Common Barrier of EBP Use Essay
Common Barrier of EBP Use Essay
Apa format. 1 paragraph for each discussion. 2 references are needed. scholar authors only.
Discussion 1:
The staff nurse is the final stop between an error and the patient. The staff nurse implements care plans to promote patient safety and it is their responsibility to educate that patient and their family to ensure a safe stay. For this to happen a culture must be in place that promotes safety and quality of care. The three levels of organizational culture can be implemented at each individual unit as well as the hospital level. Common Barrier of EBP Use Essay These three levels of culture include: Observed culture (that what we see to imitate), shared values (individual awareness of the organizational values and their value to practice), common assumptions (shared experiences that cause groups to take knowledge for granted) (Spath, 2018, Chapter 12). My organization is very passionate about their “pillars” (shared values) that the organization are founded on. They incorporate them into all training sessions and do a reflection on what pillar best suits the training happening that day. Given that training is a big part of our culture the pillars are strongly a part of the culture and why we are not running into the common barrier of EBP use in our facility. I had not considered that the culture of shared values leads to increased use of EBP, but I am finding that not all facilities are strong at using EBP (Ost et al., 2020). This culture has been beneficial to pushing me to further my education and always look for changes to benefit patient safety.
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Leadership in my hospital has changed hands about three times in four years. I have not heard much from our current CNO as she just took over about the time covid-19 hit our area. I can say she has worked hard to ensure our safety at bedside by getting funds to acquire new PAPR’s as ours were so outdated there were no parts available any longer, including the HEPA filters. Finkelman describes the style of leadership I have been seeing during the pandemic as “team leadership” (2016, Chapter 1). This type of leadership is both concerned about productivity and morale. The willingness to understand that the two are intertwined in stressful situations is essential at this point. It was brought up to the prior CNO that we had outdated equipment and were met with resistance to replace it since, “it still worked” even though we could no longer prove it was providing protection. This caused several people to leave once the pandemic hit as they felt their lives were not worth risking. The current CNO looked at the equipment and authorized emergency funds to provide the ICU with current equipment, albeit not top of the line it can be tested and parts replaced.Common Barrier of EBP Use Essay
I never want to personally be in a situation that requires me to be responsible for an entire unit nor an entire hospital. I am grateful for those that wish to pursue management and have the minds that can do the thought processes to weigh benefits, risks, and financial responsibility. The only thing I can think of doing to increase our facility to a higher performance is looking at management and who covers whom. The director of ICU also is the director for ED and we often get overlooked in the ICU for budget and required gear when the ED gets first pick at new procedure items and gear. This leaves the ICU feeling left out of the loop, and we often are. This happens at other levels in the hospital as well and it is bad for retention as well as staff morale.Common Barrier of EBP Use Essay
Discussion 2:
The role of the staff nurse is endless, staff nurses are med passers, house keepers, patient advocates. Nurses assess a patient and sometimes are the first ones to rise a red flag to the providers when something is not ok with the patient. Nurses are social workers; we examine the need for services in the community to support the patient and the family after discharge. Nurses are educators, we explain medications, treatment, and disease processes. And the list goes on and on.Common Barrier of EBP Use Essay
The role of the staff nurse for promoting quality in a high-performing healthcare organization is broad. Staff nurses are the base of any healthcare organization functioning. The Joint Commission’s defines a high-reliable organization as an organization that achieves high quality and safety standards (Yoder-Wise, 2019). Nurses have an important role in the quality management process because they provide direct care to the patients, nurses are in charge of the day to day monitoring of patients changes and they are the base for safe delivery of care (Yoder-Wise, 2019).Common Barrier of EBP Use Essay
The healthcare organization I work for is Denver Springs Behavioral Hospital, I am please to say that this organization promotes a Just Culture. The Just Culture concept promotes transparency, collaboration, and accountability within staff (Bashaw & Lounabury, 2012). This blame free reporting system, promotes honesty between staff members and management, early coming forward with an error decreases the chances of negative outcomes and promotes a safe work environment. Our managers consider an error as a teaching moment and not a punishment situation.Common Barrier of EBP Use Essay
We experienced an upper management change at the beginning of this year, our DON and CEO are new to the facility. They started several positive changes in our hospital new computer to every unit because ours were old, implementation of charge nurses in each unit to increase organization, and self-scheduling to increase flexibility and decrease call-offs. Looking in retrospective, I can affirm that our upper management is not afraid of changes that require financing support.
There is always something we can do to improve our organization performance. I am one of the unit charge nurses and some of the strategies I have been implementing to promote higher quality of care are:Common Barrier of EBP Use Essay
– Help other units with admissions when they are getting more than one at the same time, to decrease the waiting time of the patients in the intake hallway.
– Train new nurses on the medical detox protocols to promote safe assessments and interventions for our chemical dependency unit patients.
– Keep all forms organized and stocked to increase staff compliance with documentation.
– Go to the intake hallway and assess at risk detoxing patients (like benzodiazepine and alcohol detox patients) and medicate during the intake process to decrease the rate of seizures within the facility.Common Barrier of EBP Use Essay
Evidence-based practice requires ready access to external evidence that can lead to up-to-date clinical decision making. Meanwhile, libraries have been under growing funding pressure when physiotherapists have been adapting evidence-based practice. Journal subscription prices have increased intensely past ten years in the field of medicine, the average price increase over this period was 304% (Albee & Dingley 2000). A lot of library budgets are unable to afford such increases and libraries have had to consider choices including stopping serial subscriptions and converting from paper to electronic formats. By the same token, an individual may only be able to afford to subscribe to a couple of journals (Maher et al. 2001). A lot of physiotherapists have restrictions in accessing high level evidence (as there is limited access to databases of clinical trials archives and reviews or even lack of awareness of these databases), which made them believe that there is no much evidences about physiotherapy interventions (Bithell 2000). There is a study which, found variations between disciplines’ use of online evidence and identified ease of access and time taken to locate the online evidence as barriers to evidence-based practice after interviewing Australian health professionals including some physiotherapists (Gosling et al. 2003). Both clinicians who are enquiring clinical questions and researchers who are conducting in-depth searches for systematic reviews come across a few Common Barrier of EBP Use Essay
Evidence-Based Practice: Nurses Overcoming the Barriers
From ancestral times to present, healer’s dedicated their life’s passion to exercise experienced medical techniques to improve a patient’s quality of life. As many techniques are passed from generation-to-generation they continue to evolve as research philosophers discover improved ways to enhance patient care through evidence-based practices (EBP). EBP has emerged through the years as an effective strategy to improve the quality clinical experience, implement best-researched practices, and tailor to patient values and preferences. The impact of EBP has echoed across the united states, as well as many countries, in transforming health care facilities by redesigning effective, safe, and efficient platforms. However, there has been much hardship for nurses to incorporate EBP into their daily nursing process. This paper will discus the common barriers nurses encounter when implementing evidence-based practices into the nursing process, and the effective workshop programs management has placed to overcome those barriers.Common Barrier of EBP Use Essay
Due to the many barriers health care facilities face from the lack of resources, time, and knowledge, major changes need to be made. By nursing taking the initiative to understand and learn the format and techniques of EBP, over time nurses will become proficient in their daily nursing process. As a BSN prepared nurse equipped with the knowledge and techniques of implementing EBP, this nurse will conduct the most current research practices and encourage others to facilitate the change as well. Nurse are the first a patient sees when they are admitted and the last when they are discharged. It is up to nurses to stay on top of the educational curve to know they are providing the best-practiced care
For second dimension credibility and applicability of research dimension, the most participant barriers were ”I read a paper if it is written by a nurse rather than a Professor as they are more relevant”, ”I find the research published in medical journals more use than that in the Nursing Times and the other nursing journals”, ”Research is only limited to a small bit of nursing practice -mainly procedures, and we do much more than that”, and ”Policies and procedures are unwieldy, and once you work here a while you get to know them anyway”. This was similar to (Retsas 2000) revealed that the accessibility of research findings filled the majority number of barrier items. Similar (McCaughan et al. 2002), they found that nurse participants in their study reported that research findings had no sufficient guidance and information for their clinical practice and clinical decision making. Common Barrier of EBP Use Essay
… Practice is better dealt with in the here and now”. Similarly, (Retsas 2000) illustrated in his study that a great number of nurse participants feeling that they haven’t the capability to evaluate the research and its findings, as well the research finding cannot be popularized to their clinical setting. Furthermore, (Sarabia-Cobo et al. 2015) mentioned that the highest mean scores were that nurses have no enough time to their job to implement new ideas and researchers, followed by little knowledge about nursing research. …
… McCaughan et al. (2002) agreed that facilities to help nurses implement their research were not ready on their ward. Also, a major barrier was time as a primary block on their ability in which, they stated that nurses could not use written information of researchers because it is time-consuming to be useful for the clinical practice, as well the inaccessibility of research information or different forms of research basis such as posters, files, protocols, journal articles, books, etc. Moreover (Retsas 2000), reported significant barriers nursing participants were to their organization, as there is a need from organization to support nurses in implementation and utilization of research information. According to (Mehrdad et al. 2008) the major barriers to use research information were that the lack of nurs-es time to examine researches; organization facilities are insufficient for implementation; and nurses feel they have no enough authority to change clinical care practice for a patient after implementing research.Common Barrier of EBP Use Essay
Due to increased expectations of high quality nursing care in
society, it is no longer acceptable for nurses to deliver nursing care
based only on experience and textbook knowledge; but, to provide
quality nursing care based on research findings. But still a gap
exist between the knowledge of evidence based practice and its
implementation. Evidence based practice was known as “evidence
based medicines” in 1980s; later on, the word changed to “evidence
based practice.” The purpose was to identify the importance of
scientific evidences in clinical areas Melnyk. Professional nurses of
the 21st century is facing many challenges within the dynamic state
of health care setting.Common Barrier of EBP Use Essay
Some of these challenges are lack of resources, lack of
conducive teaching environment, the attitude toward research, lack
of knowledge of research and specifically low level of knowledge
and compliance to “evidence-based nursing practice.” Nurses in
the developing world even do not know evidence based practice.
An investigation carried out by the National Board of Health and
Welfare in Sweden revealed that 8.6% of patients were injured
during hospital care. These injuries were judged to have been
avoidable if actual knowledge had been applied.
Evidence
It’s defined as anything presented in support of an assertion.
This support may be strong or weak. The strongest type of
evidence is that which provides direct proof of the truth of an
assertion. Evidence Based Practice: Clinical nurses are expected
to systemically gather the best research evidence drawn from
nursing experiences and consider patient’s preferences when
they are making professional decisions. This is known as evidence
based practice. Evidence based practice has been recognized by
the health care community as the gold standard for the provision
of safe and compassionate health care. Evidence based practice
improves the quality of care and patient safety. Factors influencing
EBP have been extensively reported. Individual nurse qualities
include EBP beliefs, confidence, time, knowledge, and skills Melnyk.
Clinical nurses’ varying backgrounds, education, and attitudes can
influence their motivation and ability to integrate evidence into
practice Swenson-Britt & Berndt.Common Barrier of EBP Use Essay
Organizational qualities that impact EBP include administrative
support and access to resources (Melnyk. Two categories of
organizational factors are infrastructure aspects such as library
resources, and unit or facility climate such as authority to
make changes, resistance or support by colleagues and leaders.
Consistently cited barriers to research utilization are organizational
factors and difficulty in understanding research findings [3]. A
study on evidence-based practice conducted by Susan in Sweden
has highlighted the overall positive attitude of nurses towards
evidence-based practice and decision making. The result showed
a statistically significant difference in the professional groups
regarding personal attitudes towards, use of, and perceived
benefits from and limitations of evidence-based practice. One of
the studies identified the barriers, desire and ability for evidencebased practice Funk et al. [1]. This study showed that nurses with
higher education have positive response towards evidence-based
practice. Availability of resources is also one of barrier.
Barriers to Evidence Based Nursing Practice in Tertiary
Care Hospitals of Peshawar, Pakistan
Aurang Zeb*, Mehwish Riaz, Sireeta Emmanual, Nazia Rehman, Saima Qudrat and Rubina
Student Post RN BScN Rehman Collage of Nursing, Pakistan
Received: August 08, 2018; Published: August 16, 2018
*Corresponding author: Aurang Zeb, Assistant Professor, Rehman Collage of Nursing, Hayatabad Peshawar, UAN: 111-REHMAN,Common Barrier of EBP Use Essay
Pakistan
Abstract
The study was intended to examine Perceived Barriers to evidence based nursing. The study was conducted in Khyber teaching hospital
and Rehman medical institute Peshawar. By using Rao-soft sample size calculator the size of sample was 94 from total 285 population. A selfadministered questionnaire with 24 items was applied on nurses in the stated hospitals. The identified barriers to evidence based nursing practice
were insufficient time, no access to research materials, and no authority to change patient care, inadequate facilities and unavailability of equipment.
Awareness to the importance of evidence based nursing practice is the need of the day, the Government and health authorities shall do all the
possible action for the availability of necessary equipment and policies for the implementation of EBP.
Biomedical Journal of Scientific & Technical Research Volume 8- Issue 1: 2018
Cite this article: Aurang Z, Mehwish R, Sireeta E, Nazia R, Saima Q, et al., Barriers to Evidence Based Nursing Practice in Tertiary Care
Hospitals of Peshawar, Pakistan. Biomed J Sci&Tech Res 8(1)- 2018. BJSTR MS.ID.001592. DOI: 10.26717/ BJSTR.2018.08.001592. 2/5
A study by Umarani [2] at University of California highlighted
barriers to Evidence based nursing resulted are low level of
knowledge, lack of time, unavailability of recourses, organizational
culture, lack of administrative support, unclear workplace
expectations and poor understanding of statistics. A review of
the literature revealed that nurses from different countries and
settings have consistently been complaining of similar barriers
to the adoption of EBP, which include lack of time, perception of
insufficient power to adjust patient care processes, inadequate
organizational support, insufficient access to research journals and
articles and insufficient knowledge and skills Carroll et al. [4-8].
Organizations must prioritize evidence-based practice if patients
are to receive the best available care.
Methodology
Research Design
Descriptive cross-sectional study was used in the research
study. The study was conducted during the months of February
to May 2018 in Khyber Teaching hospital and Rehman Medical
Institute Peshawar [9-15].
Study Setting
This research project was conducted in Khyber Teaching
Hospital and Rehman Medical Institute Peshawar.Common Barrier of EBP Use Essay
Study Population
Population for this study was registered nurses, working in
Khyber teaching hospital and Rehman Medical Institute Peshawar.
The total population of nurses in both the hospital was 285.
Sampling Technique
Simple random sampling technique was used for sample
selection in this research project to easily access to nurses of KTH
and RMI Peshawar [16-18].
Sample Size
Sample size was calculated by RAO software, population size
was 285 with the margin of error 5% and non-responsive rate 10%
and calculated sample size was 94.
Inclusion Criteria
All registered nurses with Diploma in Nursing/ BSN
Exclusion Criteria
Nurses in management/ supervisor/head nurses
Data Collection Tool
The tool used for this study was adopted from Funk et al. [1],
and Upton and Upton. This questionnaire was also applied on 10%
of the sample size as pilot study, and the outcome was almost the
same as the applied for main data collection [18-20].
Data Collection Procedure
Written questionnaire was distributed among the nurses of
Khyber Teaching Hospital and Rehman Medical Institute Peshawar.
And their response were asked for.
Ethical Consideration
Written permission was obtained from Nursing Director
of Khyber teaching hospital and chief Nurse of RMI Peshawar.
Informed consent was distributed among participants of this
research project. Confidentiality and anonymity were assured
throughout the study Common Barrier of EBP Use Essay