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November 12, 2024
Evidence-based Nursing Practice equips nurses with the ability to comprehend the risks and efficacy of therapies. The use of this practice guarantees that nurses possess a patient care plan (Mathieson et al., 2019). This paper will concentrate on obstacles and facilitators, clinical practice recommendations, and the maintenance and sustainability of adherence to a policy.
Nurses encounter several obstacles in implementing Evidence-Based Practice, including insufficient knowledge, lack of desire, inadequate resources, discouragement, pessimism, and negative cognition. Obstacles in the application of evidence-based procedures hinder clinical decision-making. Barriers and facilitators are categorized as organizational variables, individual characteristics, communication issues, and research quality (McArthur, 2021).
Organizational issues include the obstacles that nurses encounter in the use of research. Nurses have challenges in assessing, comprehending, analyzing, and implementing research information. A study revealed that nurses encounter several organizational obstacles that impede their practice environment. This facet was also acknowledged by Hutchinson and Johnston in Australia and by caregivers in Hong Kong (Tso et al., 2019). The primary obstacles are inadequate facilities and insufficient support for research implementation.
Commonly identified individual hurdles include a lack of understanding about analytical methodologies, insufficient awareness of analytical results, and a negative disposition towards research. A study conducted in Spain identified the three primary hurdles related to the atypical characteristics of nurses, particularly their perceptions of the significance of research and their confidence in their research abilities (Barth et al., 2016). The inability to evaluate research quality was identified as the primary impediment.
Effective communication enables family doctors to establish connections, gather and disseminate essential information, and collaborate efficiently with patients and their families. However, when medical professionals face the time constraints of a busy clinical workday, effective communication often becomes compromised. Communicative elements are crucial in nursing practices as they facilitate the understanding of circumstances between physicians and patients. Communication skills are recognized as a crucial element in bridging the divide between evidence-based practice and patient-centered care, hence improving patient health outcomes (Proctor et al., 2011). Consequently, health practitioners serve as 'frontline facilitators' in the implementation of evidence into practice; the effectiveness with which nurses communicate this knowledge to patients depends, in part, on their relevant skills, qualities, and comprehension. It is essential that evidence-based information be communicated clearly and sensibly to enable patients to make informed decisions.
A crucial factor may be the quality of published study. Methodological deficiencies, inadequate justification of study outcomes, and inconsistent results pose significant challenges for novice researchers. The fortuitous nature of analytical results and the delayed dissemination of articles are additional factors influencing the quality of analysis and the components of innovation.
Understand the medication adherence behaviors of each patient. Inquiring whether the patients are encountering any obstacles in paying their medications. Nurses may inquire whether patients are experiencing challenges in adhering to their medication regimen (Yoo et al., 2019).
Considering the Side Effects - There may be potential side effects associated with the drug; patients sometimes encounter these issues, which may be mitigated by obtaining an appropriate prescription in advance. Nurses and midwives must address adverse effects and avoid additional medication reactions.
Engage with Patients - Providers or midwives should inquire about the optimal time for patients to administer their prescription, offering explicit instructions, such as identifying certain medications that should be taken in the morning. Collaborative methods assist patients and nurses in identifying gaps that may impede the medication process.
Reducing the complexity of pharmacological prescriptions increases the likelihood that patients will adhere to their medication regimens properly. Administering the appropriate medicine may mitigate the difficulty (Mathie et al., 2012). Another approach is to provide a single medicine instead of many prescriptions daily.
Financial load - The financial load is a significant difficulty faced by many patients throughout their treatment, since several individuals are unable to purchase their prescription. To address this issue, the hospital's administrative system may facilitate connections for patients to different services that alleviate burdens, such as health insurance and outpatient facilities (Proctor et al., 2011).
The use of technology—specifically, alarm watches—can improve patient compliance with prescriptions. The Bluetooth pillbox is a significant device that notifies patients to take their prescription punctually (Proctor et al., 2011). Numerous challenges are encountered during medication, which may be mitigated by various strategies.
The guidelines provide valuable evidence-based suggestions for both specialists and patients, with the objective of improving treatment quality. Typically, the adoption of policies does not happen spontaneously, and a functional performance technique is often necessary. Furthermore, if a method is effectively implemented, sustaining the quality improvements over a prolonged duration may be difficult (Yoo et al., 2019). Individuals sometimes revert to previous habits, which may affect sustained commitment to the method. Clinical guidelines aim to provide effective patient care and treatment protocols; for instance, in the case of cervical cancer patients, they include advice for diagnosis and therapy. Psychosocial assistance is also advised to assist in recovery and follow-up treatment. Systematic patient care may serve as an additional guideline that will enhance patient benefits. Recommendations are designed to augment importance while ensuring quality treatment, minimize discrepancies in medical practices, and decrease costs alongside adverse occurrences.
It is advisable to establish guidelines for conducting audits, which will assist nurses in receiving appropriate advice on designated responsibilities. Clinical Practice Guidelines (CPGs) are recognized for facilitating quality improvements that assist in determining fundamental outcomes and standards of patient care. These guidelines facilitate the attainment of prospective advantages and enhanced recommendations from medical specialists. For instance, in the therapy of anxiety, organizations like the National Institute of Mental Health will assist in lowering patients' anxiety levels.
Nurses may maintain best-practice guidelines for individuals or a combination of issues related to the screening of certain illnesses and diseases, diagnosis of conditions, and monitoring. The word 'protocol' refers to prescribed behavior in formal and social situations. In the medical and health professions, it aims to establish regulations for executing specialized procedures accurately and without error. Clinical pathways improve by providing more precise information on the order, timing, and conditions of treatments. They are often based on CPGs and tailored for use in certain contexts. Nurses are advised to review the guidelines and policies prior to implementation; alternatively, they may consult their colleagues on the procedures involved in treatment and medication (Tso et al., 2019). To ensure effective implementation of the newest clinical practice recommendations, a detailed strategy for evaluating effectiveness must be established. This often occurs in healthcare settings as a quality assurance process for advancement.
This article analyzes the obstacles and enablers of using research evidence in nursing practice among nurses. Diverse initiatives have contributed to the reduction of policy non-compliance. The report has also included guidelines for nurses to adhere to throughout treatment planning and patient care.
Barth, J. H., Misra, S., Aakre, K. M., Langlois, M. R., Watine, J., Twomey, P. J., & Oosterhuis, W. P., (2016). Why are clinical practice guidelines not followed?. Clinical Chemistry and Laboratory Medicine (CCLM), 54(7), 1133-1139.
https://www.degruyter.com/document/doi/10.1515/cclm-2015-0871/html
Mathie, R. T., Roniger, H., Van Wassenhoven, M., Frye, J., Jacobs, J., Oberbaum, M., & Fisher, P., (2012). Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study. BMC Medical Research Methodology, 12(1), 1-9. https://link.springer.com/article/10.1186/1471-2288-12-49
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. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/strategies-facilitators-and-barriers-to-implementation-of-evidencebased-practice-in-community-nursing-a-systematic-mixedstudies-review-and-qualitative-synthesis/74D8FB3E7561129C8CBBF01207837BCC
McArthur, C., Bai, Y., Hewston, P., Giangregorio, L., Straus, S., & Papaioannou, A., (2021). Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis. Implementation Science, 16(1), 1-25.
https://implementationscience.biomedcentral.com/articles/10.1186/s13012-021-01140-0
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., & Hensley, M., (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and policy in mental health and mental health services research, 38(2), 65-76. https://link.springer.com/article/10.1007/s10488-010-0319-7
Tso, A. W. B., & Lee, S., (2019). Reading the Short Story: A Student's Guide to Selected British, Irish and American Works. McFarland. https://books.google.co.in/books?hl=en&lr=&id=6z67DwAAQBAJ&oi=fnd&pg=PP1&dq=aspect+was+also+recognised+by+Hutchinson+and+Johnston+in+Australia+and+by+nursemaids+in+Hong+Kong&ots=At6CH8qVT4&sig=6MJOissQXxtLOk65Oq2utGbj7nA&redir_esc=y
Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S., (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS One, 14(12), e0226742. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226742
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