Implementation of Evidence in Practice…what helps, what doesn’t

I’ve been interested in Evidence Based Practice (EBP) for quite some time. It’s well known that implementation of evidence in practice results in better patient health outcomes, yet practice doesn’t always have an evidence focus. I completed a Doctor of Nursing Practice degree earlier this year. I researched nurse practitioner beliefs about, and implementation of evidence in practice.  I discovered that NPs have strong beliefs about the value of evidence based practice, however, they had relatively low levels of implementation.  I also asked questions about facilitators and barriers. During the study period, the legislation for NP practice in my province was quite restrictive. I was certain that the NP legislated scope of practice would be one of the most common barriers to the implementation of evidence.  It was a barrier, but it didn’t even fall into the top three.

It’s no surprise that ‘time’ was the most common barrier cited by the NPs.  Information overload and lack of skills in analyzing research studies are other barriers. Interestingly, one of the most significant barriers, but also a significant facilitator to NP’s implementation of evidence based practice, was working on an interprofessional team.  When teams work well, things like implementation of evidence is easier.  The trick will be to figure out the factors related to better teamwork.

The ‘patient’ was also cited as a common barrier to the implementation of evidence in practice.  I was reminded that regardless of our convictions, the patient perspective has to be taken into consideration.

EBP is complex.  Even when we believe that the process of EBP or EBN is best for the patient, it isn’t always easy to implement.  Understanding and identifying barriers to the implementation of evidence in your practice is the first step in development of more effective nursing care.

Roberta Heale

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