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DQ: What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

NUR 590 Topic 4 DQ 1

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

Barriers to evidence-based practice research can prevent research from reaching potential. Barriers that involve resource management, interdisciplinary involvement and lack of support are common in evidence-based practice research in varying levels depending on the research setting or question being explored. Building research within a medical center has its benefits as well as its barriers to obtaining research goals for health outcomes. Health related education especially can sometimes take a back seat to patient care interventions in terms of implementation of research (Swindle, Johnson, Davenport, Whiteside-Mansell, Thirunavukarasu, Sadavsin & Curran, 2019)

Hello! Nursing shortages continues to be an ongoing problem, and our patients are affected greatly when we continue to work short. Our patients are growing sicker and are requiring more time and care. Our nursing workload is increasing and the time that we are able to spend with our patients is decreased. When we have such as heavy workload, our time being spent collaborating with our patients and with the physician, decreases. This is where medical errors can happen and can lead to a poor communication amongst the interdisciplinary team, including our patients. Our patient’s quality of care decreases as well. Our patients are at a great risk for infection and poor outcomes when we are not able to spend time understanding and caring for their needs. Our nurses are having to take on such a great deal of workload that we are seeing an increase in our nurse burnout. Our nurses are being burned out by limited resources and shortages; our nurse satisfaction rates are going down. When nurses are feeling unsatisfied with their jobs, our patients care is also affected. Our nurses are not able to practice at the highest level that they can when they are feeling burned out, and unsatisfied with their positions. This is leading to an increase in workload and an increase in errors as well.  We are not able to spend our time and knowledge in using our critical thinking skills. We may not be able to notice with the decrease in time spend on patient care when something may be going on with our patients.

One barrier that I would predict would interfere with the implementation process deals with interdisciplinary communication for educational purposes. Although using education can be used to disseminate information to health care providers and the public, interdisciplinary information and coordination may make this difficult. This would impact my project because coordinating with nutrition and educational departments will become very important to the research outcomes and the amount of involvement or coordination may revolve around the ability to utilize these connections with other disciplines (Shayan, Kiwanuka & Nakaye, 2019).

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

References:

Swindle, T., Johnson, S. L., Davenport, K., Whiteside-Mansell, L., Thirunavukarasu, T., Sadasavin, G., & Curran, G. M. (2019). A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start. Journal of Nutrition Education and Behavior51(9), 1067–1079. https://doi-org.lopes.idm.oclc.org/10.1016/j.jneb.2019.06.019

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 Nursing16(1), 12–20. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12337

Mathieson and Brooke reported “barriers (to EPB) frequently reported include lack of time, staff shortage, heavy patient caseload,

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing
DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing

family commitments, limited knowledge of EBP and negative beliefs toward it, and limited academic skills” (Mathieson et at., 2019). Staff shortages with heavy caseloads are not new to nursing, but are intensely felt with nurse burnout and ethical conundrums.  As a life-long learner with an ADN, BS Biology, and eventual MSN, I feel intense pressure to continue gaining knowledge and desire to increase nursing knowledge However, lack of time makes a war between my family, work rand educational responsibilities.

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

Lack of time is a one barrier to implementation of my EBP project. Several members of the EBP team, like the floor nurse and CNAs, have limited time during a shift. While a note in the EHR documentation may only take a moment, it can be hard to find those extra minutes on a busy and understaffed floor. Lack of time may be a barrier for the participants who will be completing educational modules. The participants, informal/family caregivers, may be busy or not give the education priority enough to finish. If team-members and participants don’t have the time to complete their needed responsibilities to the project, the data will be biased.

 

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Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488

There will always be barriers when implementing change. A study written by Mathieson, et al, in 2019 explored the barriers to implementing EBP in nursing. It was found that organizational changes – restructuring and the decentralization of services – had a negative impact upon implementation. I think the biggest barrier to change is timing. If the unit or hospital is not fully invested or there are other priorities then the EBP changes will suffer. The timing of implementation is crucial to the success of a project. For example, for my EBP proposal I think there will be obstacles because of our staffing issues. The lack of proper staff takes priority and it can be difficult to train and implement a new process when there is constant turnover of nurses. I am hopeful with a recent change in leadership, there will be better staffing models and my unit can return to focusing on improving nursing practice instead of staffing shortages.

DQ: What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

Reference:

 

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20 doi:http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488

The process of evidence-based practice (EBP) begins with a clinical query and then moves on to seeking and critically evaluating the evidence. When implementing evidence-based practice in nursing, there will be obstacles and barriers that will affect health care practices. Barriers can come in various forms on an organizational level or personal level. Examples of organizational level include the lack of human resources, shortage of internet service at work, and high workload were all issues at the organizational level (Khammarnia et al., 2017). Personal barriers examples included a lack of time to study literature, a lack of computer skills, and a poor command of the English language. Resistance is another barrier to healthcare when trying to implement evidence-based practice. Resistance is an obstacle that would impact the evidence-paste project; culture can be seen as a significant challenge on Hospital units (Ginex, 2019). It takes more than one person to alter a practice, which is why establishing a culture that promotes a spirit of inquiry and an evidence-based approach to treatment is crucial. When there is resistance in a unit towards change, it inhibits the progression of quality improvement.

Ginex, P. (2019). Overcome barriers to applying an evidence-based process for practice change. ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change

Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2017). Barriers to implementation of evidence-based practice in zahedan teaching hospitals, iran, 2016. Nursing Research and Practice2017, 1–5. https://doi.org/10.1155/2015/357140

The most common barrier that I have experienced while participating or initiating organizational change is technology. The future consists of nothing but technological change. Especially within the last 10 years alone the nursing profession has drastically changed, advancing practice with computer technology. Charting has transitioned from paper chart to electronic health records, medication is now scanned using bar code administration replacing a check within a box on a paper chart. Nursing is driven by technology and will only become more advanced as the technology advances lack of familiarity and uncertainty about the skills related to the use of technical applications can affect acceptance of the systems: staff members may have insufficient knowledge of computers and difficulties handling the applications (Koivunen & Saranto, 2018). It was determined that if applications were easy to use and users were well educated in utilizing them, staff felt more satisfied with the implementation of application and more likely to make sufficient use of it (Koivunen & Saranto, 2018). While the advancement of technology is used to advance and improve the healthcare delivery system, it can serve as a barrier to implementation amongst nurses. While the implementation of my project does not include the use of new technological applications, it involves the use of new technological devices to carry out continuous compressions during defibrillation. This will require significant educational and hands on simulation opportunities to competency staff.

DQ What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

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