Introduction
The purpose of evidence-based practice (EBP) in the clinical setting is to provide patients with the most effective level of care that is available to practitioners. The process draws on up-to-date scientific evidence to develop and enhance care delivery strategies (Abu-Baker et al., 2021). Understanding the barriers to EBP implementation in the clinical setting is essential for identifying gaps in care delivery and implementing change measures to facilitate improved patient outcomes.
Examples
The hurdles healthcare facilities face when integrating EBP are diverse. The barriers to EBP care have been studied extensively; they range from the quality of guidelines clinical practitioners use to financial factors (McArthur et al., 2021). Drawing on experience caring for patients in hospital and public school clinic settings, the identified constraints included inadequate staffing levels, time constraints, a lack of leadership support, and limited research resources. As a result, it was challenging to implement EBP consistently, as the expectations for care quality did not align with the team’s capabilities.
Overcoming Barriers
How the identified barriers could be addressed depends on a variety of factors, especially resource-based ones. Nevertheless, one of the initial steps is to assess the facility and its team to evaluate existing skills, knowledge, and overall attitudes toward EBP integration. The second step is to use the assessment results to identify the main problem areas that require immediate attention. In particular, managing staffing levels could reduce practitioners’ workload. The third step is implementing a change process to make EBP a consistent component of the care process, ensuring it informs every decision. The fourth recommendation is to integrate practitioner training and education to enhance their knowledge and abilities, which they can later apply to the care process.
Model
Sackett’s five-step model of EBP can be a good fit for the institution because of its flexibility and its ability to be adjusted to a specific context and setting. Within the model, the EBP process is differentiated into five steps: “asking a question, gathering the best evidence, appraising it, applying findings to clinical practice, and evaluating outcomes” (Dusin et al., 2023, e071188). This model is patient-oriented and will encourage all stakeholders in the care process to apply their clinical skills and knowledge to meet the specific needs of the individual under care. How the evidence may be reviewed depends on the capabilities of clinical professionals and the resources available to them.
Conclusion
This overview of EBP implementation in the clinical context revealed that, despite the approach’s benefits, there are significant limitations to its use, especially given the resources available to healthcare institutions. While the barriers can range from one organization to another, workload issues and limited resources, including time constraints, prevent many practitioners from integrating EBP into the care process. A comprehensive assessment of the team’s EBP skills and knowledge is needed to identify gaps in the care process and implement positive changes across the team. Integrating Sackett’s five-step model is advised because it is flexible enough to fit any healthcare context and adjust to the skills and knowledge of the clinical staff.
References
Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20, 13.
Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: a scoping review. BMJ open, 13(5).
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, 70.