Barriers Associated With Evidence‐Based Practice Among Nurses in Low‐ and Middle‐Income Countries: A Systematic Review

Abstract

Background Evidence‐based practice (EBP) is both a goal and an approach that requires a combination of clinical experience with the most credible recent research evidence when making decisions in healthcare practice. The approach has been widely embraced; however, an evidence‐to‐practice gap still exists. Aim To assess barriers to EBP among nurses in low‐ and middle‐income countries. Methods This review conforms to the PRISMA statement. Databases PubMed, Scopus, EMBASE, and Web of Science/Knowledge were searched using a combination of keywords that included “barriers,” “evidence‐based practice,” and “nurses.” The references of the selected articles were also hand‐searched to obtain additional relevant articles. Studies published in peer‐reviewed journals in English between 2000 and 2018 were included in the review. Results Sixteen articles were included in the analysis, with a total number of 8,409 participants. Both qualitative and quantitative studies were included in the review. Three main themes emerged from eight categories found. The three main themes were institutional‐related barriers, interdisciplinary barriers, and nurse‐related barriers. The theme of institutional‐related barriers emerged from four categories, which included scant resources, limited access to information, inadequate staffing, and lack of institutional support. The theme of interdisciplinary barriers emerged from subcategories that included lack of communication between academic and clinical practice environments, inconsistency between education and practice in the nursing discipline, lack of teamwork, and the public's negative image about the nursing profession. Finally, the theme of nurse‐related barriers emerged from categories including perceived limitations in the scope of nurses’ practice, time, knowledge of EBP, and individual‐related barriers. Linking Evidence to Action These findings may guide the design of future interventions aimed at fostering EBP. Implementing EBP in practice should be systematic and requires institutional will and interdisciplinary and individual commitment. It should be a collective goal and a win‐win situation for nurses, clinicians, and healthcare organizations.

Ranking of Risks for Existing and New Building Works

“…Originating from clinical research, evidence-based practice (EBP) is both a goal and a method that suggests decisions should be made according to the up-to-date, valid, and appropriate evidence. Defined as a combination of clinical experience and recent credible research evidence, the evidence is obtained from systematic reviews or well-designed clinical trials [12]. The root metaphor of contemporary, idiographic evidence-based practice is the three circles, also known as the three-legged stool: (a) the best available research evidence; (b) clinical expertise; and (c) patient values, preferences, characteristics, and circumstances [13].…”

Value, knowledge and implementation on evidence‐based practice among nurse managers in china: A regional cross‐sectional survey

“…However, the gap between evidence and practice points to the existence of various difficulties in achieving EBP among nurses. A great number of well‐documented research evidence reported that there are many barriers to EBP implementation including poverty of knowledge and skills about EBP, limited access to information and lack of time (Bressan et al, ; Shayan, Kiwanuka, & Nakaye, ; Sundberg et al, ). Cheng et al () pointed that the common barriers to EBP implementation were from the organisational level, such as lack of managers’ support.…”

The EBP lockout. What clinicians need to put the “E” into EBP

“…Wide disparities among nurses and other health professionals being able to access evidence have been found. This has been reported in developing and poorer countries (Aronson, ; Shayan, Kiwanuka, & Nakaye, ) but the problem is by no means limited by geography or economics. For example, clinical colleagues in Germany and other (Hallam & Plaice, ) “advanced” countries have reported to us the difficulties that they face in gaining access to evidence and digital databases.…”