Discussion: NURS 490 Barriers that prevent Nurses from implementing Evidence-based Practices
Discussion NURS 490 Barriers that prevent Nurses from implementing Evidence-based Practices
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After reading the article Nurses struggle to implement evidence-based practice, reflect on your experiences with evidence-based care. What barriers have you seen prevent nurses from implementing evidence-based practices? What strategies have been effective in removing those barriers?
Barriers caused by organizational culture that can be encountered by nursing leaders that can make them feel powerless can be multiple factors. The culture that is found in organizations includes the values, customs, norms, beliefs and mores that dictate this how people behave within that culture. This cultures influences how people behave within that organization, for better or worse. Nurse leaders within a corporate model can feel powerless by a lack of communication from upper management, keeping employees uninformed, administration distancing themselves from employees, conflict among staff and lack of trust can leave nurse leaders feeling quite powerless within an organization. Some other barriers include: a lack of involvement, the negative image of nursing, a lack of enabling structures, a process which exclude nurses, and a lack of available resources (Shariff 2014). Nurse leaders may also come across barriers due to financial reasons and bureaucracy from upper management if the nurse leader is wanting to implement changes in their department or an area of management.
Background: Evidence-based practice is important in improving the overall quality of patient care, enhance nursing practice and increase the confidence in decision-making. Evidence-based practice is a technique used in solving clinical issues regarding patient care by integrating well-designed evidence with patient preferences, patient assessments, and health professionals. This review aims to explore barriers that confront nursing in the implementation of evidence-based practice. Consequently, by determining some of the barriers to the implementation of EBP among nurses, health care systems can form solutions that allow the health centers to avoid such issues and execute the approach among health care providers. Methods: peer review was undertaken following a literature search in the databases involved CINAHL, MEDLINE and EBSCO Web of Science databases. Included studies were from October 2018 to December 2018, English language and peer-reviewed studies that aimed to explore the organizational and individual barriers within the healthcare setting. The quality appraisal tool was used to appraise all the included studies. Results: A total of 12 studies were included. Six studies were quantitative, five studies were qualitative, and one study used mixed methods. Four organizational barriers to implementing Evidence-based practice among nurses were found by reviewing the literature which is (“lack of support and supervision”, “lack of training” and “education”, “limited resources” and “time restriction”). While, four main themes were considering as an individual barrier to implementing Evidence-based practice among nurses: (“lack of nurses’ knowledge”, “skills and awareness regarding use the Evidence-based practice”, “lack of professional characteristic”, “nurses’ attitude and experience in using” and “language barrier in using or implementing Evidence-based practice”). Conclusions and implications for future practice: Nursing administrators and educators have the main role to facilitate evidence-based practice implementation among nurses, therefore; the findings of this review can help to overcome the identified barriers. Training and education are important to enhance the knowledge and skills of nurses to use evidence-based practice. Time management, providing the required resources and adequate supervision can facilitate the implementation of evidence-based practice which positively influences the quality of care. For further research, it is very fruitful to investigate the common barriers of EBP in one specific culture such as the middle eastern culture. Furthermore, future research may focus on barriers of implementing EBP related to the patients and their families.
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Introduction Evidence-based practice (EBP) is a technique used in solving problems regarding patient care by integrating well-designed evidence with the patient preferences, patient assessments, and health professionals’ expertise leading to lower health costs, better patient outcomes and safer care [1]. Furthermore, this approach has been promoted as a method for patients to receive the best services [2]. Nowadays, the health care system faces the challenge of providing consistent and high-quality services. If it is well implemented and
A Literature Review utilized in health care facilities, EBP helps in improving the overall care for patients [1]. Four major steps are followed in implementing EBP to solve a clinical problem as well as to assist the healthcare professionals in decision making. Firstly, healthcare professionals need to cultivate a spirit of inquiry and develop a clear clinical question regarding the patient’s issue [3]. After formulating the clinical questions, nurses need to search in the literature for clinically relevant articles that explain the problem the patient might be experienced [2]. If the nurses are successful in finding clinically relevant articles, they need to evaluate the included studies to determine how useful and valid they are. It is important to evaluate the quality of the included articles because some of the procedures or tests that may have been discussed regarding patient care may be outdated or irrelevant. Finally, after conducting an evaluation, the nurses can implement and disseminate the findings that they found useful in their clinical practice [2]. Nurses are often placed in a convenient position to enhance the quality of health care services that are based on knowledge and research [4]. Several advantages were found in applying EBP in the provision of health care services. EBP ensures that health professionals are delivering patient care that is innovative and, thus, guaranteeing better outcomes for patients [4]. Evidence-based practice also contributes to the science of nursing and increases the confidence in decision-making, resulting in ideal outcomes [4]. Finally, EBP maintains certain health practices relevant and current [4]. In the health care system, nurses make up the greatest percentage of health care providers, meaning that their role in the promotion of health care and delivery of quality services is massive. EBP has become an important subject in nursing and is being integrated into daily practices because it influences the capabilities, responsibility and professional development of nurses [5]. Nurses known for practicing based on scientific evidence make better decisions concerning the delivery of services and care. However, the approach is not being consistently utilized despite the greater professional satisfaction it is known to cause [6]. The development of research strategies has caused a change in the healthcare setting. Both experienced and new nurses experience few difficulties to adjust to the new environment of evidence-based practices from class practices [5]. However, several changes, on how nurses provide quality care to their patients, need to be made to ensure that EBP is correctly implemented into the healthcare system [5]. Several barriers were found to hinder the implementation of EBP among nurses. Evaluations conducted have revealed that both organizational and human factors are linked with barriers affecting the implementation of EBP [7]. Consequently, by determining some of the barriers to the implementation of EBP among nurses, health care systems can form solutions that allow the health centers to avoid such issues and execute the approach among health care providers. By doing so, policymakers and managers will be in a better position to plan for better utilization of EBP among all health care providers in health facilities.
Spirituality is the way to find meaning, hope, comfort, and inner peace in life. Many people find spirituality through religion. Some people find it through music, art, or a connection with nature. Others find it in their values and principles. Spirituality involves the recognition of a feeling or sense or belief that there is something greater than myself, something more to being human than sensory experience, and that the greater whole of which we are part is cosmic or divine in nature.
Healthy spirituality gives a sense of peace, wholeness, and balance among the physical, emotional, social, and spiritual aspects of our lives. However, for most people, the path to such spirituality passes through struggles and suffering and often includes experiences that are frightening and painful. Positive beliefs, comfort, and strength gained from religion, meditation, and prayer can contribute to well-being. It may even promote healing. Improving your spiritual health may not cure an illness, but it may help you feel better.
Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life (Bogue, 2020).
Similar to other caring activities and procedures, spiritual care improves people’s spiritual well-being and performance as well as the quality of their spiritual life. Spiritual care has positive effects on individuals’ stress responses, and spiritual well-being such as the balance between physical, psychosocial, and spiritual aspects of self, a sense of integrity and excellence, and interpersonal relationships. Spiritual well-being is important for an individual’s health potential and the experience of illness/hospitalization can threaten the optimum achievement of this potential. Professional nursing embraces spiritual care as a dimension of practice.
Nurses’ practice patterns in the area of spiritual care can be grouped into two categories including religious and nonreligious interventions. Religious interventions include treating patients’ religious beliefs without prejudice, providing them with opportunities for connecting with God and expressing their values and beliefs, helping them practice their religion, and referring them to clerical and religious leaders (O’Brien, et al., 2019). Nonreligious interventions include nurses’ presence for patients and their families, making direct eye contact when communicating with patients, sympathizing with patients and their families, listening to patients and their families attentively, and having love and enthusiasm for patients.
Although spiritual care is meant to help people, I frequently gain as a nurse. Interpersonal trust and a connection with the patient require high emotional intelligence. It’s important to realize that spirituality isn’t always theological care (Ross et al., 2018). Whereas the healthcare industry easily incorporates spirituality into therapy, spiritual care is essential in all sectors of operation. For the sake of our clients, we as caregivers must respect spiritual support, learn the required skills, and schedule time to satisfy these needs.
References
Bogue, D. W., & Hogan, M. (2020). Practicing dignity: An introduction to Christian values and decision making in Health Care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1
O’Brien, M., Kinloch, K., Groves, K., & Jack, B. (2019, August 9). Meeting patients’ spiritual needs during end of life care: A qualitative study of nurses’ and healthcare professionals’ perceptions of spiritual care training. Edge Hill University. Retrieved from https://research.edgehill.ac.uk/en/publications/meeting-patients-spiritual-needs-during-end-of-life-care-a-qualit-2
Ross , L., McSherry, W., Giske, T., Van Leeuwen, R., Schep-Akkerman, A., Koslander, T., Hall, J., Ostergaard Steenfeldt , V., & Jarvis, P. (2018, August). Nursing and midwifery students’ perceptions of spirituality, spiritual care, and spiritual care competency: A prospective, Longitudinal, correlational European study. Nurse education today. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29763841/