Over the past few decades, approaches towards healthcare reforms have been framed within the scope of clinical evidence leading to the emergence of what is commonly referred to as evidence based practice (EBP). EBP is conceptualized as a new clinical decision making approach that is based on diverse aspects of clinical practice including clinical experience, emerging research findings, patient preferences, and expert opinion. This new approach is considered a transformative perspective through which patient outcomes and quality of care can be improved. From a critical perspective, evidence based practice underpins the advancement and development across the continuum of clinical practice.
In the Australian context, healthcare professionals are involved in the assessment and implementation of EBP. However, nurses are expected to play integral roles in implementing EBP in the clinical setting. The Nursing and Midwifery Board of Australia [NMBA] 2016 standards of nursing practice require nurses to adopt evidence based interventions, in order to improve the safety and quality of practice. According to NMBA (2016) standard 1.1; a registered nurses “accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice” (p. 3). Based on this standard of practice, it is expected that nurses are at the forefront of EBP implementation in the clinical setting, yet they do not have relevant training or support.
Therefore, this essay argues that it is not feasible to expect RNs to implement EBP in the clinical setting without training/support.
Table of Contents
1. Introduction
2. Key Aspects of Evidence Based Practice
3. Barriers to the Implementation of Evidence Based Practice
4. Conclusion
Objectives and Key Themes
This paper examines the fundamental challenges that hinder registered nurses from effectively implementing evidence-based practice (EBP) within clinical environments in Australia. The central argument is that despite professional standards requiring EBP integration, systemic barriers—such as the conceptualization of nurses primarily as care-givers rather than researchers, a lack of decision-making autonomy, and inadequate support for lifelong learning—make it currently unfeasible for nurses to fulfill these requirements without significant structural support.
- The transformative role of evidence-based practice in improving patient safety and healthcare quality.
- Clinical applications and the theoretical basis of evidence-based interventions.
- The impact of professional culture and the "care-giver vs. researcher" dichotomy on nursing practice.
- Structural limitations, including restricted decision-making authority and reliance on physician-led treatment models.
- Deficiencies in institutional support for lifelong learning and professional development.
Excerpt from the Book
Barriers to the Implementation of Evidence Based Practice
Despite the relevance of nurses in the implementation of EBP in the clinical setting, there is evidence that there are several barriers to the implementation of EBP. From a critical perspective, the success of EBP in clinical setting can be achieved if nurses are involved in its implementation. The rationale for this observation is based on the fact that nurses constitute the largest proportion of healthcare workforce (Australian Institute of Health and Welfare, 2016). This implies that change management within the clinical setting depends on the response of the nurses. On the other hand, nurses are closely involved in the patients’ care throughout the continuum of care, unlike the other healthcare personnel who experience minimal contact with patients (Kieft, Brouwer, Francke & Delnoij, 2014). Therefore, it is quite surprising that Australian nurses are not adequately trained, nor are they given support to implement EBP in the clinical setting. In this context, this essay discusses three main reasons why nurses should not be expected to be in the forefront in the implementation of EBP in the clinical setting.
Summary of Chapters
Introduction: Provides the context of healthcare reforms, defines evidence-based practice as a transformative approach for quality care, and outlines the argument regarding the lack of support for nurses in the Australian clinical setting.
Key Aspects of Evidence Based Practice: Discusses how EBP enhances patient outcomes and cost-effective care through specific clinical examples, such as the use of probiotics in treating antibiotic-associated diarrhea.
Barriers to the Implementation of Evidence Based Practice: Analyzes the specific systemic obstacles, including the traditional nursing culture, limited clinical autonomy, and the lack of institutional support for continuous professional learning.
Conclusion: Summarizes the core arguments, reaffirming that while EBP is essential for quality healthcare, current barriers must be addressed to successfully integrate it into daily nursing practice.
Keywords
Evidence Based Practice, EBP, Nursing, Clinical Setting, Healthcare Reform, Patient Outcomes, Professional Development, Lifelong Learning, Clinical Decision Making, Antibiotic-Associated Diarrhea, Probiotics, Australian Healthcare, Nursing Standards, Quality Improvement, Healthcare Workforce
Frequently Asked Questions
What is the primary focus of this paper?
The paper explores the practical difficulties that nurses encounter when attempting to implement evidence-based practice (EBP) within modern clinical settings, specifically in Australia.
What are the central themes discussed in the text?
The text focuses on the role of nurses in EBP, the impact of professional standards (NMBA), the clinical application of EBP, and the systemic barriers preventing its successful implementation.
What is the author's main research argument?
The author argues that it is unrealistic to expect registered nurses to lead the implementation of evidence-based practice when they lack adequate training, institutional support, and professional autonomy.
Which scientific methodology is used to support the argument?
The work utilizes a descriptive, argumentative analysis supported by a literature review, referencing established nursing standards, medical theories (such as Virginia Henderson’s Need Theory), and empirical research findings.
What does the main body of the text cover?
The main body examines the benefits of EBP, such as patient safety and cost-effectiveness, and details three primary barriers: the "care-giver vs. researcher" culture, the lack of decision-making independence, and the insufficiency of lifelong learning support.
Which keywords best characterize this work?
Key terms include Evidence Based Practice, Nursing, Healthcare Reform, Professional Development, and Clinical Decision Making.
How does the author view the role of the contemporary nurse?
The author notes a conflict between the ideal standard—where nurses are expected to be both care-givers and researchers—and the reality, where they are often restricted to executing physician-led orders.
What role do probiotics play in the author's argument?
Probiotics are used as a representative case study to demonstrate how evidence-based interventions can tangibly improve patient outcomes and reduce treatment costs in clinical environments.
What specific systemic issues undermine EBP in Australia?
The author identifies a lack of support programs, incentives for education, and a rigid, traditional hierarchical structure in hospitals that prioritizes physician authority over nurse autonomy.
- Citation du texte
- Patrick Kimuyu (Auteur), 2018, Challenges Faced by Nurses in Implementing Evidence Based Practice in the Clinical Setting, Munich, GRIN Verlag, https://www.grin.com/document/412261
