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Barriers to Nursing

Evidence-based practice/Evidence-informed decision-making

Repeatedly, lack of time is identified one of the most crucial barriers to implementing evidence-based practice in the workplace (Bradshaw, 2010). Other documented barriers include:

Nurse characteristics:*

  • lack of the knowledge needed to interpret statistical analyses;
  • lack of interest;
  • lack of confidence in critical appraisal skills;
  • lack of knowledge and skills to confidently conduct computer based literature searches and utilize the research process;
  • nurses feeling overwhelmed by the volume of evidence (Wells, Free & Adam, 2007);
  • nurses’ perceptions that they lack the authority and cooperation to change patient care procedures;
  • negative beliefs, attitudes and values; and
  • educational preparation.

*Except where otherwise indicated, all items in the above list are from Bradshaw, 2010.

Organizational characteristics:*

  • limited or lack of time;
  • heavy patient workloads;
  • inadequate staffing;
  • limited access to resources;
  • lack of support from nurse managers;
  • different goals for practice between administrators and staff nurses (Van Patter Gale & Schaffer, 2009); and
  • lack of evidence-based practice mentors in health-care systems (Bertulis, 2008).

*Except where otherwise indicated, all items in the above list are from Bradshaw, 2010.

Nature of research information:

  • “Research is seen as too complicated, too scholarly, excessively statistical, ambiguous, and having limited or no relevance to practice” (Van Patter Gale & Schaffer, 2009, p. 91); and
  • “Research reports lack clear practice implications and generalizability” (Wells, Free & Adam, 2007, p. 136).

Health-care environment:

  • “Multiple barriers have contributed to the slow uptake of EBP across healthcare systems…traditional approaches to teaching healthcare students the rigorous process of how to do research rather than how to use research to guide best practice” (Wallen et al, 2010, p. 2762).