Physician and patient issues Research findings have suggested that physicians and patients have different values and beliefs that conflict with EBP. Treatment initiatives that have been in place for years and seem to be working may serve as a basis for conflict. Implementing change can be quite a struggle, especially if there is no desire to acknowledge that new evidence could be helpful (Alatawi, 2021). Support from administration and leadership, the establishment of a culture of change, and ongoing education for all practitioners are essential. Leadership support Administration and leadership team members should overtly support and acknowledge nurses who participate in, publish, and disseminate EBP and research findings (Melnyk & Fineout- Overholt, 2019). Such nursing actions should be acknowledged in performance evaluations and be part of the requirements for clinical advancement. Many strategies in the promotion of EBP and nursing research and strategies to reduce or remove barriers to their implementation depend on the support of administration and leadership. This does not mean, however, that staff nurses do not have a role in establishing a culture of learning and practice improvement. Here are some suggestions for staff nurse involvement in the promotion of EBP and nursing research: ● Identify ways to disseminate new, relevant evidence to nursing colleagues. Examples of ways to do this are starting a nursing journal club and sharing quick, short “blasts” of new information via electronic media such as texting, e-mail, and the organization’s website employee section. Information may also be shared with management’s authorization via the organization’s social media pages. A portion of staff meetings should be devoted to disseminating EBP or nursing research information. ● Promote the formation of an EBP/nursing research council. As more and more organizations adopt a shared governance model, forming such councils is expected and is becoming commonplace. A council with designated responsibility for EBP and nursing research can evaluate EBP data that may be helpful, not only for nursing but also for the entire organization. Consider the formation of an interdisciplinary EBP council. Patient care plans are not developed in departmental isolation. The actions of one department affect the actions of the others. Working together to promote EBP will enhance patient outcomes. ● Participate in interdisciplinary patient rounds. Regularly working with other healthcare team colleagues can improve patient care and improve interdisciplinary working relationships. Sharing EBP and nursing research data in appropriate ways will also help dispel the doubts of those who are reluctant to adopt the EBP format of delivering patient care ● Participate in and promote continuing education about EBP and nursing research. Work with nursing professional development specialists as they develop and implement such education. Encourage colleagues to participate in education. Staff nurses should also consider taking an active role in educating colleagues. They can ask experts in continuing education to help them develop and enhance teaching skills. ● Encourage the establishment of a mentor program for EBP and nursing research. Research has suggested that nurses want and need mentors to implement EBP and participate in nursing research effectively. Nurses with expertise in EBP and nursing research should consider becoming mentors. These individuals have an obligation to disseminate knowledge and promote practice strategies that improve patient outcomes. ● Stay current in the latest research and clinical practice guidelines in the field. Identify professional nursing organizations in specialty practice areas that publish standards of practice and EBP, and frequently check the online sites or receive notices of new information.
This means that ongoing continuing education regarding EBP implementation is essential (Polit & Beck, 2022). Nursing consideration: Research has suggested that the more education nurses have, the more confidence they have in implementing EBP. Thus, nursing and organizational leadership should facilitate the pursuit of additional formal academic education, including graduate education and ongoing continuing education (Polit & Beck, 2022). According to recent research, the following are barriers to EBP and suggestions for the reduction or elimination of such barriers. Organizational culture The organization’s culture is pivotal to EBP implementation and the process of conducting nursing research. If the organization’s administrative and leadership staff do not support nursing research and EBP, it is nearly impossible to implement such processes successfully (Paler, et al., 2021). An organizational culture that is stagnant tolerates an attitude of “we have always done it this way,” even if evidence suggests that the “old ways” are no longer an acceptable practice. Some nurses have reported that a culture of learning exists in organizations that promote EBP. Leadership team members want clinicians to have the most current knowledge and access to the most reliable evidence in these types of cultures. Access to the most current evidence promotes best practices from nurses. To develop a culture of learning leadership, all healthcare providers must learn about the benefits of EBP and research. Benefits that are most likely to grab the attention of these individuals are decreases in healthcare costs, decreased length of stay, decreased readmissions, and improved patient outcomes. In these situations, administration and leadership need continuing education as much as staff members do. Insufficient knowledge Lack of knowledge has been cited as a significant barrier to research and EBP implementation (Paler, et al., 2021). The education received in basic nursing education programs is not sufficient. Nurses at all levels of practice and who hold all types of nursing positions need ongoing continuing education regarding the implementation of nursing research and EBP. The organization’s nursing professional development (NPD) practitioners must work closely with all members of the organization to provide ongoing continuing education and training in EBP and research processes. Lack of motivation It is easy to become entrenched in the routine of “we have always done it this way.” Even experienced nurses believe that if they have implemented patient care in specific ways for a long time without problems, that there is no need to change (Alatawi, 2021). Some research has even suggested that the longer nurses have practiced nursing, the more likely they are to become entrenched. This further emphasizes the need for continuing education. Adult learners need to know why they are doing something or why they need to change established patterns of care. Disseminating evidence that shows EBP improves patient Nurses and nurse managers have expressed concern that there is not enough time to stay current regarding the latest evidence or to participate in nursing research (Paler, et al., 2021). Patient care is the top priority. However, nursing administration and leaders should allot time for continuing education and research whenever possible. Inadequate access to up-to-date technology outcomes is imperative. Perceived lack of time It is an overwhelming challenge to access the most current evidence and participate in nursing research without good technological equipment (Alatawi, 2021). Nurses need easy access to the Internet, assistance to use technology as needed, and education to use technology as part of EBP and nursing research. Librarians in universities and hospitals and hospital education departments can often assist.
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