This review focuses on the barriers in Nursing associated with the introduction of Evidence-based Practice. Evidence-based practice is relatively a new concept that involves a change from the traditional practice. The human tendency is always to resist first to changes. The resistance is what this review proposes to consider as barriers.
The aptly framed thesis statement reproduced here as “There is always a resistance to implement new approaches and techniques to treating patients due to the firmly established tradition and norm. As a result, the adoption of evidence-based practice faces several serious problems and challenges” deals with resistance to changes, new approaches and techniques of patients’ treatment as opposed to traditional practices firmly embedded in the professional practice. The deeply embedded nature of traditional practice poses problems and challenges for the implementation of evidence-based practice.
This review will, in the process, have arrived at a theoretical framework for the chosen topic while clearly defining the key terms, definitions, and terminology related to nursing practice and also identifying studies, models, case studies in support of the thesis statement. This will examine the various theories involved and identify the missing information and proceed to fill that gap in the subsequent chapters.
To achieve this, a thorough reading of the literature with a purpose, evaluating the same, summarising what has been examined is required before embarking upon the review (RWIT, n.d.) However, having everything upfront before writing is not desirable. It is while writing, the thinking process gets deepened contributing to the richness of the research (Booth, Colomb, Williams, 2008).
Responding to the changes in traditional practice is part of change management. The nursing profession is not alone in this respect. This applies to all professions or trades. Hence, it will be worthwhile to have a fair account of the new discipline of ‘change management’ which will be very relevant for the current study dealing with Evidence-based Practice (Morrow, Boaz, Brearley and Ross, 2012).
A multi-disciplinary approach to change management is necessary to achieve the aims and objectives of evidence-based practice. This evidence-based approach distinguishes the profession from the historical developments which have been rather “unidisciplinary” in nature. Thus, evidence-based practice has a cultural significance. It involves the forging of partnerships with fellow professionals within a health organization to draw from their experiences.
A parallel exercise to draw from the professional expertise of the external agencies as academicians, social, voluntary, and commercial sectors, is also a necessary ingredient of evidence-based practice (Trinder, Reynolds, 2000, p 131).
As a result, evidence-based practices are available in the fields of treatment related to asthma, heart failure, and diabetes. However, they are not readily implemented as health organizations tend to focus on their research to ensure patient safety and to draw conclusions whether the new approach in practice will translate into improved quality and safety for the patients. Going to the roots of the profession, foundations have been laid for the evidence-based practices by Florence Nightingale who pioneered the research in nursing practice. But very few nurses have added to the foundations laid by Florence Nightingale. (Titler, 2008). Evidence-based practice is, therefore “a conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide heath care decisions” (Titler, 2008, p 113).