Baird & Miller, 2015;Carroll et al, 1997;Funk et al, 1991;Gerrish & Cooke, 2013;Jordan, Bowers, & Morton, 2016;Kin et al, 2013;Mallion & Brooke, 2016;Mehrdad et al, 2008;Underhill, Roper, Siefert, Boucher, & Berry, 2015). In one study, Funk et al (1991) found that one of the most frequent reported barriers among more than threefourths of the participants in their study was insufficient time for implementing new ideas or reading research.…”

Barriers Associated With Evidence‐Based Practice Among Nurses in Low‐ and Middle‐Income Countries: A Systematic Review

“…The majority of the 16 studies ( n = 15) focused entirely on EBP, specifically perceptions, knowledge, and barriers (Amini, Taghiloo, Bagheri, Fallah, & Ramazani Badr, ; Ay, Gençtürk, & Turan Miral, ; DeBruyn et al., ; Duncombe, ; Ebrahimi, Seyedrasooli, Khodadadi, & Yousefi, ; Farokhzadian et al., ; Hweidi, Tawalbeh, Al‐Hassan, Alayadeh, & Al‐Smadi, ; Jordan, Bowers, & Morton, ; Kahouei, Alaei, Shariat Panahi, & Zadeh, ; Karki et al., ; Khammarnia, Haj Mohammadi, Amani, Rezaeian, & Setoodehzadeh, ; Mehrdad, Salsali, & Kazemnejad, ; Naderkhah et al., ; Subramaniam, Krishinan, Thandapani, Van Rostenberghe, & Berahim, ; Yava et al., ). It is unlikely that studies did not report on outcomes (barriers to EBP among nurses) since most of the studies included nurses as the participants.…”

“…Two studies employed qualitative research methods (Adib‐Hajbaghery, ; DeBruyn et al., ). The nurses included in the studies were from diverse settings such as nurse researchers, educators, and graduate students (DeBruyn et al., ); psychiatric, geriatric, hospital, and community settings (Duncombe, ; Ebrahimi et al., ); critical care units (Hweidi et al., ; Jordan et al., ); and teaching hospitals (Ay et al., ; Khammarnia et al., ).…”