NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

NUR 590 Topic 4 DQ 1

What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Explain how at least one of the obstacles you have described could impact the implementation for your EBP project.

Obstacles that prevent evidence-based practice research from reaching its full potential. Resource management, interdisciplinary collaboration, and a lack of support are all barriers to evidence-based practice research that vary in severity depending on the study setting or issue being examined. Building research within a medical facility has both advantages and disadvantages in terms of reaching health-related research goals. In terms of research implementation, patient-care treatments can sometimes take precedence over health-related education. (Swindle et al., 2019; Johnson et al., 2019; Davenport et al., 2019; Whiteside-Mansell et al., 2019; Thirunavukarasu et al., 2019; Sadavsin

Interdisciplinary communication for educational purposes is one barrier that I believe may obstruct the implementation process. Although education can be used to disseminate information to health care practitioners and the general public, it can be difficult to achieve multidisciplinary information and coordination. This would have an impact on my project because collaboration with nutrition and educational departments will be critical to the research’s success, and the level of involvement or coordination required may be influenced by the ability to leverage these partnerships with other disciplines (Shayan, Kiwanuka & Nakaye, 2019).

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NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? References:

Swindle, T., Johnson, S. L., Davenport, K., Whiteside-Mansell, L., Thirunavukarasu, T., Sadasavin, G., & Curran, G. M. (2019). A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start. Journal of Nutrition Education and Behavior, 51(9), 1067–1079. https://doi-org.lopes.idm.oclc.org/10.1016/j.jneb.2019.06.019

Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers Associated With Evidence‐Based Practice Among Nurses in Low‐ and Middle‐Income Countries: A Systematic Review. Worldviews on Evidence-Based Nursing, 16(1), 12–20. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12337

Mathieson and Brooke found that “barriers to EBP include a lack of time, a lack of staff, a high number of patients, family obligations, a lack of knowledge of EBP, negative beliefs about it, and a lack of academic skills” (Mathieson et at., 2019). Staff shortages and a lot of patients are not new to nursing, but they are felt very strongly when nurses are tired and have to make hard decisions about what is right. As a lifelong learner with an ADN, a BS in biology, and a future MSN, I feel a lot of pressure to keep learning and want to learn more about nursing. But I don’t have enough time to take care of my family, work, and school responsibilities.

My EBP project can’t be done because I don’t have enough time. During a shift, the floor nurse, CNAs, and other members of the EBP team have limited time. Even though making a note in the EHR documentation might only take a few seconds, it can be hard to find those few seconds on a busy floor with too few people. People who are going to finish educational modules may not have enough time to do so. People who are taking part may be too busy or not give the education enough importance to finish. If participants and team members don’t have enough time to do what they need to do for the project, the data will be skewed.

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488

There will always be barriers when implementing change. A study written by Mathieson, et al, in 2019 explored the barriers to implementing EBP in nursing. It was found that organizational changes – restructuring and the decentralization of services – had a negative impact upon implementation. I think the biggest barrier to change is timing. If the unit or hospital is not fully invested or there are other priorities then the EBP changes will suffer. The timing of implementation is crucial to the success of a project. For example, for my EBP proposal I think there will be obstacles because of our staffing issues. The lack of proper staff takes priority and it can be difficult to train and implement a new process when there is constant turnover of nurses. I am hopeful with a recent change in leadership, there will be better staffing models and my unit can return to focusing on improving nursing practice instead of staffing shortages.

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Reference:

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing?

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20 doi:http://dx.doi.org.lopes.idm.oclc.org/10.1017/S1463423618000488

The process of evidence-based practice (EBP) begins with a clinical query and then moves on to seeking and critically evaluating the evidence. When implementing evidence-based practice in nursing, there will be obstacles and barriers that will affect health care practices. Barriers can come in various forms on an organizational level or personal level. Examples of organizational level include the lack of human resources, shortage of internet service at work, and high workload were all issues at the organizational level (Khammarnia et al., 2017). Personal barriers examples included a lack of time to study literature, a lack of computer skills, and a poor command of the English language. Resistance is another barrier to healthcare when trying to implement evidence-based practice. Resistance is an obstacle that would impact the evidence-paste project; culture can be seen as a significant challenge on Hospital units (Ginex, 2019). It takes more than one person to alter a practice, which is why establishing a culture that promotes a spirit of inquiry and an evidence-based approach to treatment is crucial. When there is resistance in a unit towards change, it inhibits the progression of quality improvement.

Ginex, P. (2019). Overcome barriers to applying an evidence-based process for practice change. ONS Voice. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change

Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2017). Barriers to implementation of evidence-based practice in zahedan teaching hospitals, iran, 2016. Nursing Research and Practice, 2017, 1–5. https://doi.org/10.1155/2015/357140

Technology has been the most common barrier I have encountered while participating in or initiating organizational change. The only constant in the future is technological progress. The nursing profession has changed dramatically in the last decade, with computer technology advancing practice. Medication is now scanned using bar code administration rather than a check within a box on a paper chart, and charting has moved from paper to electronic health records. Nursing is driven by technology and will only improve as technology advances. Lack of familiarity and uncertainty about skills related to the use of technical applications can affect system acceptance: staff members may lack computer knowledge and have difficulty handling the applications (Koivunen & Saranto, 2018). It was determined that if applications were simple to use and users were well educated on how to use them, staff were more satisfied with the application’s implementation and were more likely to use it sufficiently (Koivunen & Saranto, 2018). While technological advancement is used to advance and improve the healthcare delivery system, it can also serve as a barrier to implementation among nurses. While my project does not involve the use of new technological applications, it does include the use of new technological devices to perform continuous compressions during defibrillation. This will necessitate extensive educational and hands-on simulation opportunities for staff.

Koivunen, M., & Saranto, K. (2018). Nursing professionals’ experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies. Scandinavian journal of caring sciences, 32(1), 24-44.

Care that is not evidence based is likely unethical and incompetent (DeNisco, 2021). In order to provide the best care to patients EBP needs to be integrated into daily practice (DeNisco, 2021). An important step in implementing a successful EBP project is identifying barriers and obstacles.

Some common barriers are:

• Lack of organizational infrastructure. (DeNisco, 2021).
• Lack of authority for clinicians to make changes. (DeNisco, 2021).
• Lack of time in the workday. (DeNisco, 2021).
• Lack of administrative support. (DeNisco, 2021).
• Lack of financial incentives. (DeNisco, 2021).
• Competing priorities. (DeNisco, 2021).
• Lack of knowledge and skills of EBP.(Rahmayanti et al., 2020).
• Lack of adequate training.(Rahmayanti et al., 2020).
• Lack of access to comprehensive literature libraries.(Rahmayanti et al., 2020).

Luckily the organization that I am implementing my EBP project in has all the tools needed to support EBP. The only barrier that I will need to address is the lack of time due to workload. Post COVID we are dealing with staffing shortages like many hospitals. Bedside nurses have higher patient ratios and increased acuity levels. As a Manager I will need to provide the necessary time to educate the staff on the project and assist in implementation. I will also have to look at the ideal time to implement this in order to be successful. That time will depend on when RN vacancies are filled and orientation is completed.

DeNisco, S.M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession(4th ed.). Jones & Bartlett Learning.

Rahmayanti, E.I., Kadar, K.S., & Saleh, A.(2020). Readiness, barriers, and potential strength of nursing in implementing evidence-based practice. International Journal of Caring Services, 13(2): https://search-ebscohost-com.lopes.idm.oclc.org

While evidence-based practice (EBP) improves quality and patient outcomes, implementation is a complex process. The time lag for translating new knowledge into clinical practice ranges from 8 to 30 years, with many barriers also lasting the test of time (Melnyk & Fineout-Overholt, 2018). These long-term barriers include lack of time, lack of EBP education, and lack of resources. Integration of EBP continues to be perceived as burdensome and is often delegated, avoided, or ignored. Embracing EBP implementation strategies must be designed to shift practice from provider-centric care to evidence-based and patient-centered care. The practice gap at the baccalaureate nurse level needs models to integrate the skills and competencies to integrate the existing evidence. Models to guide the process are increasing and bring strengths for implementation and integration and help to educate the current and future workforce. Raising the bar of practice and performance is a dynamic process and leaves many questions for all stages. Evaluating data and calculating a budget is just a couple of uncertainties. Lack of funds and resources are obstacles that impact project implementation and quickly put an end to the project. More experience in the process and mentor access will eventually decrease many of the questions that remain unanswered and unknown.

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Reference

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer Health.

The provision of services that are both reliable and of consistently high quality is currently one of the most significant challenges facing the health care system. Evidence-based practice (EBP), also known as a problem-solving approach to patient care that is based on the best available and valid evidence, can result in an increase in the overall quality of care provided, a decrease in associated costs, and the personal and professional growth of nurses and other health workers. Additionally, evidence-based practice (EBP) that is based on international standards improves the quality of clinical practice. EBP has been marketed to clients as a means of providing them with the highest possible quality of care.

Multiple studies have come to the conclusion that there are human and organizational factors that are associated with barriers to the use of evidence-based practice (EBP). These factors include a lack of time to read the relevant literature, a heavy workload, a shortage of staff experienced in EBP, and a dearth of resources. (Khammamia et al., 2015) A recent systematic review found that there are numerous hurdles to the implementation and usage of EBP and came to the conclusion that identifying barriers is the first step in removing them. The review demonstrated that there are several barriers to the implementation and use of EBP.

The barrier my proposed Evidence based practice may encounter is heavy workload. The heavy workload of hospital nurses is a major problem for the American health care system. The demand for nurses is increasing as a result of population aging. There are several important consequences of high nursing workload. Research shows that a heavy nursing workload adversely affects patient safety. In addition to the higher patient acuity, work system factors and expectations also contribute to the nurses’ workload: nurses are expected to perform nonprofessional tasks such as delivering and retrieving food trays; housekeeping duties; transporting patients; and ordering, coordinating, or performing ancillary services. (Carayon & Gurses, 2008).

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Reference

Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to implementation of evidence based practice in zahedan teaching hospitals, iran, 2014. Nursing research and practice, 2015, 357140. https://doi.org/10.1155/2015/357140

Carayon, P., & Gurses, A. P. (2008). Nursing Workload and Patient Safety—A Human Factors Engineering Perspective. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2657/

Qualitative data is obtained through the study of human behavior, body language, attitude, opinions, and feelings. Many techniques like word association, sentence completion and even drawing pictures can be used and is dependent on. Quantitative data, on the other hand, is mainly concerned with the measurement of a phenomenon in terms of quantity. These data are subject to statistical analysis (Bairagi & Munot, 2019).

For my EBP proposal, I will be using a quantitative design. My project involves the measurement of patients’ weight before every dialysis session and comparing this weight to the weight they left after their previous dialysis session to compute the intradialytic weight gain. Diet planning also involves measuring the estimated amount of sodium intake for the patient to get reliable results. The tool that I will be using is a simple observation of pre and post-weight along with a brief questionnaire involving their compliance with their meal plan to ensure the validity of the data gathered.

NUR 590 Topic 4 DQ 1 What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? References:

Bairagi, V., & Munot, M. V. (Eds.). (2019). Research methodology: A practical and scientific approach. CRC Press.