Assignment #1: Implementing Evidence-Based Nursing Practice
Evidence-based practice (EBP) is a medical technique attracting much attention due to its high ability to efficiently and effectively solve clinical issues and improve patient outcomes. The technique advocates for clinical practices, for example, drug prescription based on existing research evidence with the best result(Xie et al., 2018). It provides benefits such as reduced risk in medical interventions and decreased hospital stay and readmissions, among others. Research studies reveal that most nurses are positive about the use of EBP, citing better cate to patients (Xie et al., 2018). However, there is evidence that its application and acceptance is slow(Xie et al., 2018). There are several barriers within the nursing practice hindering EBP wide implementation despite its popularity and significance. The next section discusses some of the obstacles.
Barriers to Adopting Evidence-Based Nursing Practice
Limited knowledge about Evidence-Based Practice
One of the barriers to using EBP is inadequate knowledge by nurses. Xie et al. (2018)report a research study that shows that over 65% of 565 registered nurses had between moderate to low knowledge on EVP application. Also, the study found that 50% were not aware of the process involved during EBP(Xie et al., 2018). EBP requires divergent knowledge starting on how to search for information, the selection on the best research, and adjustment to a given case. Seeking information, on the other hand, requires knowledge on how to use search engines since most medical information is digitalized. Lack of such skills makes nurses avoid the practice despite its value in improving patient outcomes. The problem affects most nurses who are out of college internship programs. However, even those with experience in practice get a challenge when there are advances in technology and processes of applying research evidence. Knowledge of how to look for information and process or applying research evidence thus impacts the use of EBP in medical facilities.
Insufficient time is another barrier to EBP application due to high engagement searching for the best evidence. Khammarnia et al. (2015), in research to identify the obstacles to EBP application, found that 70% of the nurses cited workload, which affects time. Most of the healthcare facilities have a low nurse to patient ratio, which forces nurses to work overtime with only a short time to rest. As a result, they are unable to access the library, whether physical or online, in search of research evidence since they use the little time to relax and attend personal issues. Search for research evidence requires time to navigate through the volumes of medical articles published every day. The nurses,on the other hand, lack time to advance their knowledge and skills in using research evidence, including how to search for articles. Most of them end up avoiding EBP because they do not have time to learn how to apply it in practice. Time, therefore, blocks the interested nurses from using EBP due to understaffing.
Lack of or limited resources in healthcare facilities also affects the application of EBP.Shayan, Kiwanuka, &Nakaye (2019), in a systematic analysis of barriers to EBP implementation, found that scant resources in healthcare facilities are a significant theme. There are several resources which nurses need to implement EBP apart from knowledge. They include the internet, computers, and subscribed medical journals and websites to access current research. The resources support efforts to use present evidence as the practice requires. Although nurses might be aware of previous evidence, it might not be applicable in a current case due to changes in diseases and general healthcare practice. However, most healthcare facilities do not have enough of such resources to support the sizeable medical staff. Inadequate resources, therefore, blocks some of the interested healthcare practitioners in employing research evidence.
Strategies to Facilitate use of Current Evidence in Practice
One of the approachesto facilitate the application of current evidence in practice is to increase computers and related networks, both availability, and speed. Current research evidence in the medical field is online, as it would take time to have hard copies. As a result, computers and the internet are vital resources to facilitate the use of current evidence. Sufficient computers solve the challenges of limited time and inadequate resources at the same time (Kueny et al., 2015). Healthcare practitioners do not have a lot of time queue or wait for a computer to load due to their tight schedules. The would choose to use their skills and knowledge in saving patient’s lives other than seeing patients suffer as the queue in search of current evidence. Providing medical staff with enough computers and strong internet, therefore, will motivate the use of research evidence in practice.
Increase Medical Staff
Increasing the number of medical staff solves the challenge of nurse workload. As the number of nurses increases, the ratio of nurse-patient will increase, meaning that they will have sufficient time with patients (Shayan, Kiwanuka&Nakaye, 2019). The time will be enough to leave the patients for a while, turn to the computer and search for evidence related to the case at hand. Nurses also cite that high workload reduces their energy, making the weak to search for evidence. However, increased staff will allow long rest shifts where nurses can relax and have sufficient time to search for evidence on a particular case.
Another strategy to facilitate the use of current evidence in practice is to introduce training programs within the facility for medical staff on how to use and search for evidence. Lack of skills and knowledge discourages most medical staff from even using the computers despite their availability(Shayan, Kiwanuka&Nakaye, 2019). Nevertheless, the use of current evidence in medical practice requiresregular updates on skills due to frequent changes, especially on the application process and technical part on how to search for articles. The more medical staff have skills and knowledge on how to search and use current evidence, the higher the motivation to use. In-facility continuous training programs on EBP, therefore, will facilitate the use of present evidence due to ease in search and application.
In conclusion, EBP requires substantial support from the medical facilities. Most of the medical staff understands its value and are ready to use the practice in improving patient care. However, there appear to be huge barriers related to the healthcare facility and the management preventing EVP. The obstacles include understaffing, which limits the time to search for evidence, inadequate resources, and lack of regular training o nurses. All the mentioned barriers are ways to overcome once the management commits to support EBP. They can do so by introducing EBP in-facility training programs, increasing medical staff, and resources needed.
Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., &Setoodehzadeh, F. (2015). Barriers to implementation of evidence based practice in Zahedan teaching hospitals, Iran, 2014. Nursing research and practice, 2015 (1), 1-5.
Shayan, S. J., Kiwanuka, F., &Nakaye, Z. (2019). Barriers associated with evidence‐based practice among nurses in low‐and middle‐income countries: A systematic review. Worldviews on Evidence‐Based Nursing, 16(1), 12-20.
Kueny, A., Shever, L. L., Mackin, M. L., &Titler, M. G. (2015). Facilitating the implementation of evidence-based practice through contextual support and nursing leadership. Journal of healthcare leadership, 7, 29.
Xie, H. T., Zhou, Z. Y., Xu, C., Ong, S., &Govindasamy, A. (2018). Nurses’ Attitudes towards Research and Evidence-Based Practice: Perspectives from Psychiatric Setting.JOJ Nurse Health Care, 3(5), 1-7.
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