Barriers to evidenced based practice Priyadarsini John

This presentation describes the "Barriers to Evidenced Based Practice" and how to overcome these barriers specifically in the Nursing community.

1. Barriers In Evidence Based Practice
Mrs. Priyadarsini John, RN, RM, MSc N
Professor, DY Patil University, Nerul, Navi Mumbai

2. Barriers To Using Evidence Based
Practice
•Research
•Nurse
•Organisational
•Profession Specific

3. Research Related Barriers To Using
Evidence Based Practice
Lack of Valid Research
•Limited Trust-Worthy Studies
•Less Number of Studies
•Dearth of Published Replications
•Findings Inaccessible to Practitioners
•Complex Statistical Information
•Dense Research Jargon

4. Overcoming Research Related Barriers
To Using Evidence Based Practice
•Collaborate with clinicians
•Conduct high quality research
•Replicate studies
•Communicate clearly with less research jargon
•Present findings amenable to meta-analysis
•Suggest clinical implications
•Disseminate aggressively
•Disseminate broadly
•Prepare integrated research reviews

5. Nurse Related Barriers To Using
Evidence Based Practice
•Lack of formal instructions in research
•Lack of skills to judge the merits of a study
•Inability to incorporate research results in daily decisions
•Nurse’s attitude towards research
•Lack of intellectual curiosity
•Lack of motivation to engage in EBP
•Nurses are often resistant to change
•Change may be perceived as impacting job-security
•Reluctance to take risks

6. Overcoming Nurse Related Barriers
To Using Evidence Based Practice
•Read widely and critically
•Attend professional conferences
•Learn to accept evidence that a procedure is effective
•Become involved in a Journal club
•Pursue and participate in EBP projects

7. Organisational Barriers To Using
Evidence Based Practice
•Resistance to change by organisations
•Lack of motivational incentives
•Lack of workforce
•Lack of time to implement new ideas
•Reluctance to expend resources
•Reluctance to change organisational policies
•Lack of resources
•Library materials, internet access, financials etc.,
•Lack of commitment from managers and administrators
•Lack of Strong Leaders in the health care organization

8. Overcoming Organisational Barriers
To Using Evidence Based Practice
Administrators Can Adopt the Following Strategies
•Foster a Climate of Intellectual Curiosity
•Offer Emotional and Moral Support
•Develop Journal Clubs
•Serve as Role Models for Staff Nurses
•Offer Financial or Resource support for EBP Utilisation
•Reward efforts for using Research
•Seek opportunities for Institutional EBP Projects

9. Nursing Profession Related Barriers
To Using Evidence Based Practice
•Shortage of Role Models
•Historical Baggage
•Nurses do not perceive themselves as independent professionals
capable of recommending changes based on research results
•Notion that nurses do not have authority to initiate innovations
based on research findings
•Lack of valuing research as a foundation
for nursing practice –not just teaching research

10. Overcoming Nursing Profession Related
Barriers To Using Evidence Based
Practice
•Educators can help to promote use of research evidence
through the following:
•Incorporate research findings into the curriculum
•Encourage research and research use
•Initiate Journal clubs
•Place demands on researchers
•Demand that researchers demonstrate the proposed studies’
potential for clinical use
•Encourage student nurses to refer journals and incorporate in
their practice

11. An overview of Research On Barriers
of EBP
•The aim of this study was to identify the barriers to research utilization
among registered nurses practicing in a community hospital. In January of
2006, 376 registered nurses working in a community hospital in
Washington State were invited to complete the 29-item Barriers to
Research Utilization Scale. Twenty-one percent participated in this
descriptive study.
•Barriersreported include lack of authority to change patient care
procedures, lack of time to read research, and lack of awareness of
research.
•Organizational strategies that can be used by staff development
professionals to influence research awareness and utilization are discussed.

12. An overview of Research On Barriers
of EBP
•To assess nurses' current readiness and willingness to implement EBP, Melnyk
and colleagues at Ohio State University (OSU), Columbus, conducted a
descriptive survey of a random sample of 1,015 members of the American
Nurses Association.
•The results showed that only 34.5% of respondents (350) agreed or strongly
agreed that their colleagues consistently used EBP in treating patients.
Although a majority (76.2%) felt it was important for them to have more
education and skills in EBP, most found educational opportunities wanting, as
they did access to knowledgeable mentors, resources, and tools needed to use
EBP.
•The two most frequently cited barriersto EBP, however, were a lack of time
and an organizational culture that didn't support it—getting past
workplace resistance and the constraining power of the phrase, “That's the
way we've always done it here.”

13. An overview of Research On Barriers
of EBP
•A study done in Australia in 2014:The study showed that the major
barriers to research use were that “the relevant literature is not
compiled in one place,” there is “insufficient time on the job to
implement new ideas,” and “administration will not allow
implementation.”
•The key facilitating factors for EBP include support, encouragement,
and recognition by the management and administration.

14. An overview of Research On Barriers of EBP
Cross-sectionalstudy conducted on a sample of 210 nurses in a
teaching hospital in Tehran in 2013.
•“The lack of sufficient time for reading the studies,” “the lack of
sufficient time to implement the new ideas,” “the lack of adequate
facilities to implement the ideas,” “nurses’ little interest in
conducting studies,” and “the lack of authority to change the
methods and patterns of care” with, respectively, 85%, 84.6%,
83.8%, 83.4%, and 80.5% agreement with the existence of barriers
were the most barriers to application of research findings from the
studied nurses’ perspective

15. An overview of Research On Barriers of EBP
Perceived barriers to Evidence Based Practice among Registered
Nurses
•The study was conducted among 100 registered nurses of Yenepoya
University and hospital.
•The finding of the study denotes that most of the respondents
perceived that the physician, administration and other staffs won’t
cooperate to implement the research findings. The nurses working
in the hospital felt that there is no time to implement the evidence
into practice; relevant literature is not compiled in one placeand
uncertain whether to believe the research results.
•The greatest barriersidentified by the registered nurses are that the
nurse doesn’t have enough authority to make change, the benefits
of change will be minimal and the nurse is unwilling to try new
ideas.

16. An overview of Research On Barriers of
EBP
•Behavior change is tough,” says Melnyk, who is also dean of the
College of Nursing, associate vice president for health promotion, and
chief wellness officer at OSU. The key seems to lie in creating a
context and support system under which EBP efforts can be sustained.
•Nurse leaders who want to encourage EBP among their staff, Melnyk
says, “need to realize that a one-or two-day workshop isn't likely
to cause sustainable change”.To really make it happen,she
believes,nurse leaders need to place enough EBP mentors at the
bedside who can work hand in hand with clinicians to help them
learn these skills and implement them consistently.