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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)

Asses the barriers in evidence base practice learning among nurses

In district headquarter hospital Abbottabad

by

Muhammad Irfan

Department of nursing, VIST college of nursing

Submitted to

Sir! Qaasi Hassan

Lecturer research practicum

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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)

Introduction

Nursing practice that is evidence-based, is essential to giving patients the best care possible. It

has been associated with reducing expenses, advancing nursing research and education, and most

importantly improving patient outcomes. Evidence-based medicine has been found to improve

patient outcomes by lowering the patient death rate [1].

By setting the objective that 90% of clinically based decisions will be evidence-based

practice by 2020, the Institute of Medicine (IOM) highlighted the significance of EBP [2]. While

it was 2018 by which the article was published.

Since nursing is a profession that places a strong emphasis on clinical practice, research

findings should occasionally be applied in clinical settings [3]. The average time it takes for

knowledge to start being used and accepted in the market is 20 years [4]. It's not new to see a

disconnect between what knowledge is available and how it's used in practice and policy. The

best available scientific evidence and strategic research should be encouraged via new methods.

In addition, they ought to make use of practical knowledge, creativity, and a focus on problem-

solving in order to tackle urgent health issues on both a global and local scale. Knowledge needs

to be used wisely in order to close the know-do gap and improve health. Knowledge must be

created and shared in order to be used effectively in practice [5].

In the 1980s, the term "evidence-based practice" was first used; later, it was known as

"evidence-based medicines." The goal was to highlight the significance of scientific data in

clinical
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)

settings, according to Melnyk. The dynamic nature of the healthcare environment presents a

number of obstacles for professional nurses in the twenty-first century. (Aurang Zeb*, 2018)

Enhancing the quality of nursing care through the use of research evidence in clinical

practice may also improve nurses' personal and professional performance [6, 7]. Five steps make

up evidence-based practice (EBP), including asking pertinent questions in particular clinical

situations, locating the best evidence, critically evaluating that evidence, incorporating that

evidence with the patient's preferences in clinical decision-making, and assessing the efficacy

and efficiency of the process. These steps are also known as the five training steps: "ask, find,

evaluate, use, and analyze/adjust, which are known as the key skills acquired during the training

course [8, 9].

A nurse must be able to do the following in order to apply the EBP process effectively:

(1) identify knowledge gaps; (2) formulate pertinent questions; (3) efficiently search the

literature; (4) apply rules of evidence to assess the validity of studies; (5) appropriately apply the

literature findings to the patient's problem; and (6) appropriately involve the patient in clinical

decision-making [10].

The large amount of health care material that is produced in a variety of sources, which

makes it nearly difficult for individual medical practitioners to stay up to date, is one obstacle
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)
that some studies identified. An estimated 8,000 family practice-related articles are published

each month, and a family medicine practitioner would need to commit about 20 hours each day

to be up to date on new research [11]. "Not having enough authority to change patient care

procedures" and "having insufficient time on the job to implement new ideas" were the top two

impediments mentioned. The main obstacles to community nurses adopting EBP were a lack of

time, a lack of resources, and a problem understanding statistical analysis [12, 13].

O'Connor and Pettigrew looked into the perceived obstacles therapists in southern Ireland

face while attempting to use EBP [14]. They cited a lack of time to identify, comprehend, and

evaluate study findings as the biggest obstacle. The same hurdles were also discovered when

participants' experiences with EBP were compared across three various health professions [15,

16]. Inadequate access to information technology (IT), a lack of IT expertise, and poor

information search abilities are additional obstacles to the adoption of EBP [17].

Nurses are required by the International Council of Nurses (ICN) to actively participate in

research and use that research to create EBP. According to the article, EBP has advantages such

as raising care quality and its results, enhancing clinical practice and patient care outcomes,

increasing nurse satisfaction, and standardizing the standard of care [18].

Key words;

Assess
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)
Barriers

Evidence-based practice learning

Nursing

Hospital

Definition of Key words

Assess: Data collecting to characterize or better understand a problem is referred to as

assessment.

Barriers: something that hinders, inhibits, or prevents development or the accomplishment of a

primary goal or end.

Evidence-based practice learning: Evidence-based learning refers to a collection of tactics,

methods, and procedures that have been experimentally shown to produce positive learning

results.

Nursing: Nursing encompasses autonomous and collaborative care of individuals of all ages, families,

groups and communities, sick or well and in all settings. Nursing includes the promotion of health,

prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
(Abbottabad)
environment, research, participation in shaping health policy and in patient and health systems

management, and education are also key nursing roles”. (international council of nurses)

Hospital: According to the American Hospital Association (AHA), hospitals are licensed institutions with

at least six beds whose primary function is to provide diagnostic and therapeutic patient services for

medical conditions; they have an organized physician staff; and they provide continuous nursing services

under the supervision of registered nurses. (American hospital association)

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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
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References

[1]. (Emparanza, Cabello, & Burls, 2015).

[2]. (IOM, 2009)

[3]. Melnyk BM, Fineout-Overholt E, Fischbeck Feinstein N, Li H, Small L, Wilcox L, et al., (2004):

Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice:

implications for accelerating the paradigm shift. Worldviews Evidence Based Nurs. 1(3):185-93.

[4]. (AHRQ) Agency for Healthcare Research and Quality (2006). National health care quality

report. Rockville, MD: AHRQ.

[5]. Canadian Health Services Research Foundation (2005): Lever aging Knowledge: tools &

strategies for action. Report of the 7th CHSRF Annual Invitational Workshop, Montreal, Quebec;

March 3.
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
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[6]. Chien WT, Bai Q, Wong WK, Wang H, Lu X. (2013): Nurses' perceived barriers to and

facilitators of research utilization in mainland china: a cross-sectional survey. Open Nurs J; 7: 96-

106. (5): 314-22.

[7]. Kajermo, KN, Undén, M., Gardulf, A., Eriksson LE, Orton ML, Arnetz BB, et al. (2008);

Predictors of nurses' perceptions of barriers to research utilization. J Nurs Manag; 16 (3): 305-314.

[8]. Dawes M, Summerskill W, Glasziou P, Carta-bellotta A, Martin J, Hopayian K, et al. (2005):

Sicily statement on Evidence-Based Practice. BMC Med Educ. 5(1):1.

[9]. Ciliska D. (2005): Educating for Evidence-Based Practice, Journal of professional nursing:

official journal of the American Association of Colleges of Nursing, 21(6):345-50.

[10]. Guyatt GH, Haynes RB, Jaeschke RZ, Cook DJ, Green L, Naylor CD., Wilson MC,

Richardson WS. (2000): Users’ guides to the medical literature: XXV. Evidence-based Medicine:

principles for applying the users’ guides to patient care. Evidence-Based Medicine Working Group.

JAMA. Sep13; 284 (10):1290-6.

[11]. Alper BS, Hand JA, Elliott SG, Kinkada S, Hauan MJ, Onion DK, Sklar BM. (2004): How

much effort is needed to keep up with the literature relevant for primary care? J Med Libr Assoc.

Oct; 92(4):429-37.

[12]. Griffiths JM, Closs SJ, Bryar RM, Hostick T, Kelly S, Cooke J. (2001): Barriers to research

implementation by community nurses. Br J Community Nurse, 6(10):501-10.

[13]. Solomons NM, Spross JA. (2010): Evidence-based practice barriers and facilitators from a

continuous quality improvement perspective: an integrative review. J Nurs Manag. Jan;19 (1):109-

20.
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
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[14]. O’Connor S, Pettigrew CM. (2009): Barriers perceived to prevent the successful

implementation of evidence-based practice by speech and language therapists. Int J Lang

Commun Disord. 44(6):1018-35.

[15]. Asadoorian J, Hearson B, Satyanarayana S, Ursel J. (2010); Evidence based practice in

dental hygiene: exploring the enhancers and barriers across disciplines. Can J Dent Hyg,

44(6):271-6.

[16]. Mclnerney P, Suleman F. (2010); Exploring knowledge, attitudes, and barriers toward the

use of evidence-based practice amongst academic health care practitioners in their teaching in a

South African university: a pilot study. Worldviews Evid Based Nurs. 7(2):90-7.

[17]. McKenna HP, Ashton S, Keeney S. (2004): Barriers to evidence-based practice in primary

care. J Adv Nursing; 45(2):178-89.

[18]. International Council of Nurses ICN. (2007): Position Statement on Nursing Research.
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Assess the barriers in evidence base practice learning among nurses in district headquarter hospital
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