Evidence-Based Practice and Implementation Issues

Practice Description

Evidence-based practice (EBP) has become one of the most important concepts on which healthcare policymakers, researchers, and practitioners. It has gained popularity because of its potential of having a great impact on the practice, skills, and knowledge pertaining to the profession of nursing. According to the definition Ammouri et al. (2014), EBP “is defined as a systematic adoption of the most current evidence to answer a clinical question, along with considerations of the practitioner’s own clinical experience and the patient’s values and preferences” (p. 538). The potential benefits of EBP are vast because practitioners’ attitudes toward its implementation are positive despite the fact that their knowledge about it is limited significantly. This means that the lack of education on how to successfully integrate EBP into the nursing profession is the main barrier.

The need for the practice’s implementation is associated with its effectiveness for promoting excellence in healthcare and thus improving patients’ outcomes. For example, patient outcomes can improve by as high as 28% when clinicians base their care on evidence instead of already established practices (Ammouri et al., 2014). Therefore, the aim of reaching the 90% implementation of EBP is a goal that will help the healthcare system show unprecedented outcomes.

The extent of EBP Implementation

When it comes to evaluating the extent to which EBP is being implemented currently, several aspects should be mentioned. First, the level of knowledge “that healthcare professionals (i.e., physicians, nurses, pharmacists, physical therapists, technicians, and other allied healthcare professionals)” have about EBP implementation (Weng et al., 2013, p. 112). As revealed by Weng et al. (2013), pharmacists and physicians have the most extensive knowledge about EBP implementation. Compared to other identified professionals, nurses have the lowest level of positive attitudes toward the practice, which presents a significant challenge for the initiative to integrate EBP into the operations of healthcare organizations. On the other hand, physicians are identified as the most informed and skillful of EBP decision-making and thus perceived fewer barriers to the practice’s implementation (Weng et al., 2013).

According to the systematic review provided by the Agency for Healthcare Research and Quality (2013) on childhood obesity prevention programs, the strength of evidence used for the development of interventions for children diagnosed with a severe physical condition was either low or insufficient. This shows that current practices lack efforts for combining relevant evidence and existing knowledge in order to improve patient outcomes. On the other hand, there are examples of successful EBP implementation into the healthcare practice. For instance, in Gallagher-Ford’s (2014) article on EBP implementation, the introduction of the practice through transformational leadership within a healthcare organization was “empowering and built confidence to move the organization forward” (p. 73). Through the support of the senior leadership of a healthcare organization, EBP language and processes were continuously integrated into conversations, meetings, and various decision-making activities in which healthcare professionals engaged. Despite many concerns, the integration of the practice led to an organization introducing the EBP Council to guide professionals’ practice and reflect on the purpose of the practice.

Barriers to EBP Implementation

As mentioned previously, there are significant barriers that limit the implementation of evidence-based practice within healthcare settings. According to the findings of a focus group study conducted by Tacia, Biskupski, Pheley, and Lehto (2015), key barriers to EBP implementation include cultural and institutional limitations, the lack of professionals’ knowledge, the absence of motivation for change, ineffective time management, human (patient and physician) factors, and the limited access of professionals to useful resources and tools such as technologies. When it comes to cultural and institutional barriers, it was identified that most practitioners usually fell back on their habits and established practices instead of using newly integrated EBP ideas (Tacia et al., 2015). As to the lack of knowledge, the insufficient implementation of EBP was linked to professionals not being able to recognize criteria that can assist in the effective delivery of care.

The absence of motivation for change is associated with many professionals being stagnant in their positions and therefore lacking interest in giving any modifications a chance. With regards to patient and physician factors, they are especially relevant because both players involved in the process of healthcare may have different values and beliefs that conflict with the recommended evidence-based practice (Tacia et al., 2015). Lastly, the limited access to technologies is associated with ineffective solutions that make it harder for professionals to use and navigate.

Strategies for Overcoming EBP Barriers

Dealing with barriers that limit the implementation of evidence-based practice is possible through “interdisciplinary communication and collaboration, mentorship, access to professional activities and networks, and supportive management” (Tacia et al., 2015, p. 94). Since the majority of the identified barriers are associated with the lack of experience and knowledge on how EBP can be integrated successfully, the enhancement of the existing base of information and skillsets is critical. It will give practitioners more autonomy in the process of decision-making. Such enhancements can be possible through training sessions, conference attendance, incentives, reimbursements, and so on. It is essential to recognize that the provision of informational (intangible) and financial (tangible) support is likely to remove such barriers as the lack of motivation, education, and resources for implementing EBP strategies.

Overall, professional development is the key to gaining sufficient EBP knowledge for ensuring nurses’ best preparation for ensuring clinical care for optimizing patient outcomes. However, without appropriate leadership strategies and managerial support, none of the healthcare professionals will be able to integrate EBP on a long-term basis and reach the goal of 90% implementation. In addition, it should be mentioned that modern tools and resources are necessary for the successful integration of EBP into the healthcare practice.

Resources for Successful EBP Translation

In order to help healthcare organizations successfully translate relevant EBP processes into everyday operations, several types of resources are to be put in place. The first type of relevant resources is associated with information on the best practices. Such information can be found in primary literature sources such as physical and online libraries since the availability of published research on EBP is vast. The second type of resource involves the monetary support for facilitating the introduction of EBP into the nursing practice. Incentives provided to hospitals and other facilities may help managers offer a better training platform for nurses as well as ensure that relevant accomplishments are rewarded for boosting engagement and motivation. The last category pertains to human resources, which include trained personnel that have experience in EBP implementation. Skilled practitioners can contribute with their knowledge on the subject and give insights into the best practices that have proven to work in other settings.

References

Agency for Healthcare Research and Quality. (2013). Childhood obesity prevention programs: Comparative effectiveness review and meta-analysis. Web.

Ammouri, A. A., Raddaha, A. A., Dsouza, P., Geethakrishnan, R., Noronha, J. A., Obeidat, A. A., & Shakman, L. (2014). Evidence-Based Practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman. Sultan Qaboos University Medical Journal, 14(4), 537-545.

Gallagher-Ford, L. (2014). Implementing and sustaining EBP in real world healthcare settings: A leader’s role in creating a strong context for EBP. Worldviews on Evidence-Based Nursing, 11(1), 72-74.

Tacia, L., Biskupski, K., Pheley, A., & Lehto, R. (2015). Identifying barriers to evidence-based practice adoption: A focus group study. Clinical Nursing Studies, 3(2), 90-96.

Weng, Y.-H., Kuo, K. N., Yang, C.-Y., Lo, H.-L., Chen, C., & Chiu, Y.-W. (2013). Implementation of evidence-based practice across medical, nursing, pharmacological and allied healthcare professionals: a questionnaire survey in nationwide hospital settings. Implementation Science , 8, 112-114.