Enablers and Obstacles to the Adoption of Evidence-Based Practice in Person-Centered Care

Enablers and Obstacles to the Adoption of Evidence-Based Practice in Person-Centered Care

Problems that arise with putting evidence-based practice into action

In the context of person-centered care, the purpose of this study is to provide an explanation of the factors that facilitate and hinder the adoption of evidence-based practice. These factors include ways to reduce non-compliance with policy, as well as suggestions for maintaining policy compliance over time. Although the introduction of evidence-based practice has the potential to increase the quality of nursing care, there are a few obstacles that may prevent it from being fully implemented.

In clinical practice, evidence-based practice (EBP) refers to the use of the best clinical evidence that can be used to address issues and improve efficiency. However, the implementation of EBP is dependent on the knowledge of the nurse, including the awareness of the facilitators and obstacles (Alatawi et al., 2020). For instance, a nursing medication error is one of the major clinical problems that affects the quality of care and patient outcome; consequently, nurses use EBP such as single check or double nurse checking procedure to ensure that they do not make medication errors. The implementation of evidence-based practice (EBP) is a complicated process that requires nurses to find the best possible solution from the evidence that is already available. According to Juckett et al.'s research from 2020, the adoption of an evidence-based practice (EBP) cannot be accomplished without preparation since the transition may be difficult owing to elements that might either represent facilitators or obstacles. A lack of training or education, managerial functions, staff behavior, cost, and organizational culture are the most prevalent hurdles to adoption that are common in many evidence-based practices (EBP), according to Mathieson, Grande, and Luker (2019). While it is necessary to have additional nurses in order to implement a double-check procedure in order to reduce medication errors, it is also necessary to have additional nurses because a lack of staff can be challenging. In addition, training and education of nurses is required prior to practice in order to ensure that they do check the prescriptions and the amount of medicine that is given to patients. Because of this, evidence-based practice (EBP) need to be supported by policy or guidelines (Mathieson, Grande, & Luker, 2019). In a similar vein, organizational culture and staff behavior may limit the frequency with which practitioners adhere to their practices.

The facilitators who are able to assist in increasing adherence or compliance to evidence-based practice are informed about nurses, including their behavior, which enables them to cultivate a positive connection with the nurses that they supervise. It has been shown that when nurses are provided with training and information, they are able to perform well throughout the time of transition that occurs during the implementation of evidence-based practice (EBP). Furthermore, the knowledge that nurses possess enables them to be prepared for obstacles (Duncombe, 2018). Another facilitator that enhances compliance is evidence-based practice (EBP) that is both cost-effective and simple to apply. For instance, as was said before, double-checking by nurses to prevent medication mistakes is an easy way that can be used, and re-checking can discover and reduce medication errors. In addition, strategic planning that has an emphasis on professional development and organizational growth contributes to an increase in compliance. For instance, an organization that is able to give the professionals with the essential knowledge, as well as train and educate them, would be able to reach a better result. In addition, other factors that contribute to increased compliance include ownership, flexibility, and autonomy. This evidence-based practice (EBP) that has been recommended to minimize medication errors is adaptable and gives the nurse the opportunity to take ownership, which would lead to an improvement in compliance (Howard et al., 2017).

However, compliance with the policy is contingent on the number of reasons, and similarly, there are problems that might raise the likelihood of non-compliance. The policy enables the successful implementation of a practice and makes the transition process better. Accordingly, it is essential for firms to engage in strategic planning in order to cut down on instances of non-compliance. In order to increase compliance with the policy, one approach that may be used is the documentation of the policy via the design of the policy and its application to procedures. When a policy or guideline is implemented immediately, it does not have an effective compliance rate because individuals exhibit resistance and rejection, or because they do not grasp the policy or guideline. Prior to the formulation of a policy, it is essential to provide direction to the populace and to inquire of the many stakeholders about the difficulties and issues that they face, which may be included into the policy (Shah et al., 2015). In addition, at some point during the transition phase, there can be a time restriction that is intended to assist individuals in becoming used to the new practice. In addition, it is essential to make use of positive reinforcement in the constant implementation of policies in order to guarantee adherence. If this is not done, it may result in disagreements or resistance, which ultimately leads to non-compliance (Houghton et al., 2020).

In order to increase adherence or compliance with evidence-based practice, facilitators are required.

An additional approach that may be used to enhance policy compliance is the training of personnel in relation to the policy, modifications, or the practice that has been established. Policy or changes in organizational practices are implemented in every department, and it is necessary for every stakeholder to pay attention to guarantee that they are aware of the goal of the policy. However, a lack of knowledge and awareness leads to a rise in the number of people who do not comply with the policy regulations. According to Shah et al. (2015), in order to improve the number of individuals who adhere to policies, it is vital to raise awareness and help educate the general public via training. In order to guarantee that persons in training are able to fulfill the requirements of the firm, a policy need to be presented to them. Research has shown that if companies provide their workers the opportunity to learn about their rules throughout the training process, it enhances the likelihood that those employees would comply with the policies and stick to them. In addition, it is recommended that the leaders of each department be requested to examine the policy in order to guarantee that the workers of each department are able to comply with the organizational need (Shah et al., 2015). A study conducted by Houghton and colleagues in 2020 discovered that policy training is one of the impacts that has the potential to raise awareness and reduce non-compliance with policy.

It is possible to achieve a seamless transition, implementation, and adherence to policy by providing staff with training and education. However, in order to maintain successful adherence over a longer period of time than the initial implementation phase, strategic planning that includes gentle reminders is required. According to Koohang et al.'s 2020 research, the following proposals have the potential to promote policy adherence longer beyond the first term.

• Education of workers on a regular basis: beyond the first education, there are a variety of methods in which an organization or employers may educate employees or re-communicate with them about the rules in order to promote long-term compliance. Organizations may hold seminars and workshops to bring attention to the policies in order to ensure that they remain in the forefront of their thoughts. In a similar vein, they may take the form of games and quizzes at the organizational level in order to determine the extent to which staff members comprehend the policy and to expand their knowledge. In addition, it is possible to have frequent HR meetings within the various departments in order to remind them of the significance of policy (Koohang et al., 2020).
• It is an effective way to educate employees and remind them about the policy because they have received the opportunity and freedom to self-educate and convenience. By sending gentle reminders, some organizations have resources and technologies that can be utilized to improve compliance training. For instance, online compliance training is an example of such a technology. It is possible to promote policy compliance via the use of technologies such as email communication. It is possible for organizations to provide guidance to individuals via the use of email communication and to send reminders to individuals if they have read the policy document and are using it. According to Koohang et al.'s research from 2020, it is also beneficial for a company to maintain a connection with its workforce.
• Organizations have a responsibility to take action when policies are abused in order to prevent additional resistance and non-adherence. This is accomplished by the implementation of severe action provisions. Due to the fact that many people may follow the same path and case misuse the policy, when individuals misuse a policy, they open the door to risk for the organization. On the other hand, if they have given the punishment or strict actions are taken, it restricts the people to follow the same path; consequently, strict rules and consequences of non-adherence should be educated to people in order to ensure long-term adherence (Bargain & Aminjonov, 2020).
• Having complete openness: One of the most powerful tools that can be used to promote policy compliance is transparency. As stated by Wayant et al. (2018), the business must demonstrate trust in its workforce in addition to maintaining openness by demonstrating the reason of its policies, objectives, and expectations.

Final Thoughts

On the basis of the study presented above, one may get the conclusion that evidence-based practice (EBP) in nursing leads to an improvement in clinical outcomes. However, in order to successfully implement EBP, strategic planning and policy support are essential. This is because there are a variety of obstacles and facilitators that can influence the adoption of practice.

References

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Bargain, O., & Aminjonov, U. (2020). Trust and compliance to public health policies in times of COVID-19. Journal of public economics, 192, 104316.

Duncombe, D. C. (2018). A multi?institutional study of the perceived barriers and facilitators to implementing evidence?based practice. Journal of Clinical Nursing, 27(5-6), 1216-1226.

Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., ... & Biesty, L. M. (2020). Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (4).

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Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 20.

Shah, N., Castro-Sánchez, E., Charani, E., Drumright, L. N., & Holmes, A. H. (2015). Towards changing healthcare workers' behaviour: a qualitative study exploring non-compliance through appraisals of infection prevention and control practices. Journal of Hospital Infection, 90(2), 126-134.

Wayant, C., Moore, G., Hoelscher, M., Cook, C., & Vassar, M. (2018). Adherence to reporting guidelines and clinical trial registration policies in oncology journals: a cross-sectional review. BMJ Evidence-Based Medicine.