Barriers to evidence‐based nursing: a focus group study

Abstract

Title. Barriers to evidence-based nursing: a focus group study Aim. This paper reports a study to explore the barriers to evidence-based nursing among Flemish (Belgian) nurses. Background. Barriers obstructing the call for an increase in evidence-based nursing have been explored in many countries, mostly through quantitative study designs. Authors report on lack of time, resources, evidence, authority, support, motivation and resistance to change. Relationships between barriers are seldom presented. Methods. We used a grounded theory approach, and five focus groups were organized between September 2004 and April 2005 in Belgium. We used purposeful sampling to recruit 53 nurses working in different settings. A problem tree was developed to establish links between codes that emerged from the data. Findings. The majority of the barriers were consistent with previous findings. Flemish (Belgian) nurses added a potential lack of responsibility in the uptake of evidence-based nursing, their 'guest' position in a patient's environment leading to a culture of adaptation, and a future 'two tier' nursing practice, which refers to the different education levels of nurses. The problem tree developed serves as (1) a basic model for other researchers who want to explore barriers within their own healthcare system and (2) a useful tool for orienting change management processes. Conclusion. Despite the fact that the problem tree presented is context-specific for Flanders (Belgium), it gives an opportunity to develop clear objectives and targeted strategies for tackling obstacles to evidence-based nursing.

Obstacles to the implementation of evidence-based physiotherapy in practice: A focus group-based study in Belgium (Flanders)

“…Recent findings of a focus group-based study indicate that nurses still have limited space for autonomous decisions under the supervision of doctors. They stated that physicians are more willing to take advice from physiotherapists (Hannes et al, 2007).…”

“…It is not quite clear whether the low number of empirical, in-depth qualitative studies found is due to a lack of qualitative research being conducted, researchers' reluctance to submit to physiotherapy journals, or reluctance of the journals to accept qualitative studies (Gibson and Douglas, 2003). While qualitative studies listing the barriers to the implementation of EBP in doctors, nurses, and dentists have been conducted in Belgium (Hannes et al, 2005;Hannes et al, 2007;Hannes et al, 2008b), no such studies have been done in the physiotherapy profession. We aimed to perform a context-specific research study to answer the question: ''What barriers do Belgian (Dutch-speaking) physiotherapists meet when trying to use evidence in practice?''…”

Exploring Barriers to the Implementation of Evidence-Based Practice in Psychiatry to Inform Health Policy: A Focus Group Based Study

“…This appears to be consistent with international literature and therefore contributes to the validation of our findings. However, it was noticed that many of these concerns have been mentioned by other health care practitioners as well (Hannes et al 2005(Hannes et al , 2007(Hannes et al , 2008a(Hannes et al , b, 2009Schofield et al 2006). A recent study comparing obstacles experienced by psychiatrists with obstacles experienced in other health care disciplines revealed that general practitioners and physiotherapists also experience a broad variety of complex problems and difficulties to diagnose patients during the first encounter (Hannes et al 2008b).…”

“…A recent study comparing obstacles experienced by psychiatrists with obstacles experienced in other health care disciplines revealed that general practitioners and physiotherapists also experience a broad variety of complex problems and difficulties to diagnose patients during the first encounter (Hannes et al 2008b). Nurses state to be focussed on their relationship with patients as well and are often confronted with patients' psychological and social problems, especially those working in the home environment (Hannes et al 2007). Whether or not certain obstacles are typical to the psychiatric discipline needs careful consideration.…”

“…Obstacles preventing psychiatrists from applying EBP have been extensively discussed in the psychiatric literature. Some are general and apply to many health care disciplines, such as the insufficiency of training and lack of time to implement EBP in practice and the lack of resources or access to information (Hannes et al 2005(Hannes et al , 2007(Hannes et al , 2008a(Hannes et al , b, 2009Schofield et al 2006). The absence of evidence in relation to many clinical questions and the difficulties to translate scientific results from RCT's into meaningful interventions for individual patients contribute to the difficulties of implementing EBP.…”