Barriers to evidence based nursing care.

A new survey conducted by Ohio State University has explored nurses views around the implementation of evidence based patient care… with some unexpected results.

20,000 members of the American Nurses Association were selected at random and emailed a survey. Of those, 1,015 nurses completed and returned it (that sounds about right).

Just over half the respondents reported that evidence-based practice was consistently used in their organisation
One third said that their colleagues consistently used these practices.
Fewer than a third of respondents reported that mentors were available to teach and support them with these practices.

The suprise came when they were asked to identify the top barriers to the implementation of evidence based care in their workplace. Resistance from nursing leaders and nurse managers, as well as politics and organizational cultures that avoid change were both ranked in the top 5.

“Another disconcerting finding in our survey was that a substantive number of nurses said their leader or manager is resistant to evidence-based practice. What I’ve seen as a consultant is a lot of leaders and managers will say they want their clinicians to deliver evidence-based care, but they don’t walk the talk. If leaders do not role model evidence-based decision-making and they are not providing tools, education and resources for their clinicians to get the knowledge and skills they need to consistently implement this, it’s probably not going to happen nor will it be sustained…..”

….The average age of nurses is 47, and they were educated at a time when evidence-based practice was not well integrated into educational programs. As a result, many nurses are practicing the way they were taught or steeped in tradition of the health-care system in which they work. When new graduates who have learned to take an evidence-based approach to care are meeting these nurses in real-world settings, they encounter this prevalence of a ‘this is the way we do it here’ culture.

Now, I often bang on about how the senior nurses in the workforce are holders of a great deal of accumulated experience, wisdom and knowledge that often goes under-recognised.

But let us not forget that the science of nursing is in a constant state of flux, and that the newly post graduate nurses that move into our midst may well have superior skills in tapping into the latest evidence and evaluating our current practice with the eyes of ‘Shoshin’ .

Take, for example, the day a new-grad taught me how to give an injection properly.

Respect is a two way sphincter.

The study is published in the September issue of the Journal of Nursing Administration.
Read more here.