Factors influencing application of evidence-based practice among nurses

Abstract

Evidence-based practice (EBP) involves the application of care that is based on scientific evidence, to ensure the delivery of quality patient care. Generally, there is a dearth of documentary evidence on the evolution of EBP and standardization of nursing practice in the developing world. This study was conducted to determine factors influencing application of EBP specifically at the Kenyatta National Hospital, in Nairobi, Kenya. Nurses working in medical and surgical wards, the surgical outpatient clinic (SOPC) and medical outpatient clinics (MOPC) were purposefully selected. A sample size of 156 was determined, with 130 nurses consenting to be interviewed and 14 nurse managers discussing and informing the interview guide to gather qualitative facts and to determine their knowledge on EBP and the extent of EBP application in the wards. Results of the descriptive analysis suggested that over 92% of the respondents agreed that EBP was not widely used and not factored into current practices. Major factors that affect application of evidence-based nursing are: level of education, ability to review literature, and nursing practice guide (hospital policy and ward routines). It appears research evidence is not fully utilized in patients’ care, although self-rating among nurses indicates that nurses with a Bachelor's degree are better placed to apply research evidence in nursing care. Other major limitations to EBP application are resources and time. Hospital management should therefore invest in and develop comprehensive policy that entrenches EBP in patients’ care. In addition, a deliberate policy stance to train more nurses to degree and postgraduate levels will positively impact on adoption of EBP.

Facilitators and barriers to evidence-based practice: perceptions of nurse educators, clinical coaches and nurse specialists from a descriptive study

“…Unfortunately, barriers present in clinical settings make EBP difficult to fully incorporate into practice. These barriers include individual nurse characteristics, organisational structure, the nature of research information and the healthcare environment (Adib-Hajbaghery, 2007;Barako, Chege, Wakasiaka, & Omondi, 2012;Eizenberg, 2010;Koehn & Lehman, 2008;Majid et al, 2011). Hutchinson and Johnston (2006) reviewed 30 studies between 1991 and 2005 using the BARRIERS scale to measure nurses' perceptions of barriers to EBP.…”

“…Studies have identified lack of time available to review and implement research findings as a primary barrier (Adib-Hajbaghery, 2007;Barako et al, 2012;Breimaier, Halfens, & Lohrmann, 2011;Brown, Wickline, Ecoff, & Glaser, 2008;Eizenberg, 2010;Koehn & Lehman, 2008;Majid et al, 2011). Similarly, during implementation of the Johns Hopkins Nursing Evidence-Based Practice Model as a strategic initiative to enhance an EBP culture at Johns Hopkins Hospital in Baltimore, USA, Newhouse, Dearholt, Poe, Pugh, and White (2005) were confronted with the realities of practice and everyday heavy workloads.…”

“…Additionally, it was reported that managers did not always take into account the limitations of the practice settings for application of EBP. There was a discrepancy between a stated goal for implementation of EBP and organisational priorities (Adib-Hajbaghery, 2007;Barako et al, 2012;Majid et al, 2011). Support from immediate managers and unit educators is required to facilitate change towards evidence-based care (Brown et al, 2008).…”

“…Previous studies on nurses' perceptions towards EBP have considered nurses as collective, rather than exploring views of individuals on EBP (Barako et al, 2012;Brown et al, 2008;Majid et al, 2011). Studies examining this senior group of nurses' perceptions are scarce, despite positioning of these nurses as trusted, knowledgeable and influential nurse practice experts in healthcare settings.…”

An Analysis of Evidence-Based Practice Curriculum Integration in Australian Undergraduate Nursing Programs

“…Recently, there has been an explosion of knowledge and evidence to guide clinical practice, however studies suggest implementation of evidencebased care by health professionals is typically very slow across the globe [1], [2], [3], [4]. Multiple factors reportedly contribute to slow paradigm shift, particularly in nursing including lack of time, poor knowledge and skills, lack of mentorship and administrative support, limited resources within organisations and rigid organisational culture [5], [6].…”