Implementation of Evidence-Based Nursing: Challenges and Barriers

Abstract

N ursing research provides the foundation for evidence-based nursing (EBN) practice. Evidence based practice (EBP) has gained momentum in nursing although definitions vary widely. Research findings, knowledge from basic science, clinical knowledge and expert opinion are all considered "evidence". However, practices based on research findings are more likely to result in the desired patient outcomes across various settings and geographic locations. The staff nurse is a critical link in bridging research-based changes into clinical practice. Depending on the environment, a health care organisation may or may not have the resources to ensure critical, succinct, reasonable evaluation and application of research findings as they relate to the point-of-care delivery. Both EBM and EBN fall under the umbrella of evidence-based practice. Nurses are committed to providing holistic care; treating and working with patients rather than working on them. Effectiveness of treatment is only one part of the clinical decision-making process. In deciding on therapeutic interventions, acceptability to the patient and cost-effectiveness are considered. Several barriers in implementing evidence-based practice have been identified. Nurse administrators are key leaders in facilitating an EBP culture within a healthcare facility. They are in the best position to support new nurses in their transition and in evidence-based practice. The past century has witnessed spectacular changes in the way we live and think. Human brilliance and technology have come together to propose solutions we dared not imagine 50 years ago. Many diseases have been conquered, millions of people have been saved from premature death and disability and the search for better solutions to health care is on. In EBP approach, health care professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients. It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics and preferences.