Barriers to Evidence-Based Practices

Proper collection of blood cultures are necessary and the most direct method of determining whether or not a patient is septic. The purpose of obtaining blood cultures is to identify and isolate the bacteria that are causing an illness and then determine the best course of treatment based on the sensitivity of the bacteria to particular antibiotics. One of the most frustrating problems plaguing hospitals is the increased rate at which blood culture results are being returned as contaminated specimens. These results can lead to a significant increase in cost to the hospital and patient as well as an increased length in hospital

Even though evidence informed practice helps improve healthcare, there are still a few limitations. One main limitation is lack of time and accessibility. The best quality evidence is usually very difficult to locate, a busy nurse may not have the time to delve deep to find reliable sources. (NICE 2007) However there are now

Sackett, D. Richardson, W. Rosenberg, W. et al (2000). Evidence based medicine; how to practice and teach EBM. London: Churchill

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

Nurses mostly preferred to use experience based skills in their practice despite Evidence-Based Practices (EBPs). Inadequate time and reviewing research studies were recorded the greatest barriers (Dalheim, A. et al., 2012). Despite awareness regarding the importance and benefits of EBP, they still like better to ask their colleagues rather than the use of the internet to search new findings from nursing research articles. The majority of nurses followed the practices which they had learned in their education and experience (Ammouri, A, A ., 2014).

Experience with EBP: Evidence-based practice plays a crucial role in the quality of patient care. When care is performed based upon evidence opposed to outdated textbooks, instinct, tradition, or colleagues influence (Beyea & Slattery, 2006). The average nurse is currently more than forty years of age, without the frequent education upon new topics, many nurses’ knowledge has become outdated. As new textbooks are not published yearly or often times not kept up to date within facilities, they do not serve as reliable sources of

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

Evidence-Based Practice (EBP) was initially a movement in medicine, dating back to early 20th century (Spring, 2007). It was described as a careful decision making process about the care of individual patients using best available evidence by Sackett, Rosenberg, Gary, Haynes, and Richardson (1996). Greenhalgh (2010) gave a similar definition but with more emphasis on the mathematical assessment of the potential benefit and harm. By now, EBP has been widely adopted by many health disciplines, including psychology. In 2005, the American

Nursing improves when Evidence Based Research findings can be utilized and implemented by nurses in their daily practice. J. Dracup (2006) stated what some nurses had identified as barriers to Evidence Based Research, namely: “accessibility of research findings, anticipated outcomes of using research, organizational support to use research, and support from others to use research.” Dracup believed that “evidence-based practice must include an assessment of the available resources” since the cost of implementation is yet another barrier and “will not be adopted if resources are insufficient to incorporate them into the daily routine” nursing care. G. Mitchell (1999) raised “ the lack of sufficient meaningful research” as an additional barrier.

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

The impact of evidence based practice has been brought into nursing through education, practice, and science over the last decade. Evidence based practice provides quality care to patients that is effective, safe, and efficient. Evidence based practice promises moving care to a high level of producing the intended health outcome for the patients. “EBP is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes” (Stevens, 2013). EBP empowers nurses and expands their skills by using the best available evidence to guide nursing care and patient outcomes.

Evidence- based practice is a trend both within the occupational therapy field and in the medical profession as a whole. It was first introduced in 1971 when Archibald Cochrane published “Effectiveness and Efficiency” where he suggested that because resources are limited clinical evaluation and treatment should be made based on sound evidence (Katsikis, 2014; Shah & Chung, 2009). The definition of EBP written by Sacket (1996) is still frequently quoted today; he defined EBP as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research."

This paper will summarize and discuss the major points of the article titled Use, knowledge, and attitudes toward evidence-based practice among nursing staff by White-Williams et al. (2013). The premise of researching this topic is to fill the gap in research with regards to attributes that lead to positive attitude and the use of evidence-based practice. White-Williams et al. uses correlated and multivariate analyses of covariance (MANCOVA) to find links to three sub categories that are labeled positive attitude, the practice or use of evidence based practice, and the general knowledge/skill of evidence based practice in a magnet-designated hospital.

Evidence based practices are important to explore for various diseases so that their efficacy level can be determined and medical staff can be trained accordingly. Particularly speaking in the context of chronic diseases, evidence based practices are to be evaluated with the joint efforts of multiple healthcare institutions so that it can bring benefits to the overall healthcare industry.