Ebp In Nursing

Introduction Evidence-based practice(EBP) is defined as "the integration of best research evidence with clinical expertise, and patient values in making clinical and patient care decisions." (Sackett et al., 2001, p. 1). It also involves the integration of research evidence, scientific theories, local circumstances and existing resources. While undertaking evidence-based practice has the advantage of improving clinical practice and the quality of care, the development of EBP is still not prevalent in nursing. In this essay, barriers hindering the development of EBP in nursing will be discussed and elaborated with examples. Besides, facilitators promoting the development of EBP will also be discussed with examples to provide ideas on how to

Nurses ' heavy workload causes them to have less time to consider adopting EBP in their clinical practice. For example, the nurse-to-patient ratio in Hong Kong is around 1 nurse to 11 patients. This low nurse-to-patient ratio leads to a heavy workload in each duty of the nurses and they already find it hard to finish their routine work within their shift, not to mention using extra time to adopt EBP in their practice. Moreover, nurses have a tendency to follow opinions from co-workers and clinicians and make decisions based on rituals and habits. It is about conformity which means change behavior in order to adhere to social norms or as a result of real or imagined group pressure. For nurses, the ward they work at decides what the social norm is about. For example, the ritual of a ward is using hibitane solution for all wound dressing. Although a nurse working at that ward has learned that normal saline solution would be a better dressing solution for normal wounds, s/he may still choose hibitane for all wound dressing because this is the habit of the ward. As the social norm about wound dressing in that ward is using hibitane for all wounds, s/he may feel group pressure from her/his colleagues such as questioning her "why don 't you follow our habit using hibitane for dressing?" and "we always use hibitane for wound dressing. What 's the problem with it and why do you change

Organizational barriers are about the culture, resources and policy in the nurses ' working environment. Inadequate support and time provided to implement new ideas and the reluctance to expand resources for developing EBP make the nurse feel not supportive from the administration in adopting EBP. Yadav and Fealy 's study (2012) points out that insufficient resources and insufficient time at work to implement changes are ranked as the first and third barriers to changing practice on the basis of best evidence respectively. Moreover, a lack of authority in the workplace to change practice is another barrier which inhibits the development of EBP in nursing. Furthermore, failure to motivate or reward nurses for critiquing research evidence and applying it in clinical practice makes it hard to cultivate a positive research climate. Lacking of a spirit of intellectual curiosity an openness also causes an unenthusiastic atmosphere in adopting EBP. Research-related barriers mainly focus on the availability and the applicability of the research evidence into clinical practice. Methodological errors can adversely affect the research evidence 's validity and trustworthiness. The presence of conflicting and inconclusive findings makes the nurses uncertain about whether to integrate the research findings into practice. Moreover, there may be gap between research and practice. Some of the researches do not focus on issues that are highly relevant to clinical practice and cause it