Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature Review

Abstract

Background: Evidence-based practice is important in improving the overall quality of patient care, enhance nursing practice and increase the confidence in decision-making. Evidence-based practice is a technique used in solving clinical issues regarding patient care by integrating well-designed evidence with patient preferences, patient assessments, and health professionals. This review aims to explore barriers that confront nursing in the implementation of evidence-based practice. Consequently, by determining some of the barriers to the implementation of EBP among nurses, health care systems can form solutions that allow the health centers to avoid such issues and execute the approach among health care providers. Methods: peer review was undertaken following a literature search in the databases involved CINAHL, MEDLINE and EBSCO Web of Science databases. Included studies were from October 2018 to December 2018, English language and peer-reviewed studies that aimed to explore the organizational and individual barriers within the healthcare setting. The quality appraisal tool was used to appraise all the included studies. Results: A total of 12 studies were included. Six studies were quantitative, five studies were qualitative, and one study used mixed methods. Four organizational barriers to implementing Evidence-based practice among nurses were found by reviewing the literature which is ("lack of support and supervision", "lack of training" and "education", "limited resources” and “time restriction”). While, four main themes were considering as an individual barrier to implementing Evidence-based practice among nurses: ("lack of nurses' knowledge", "skills and awareness regarding use the Evidence-based practice", "lack of professional characteristic", "nurses' attitude and experience in using" and "language barrier in using or implementing Evidence-based practice"). Conclusions and implications for future practice: Nursing administrators and educators have the main role to facilitate evidence-based practice implementation among nurses, therefore; the findings of this review can help to overcome the identified barriers. Training and education are important to enhance the knowledge and skills of nurses to use evidence-based practice. Time management, providing the required resources and adequate supervision can facilitate the implementation of evidence-based practice which positively influences the quality of care. For further research, it is very fruitful to investigate the common barriers of EBP in one specific culture such as the middle eastern culture. Furthermore, future research may focus on barriers of implementing EBP related to the patients and their families.