Evidence-Based Protocols in Nursing

Thesis

“The nursing personnel contribute immensely towards the implementation and adoption of the evidence-based protocols which contribute towards the provision of quality care. The evaluation of the challenges that the nurses experience in implementing evidence-based protocols is critical to the achievement of the desired outcome of improving the quality of care provided.”

Evidence-based protocols are defined in the existing literature as the different care processes that seek to provide standardization through the application of evidence provided through research. The recent developments in healthcare indicate an increased need to ensure the implementation of the emerging evidence to provide the patients with the best care available. However, the translation of the evidence available in the peer-reviewed sources into practice is still a challenge. There is a need to understand the challenges that nurses face in implementing evidence-based protocols. An understanding of the difficulties involved in the implementation of the research evidence in care will help to refine the support functions that exist today so that the nurses can achieve the desired outcome.

This research seeks to evaluate the challenges that nurses face in the adoption and implementation of evidence-based protocols. The paper begins with a provision of a thesis statement, a description of the topic and outlining of the research plan. The literature will be searched in various databases to identify six articles that discuss issues related to the topic. The articles will be reviewed to determine the findings available, which will then be used to draw conclusions on the subject and make connections to the broader scholarly discussions in the area.

Abstract

Evidence-based protocols are perceived as an integral part of improving the quality of care provided. Given that literature has demonstrated that the implementation of evidence-based protocols is still low, this paper evaluates the current challenges faced by nurses in the implementation process. The findings indicate that factors such as lack of time to assess the literature for new knowledge and inability to evaluate research findings cause challenges in implementing evidence-based protocols coupled with the lack of adequate human resources to contribute largely towards the issues. The literature also indicates that nurses are faced with uncertainty regarding the applicability of the evidence from literature in the clinical settings and the lack of policy guidelines to direct the process. The adoption of transformation leadership can help nursing leaders overcome some of the challenges they face in the process and provide the motivation required to pursue the overall goal of adopting the evidence-based protocol.

Support for Thesis

“The nursing personnel contribute immensely towards the implementation and adoption of the evidence-based protocols which contribute towards the provision of quality care. The evaluation of the challenges that the nurses experience in implementing evidence-based protocols is critical to the achievement of the desired outcome of improving the quality of care provided.”

Leadership Theory

Healthcare provision occurs in an environment that is chaotic, dynamic, and characterized by an increasing number of problems that require navigation. Thus, healthcare leadership should ensure that they can keep their staff inspired to enable their staff to continually develop innovative solutions to overcome the challenges they face in their work. Based on this understanding of the healthcare delivery environment, the organizations seeking to implement evidence-based protocols must adopt transformational leadership theory.

Based on this theory, leadership in healthcare are required to be transformative. Transformative leaders tend to drive their staff towards committing to actionable goals and convert them into change actions. Rather than use power to control, the transformation leaders empower their teams to adopt the vision of pursuing the fundamental organization objective. In implementing the evidence-based protocols, these leaders would then rally their teams in the collective responsibility of adopting these new guidelines and ensuring that they are used in their areas of work. The empowered staff tends to think critically through the issues they face in implementing the evidence-based protocols.

Barriers in the Implementation of Evidence-Based Protocols

Manspeaker and Van Lunen (2011) identified various challenges encountered when implementing evidence-based practices (EBP) for clinical practices in the training of athletes. One of the challenges cited is the lack of time adequate time to evaluate the literature searching for new knowledge and interpreting the information for inclusion in the training programs. In their work, Shifaza, Evans, & Bradley (2014) indicated that organizational factors such as insufficient time at work to implement new ideas were cited as barriers to the adoption of EBP. Most clinical practitioners, including nurses, are tasked with various duties; hence, the inclusion of EBP in their work areas presents a strain on the roles they currently play.

Shifaza et al. (2014) identified another barrier that nurses face in implementing EBP, which is uncertainty as to whether to believe the results obtained in the literature can be used in clinical settings. In a different study, Manspeaker and Van Lunen (2011) also point out that clinical trainers in the athletic programs acknowledge a perceived gap in knowledge between what is obtained through the research process and the actual clinical practice. This uncertainty is coupled with various factors that present barriers to implementing the EBP, such as the inability to decipher the statistical analysis in the available literature, which was also identified as a barrier towards the implementation of EBP (Stacey et al., 2015). The perceived knowledge gap could also be attributed to the fact that most nurses lack access to reports that could enable them to implement EBP (Shifaza et al., 2014). Branham, DelloSritto, and Hilliard (2014) indicate that nurses restrict their reading of formal research to the areas which they are familiar with; hence they are unable to interpret EBP holistically. The issue of lack of adequate knowledge as one of the barriers to the implementation of EPB could be attributed to the failure to adopt continuous professional education among the staff working in the various healthcare organizations (Stacey et al., 2015).

The lack of adequate knowledge on the skills required to evaluate research among care provides results in the lack of motivation to modify their behavior and attitude towards new care practices hence presenting more challenges toward implementing EBP (Iravani, Janghorbani, Zarean, & Bahrami, 2016). When this is coupled with the issue of lack of enough human resources, the challenges tend to be amplified. For example, the lack of adequate human resources is as an organization results in slower adoption of EBP (Stacey et al., 2015). This is because it results in reduced clinical supervision for the clinical staff during the process hence increasing the challenges of implementing the EBP as the personnel does not receive guidance and motivation required to effectively complete the process (Iravani et al., 2016).

There are some patient-related factors that pose challenges in the adoption of EBP. For example, in obstetric care provision, patients tend to request ineffective interventions that are in line with the existing EBP practice (Iravani, Janghorbani, Zarean, & Bahrami, 2016). The fear of legal implications that could occur because of the EBP procedures’ failure is also cited as another reason for the challenges that face the implementation of evidence-based protocols. Patients’ perception as always right is also another cause of barriers related to the implementation of EBP (Branham et al., 2014). The lack of communication between the healthcare providers and the policymakers also presents challenges in implementing the EPB as it leads to weak health policies to guide the process (Stacey et al., 2015). The lack of enough financial resources has also been shown in literature as one of the reasons that interfere with the implementation of EBP in the clinical set up (DeBruyn, Ochoa-MarĂ­n, & Semenic, 2014).

Conclusion

The leadership in nursing care are faced with the delayed adoption of the evidence-based protocol in the clinical areas. The reviewed literature indicates that these issues are associated with multiple based on the nurses’ experience in the process. The transformation leaders can play a role in enabling the nurses to be motivated to pursue the goal of evaluating the available literature in search of new evidence to include in their care. Transformational leaders provide the motivation required to create enough time to obtain skills for reading and interpreting research findings. Through leadership, the environment for the development of the necessary policies to guide the implementation of EBP will be created, enabling the nurses to understand how they can adopt new findings in their care. The existing literature has indicated that the implementation of EBP in healthcare will require a continued evaluation of challenges that the entire healthcare system faces (Branham et al., 2014). Thus, the involvement of policymakers in the process will help address the issues faced by a macro-perspective, which could also benefit other healthcare team members.