Discussion:
The biggest issue in addressing evidence-based nursing practice (EBP) is lack of nurse compliance due to lack of time and education. The unit has been struggling to get nurses to implement new evidence-based practices consistently. Many of the nurses here complain about the time these new policies take. One survey found several barriers to implementing evidence-based practice. The most common complaint was a lack of time, nurses already spend about 70% of their time on non-patient care activity, and they are often hard-pressed to do what they need to do within their shift (Pravioff, Tanner, & Pierce, 2005). Another reason for the lack of compliance has been lack of education. Some nurses tend to believe that if something is not broken then there is no need to fix it. It is common to hear a nurse say she has been doing it this way for years. One example is nurses that do not believe breastfeeding is best because they grew up in a culture where only poor people who couldn't afford formula chose to breastfeed. Despite evidence that exclusive breastfeeding for at least six months has many benefits, there are many nurses here that pressure moms to supplement with formula. One study stated that things that get in the way of nurse compliance include a culture that is resistant to change; a lack of education on EBP; no access to information on EBP; managerial resistance; inadequate staffing/patient loads; nursing resistance; physician resistance; budgetary or payer issues; and lack of resources (Melnyk, Fineout-Overhold, Gallagher-Ford, & Kaplan, 2012). The first step in resolving these issues should be to educate staff and management. When one knows better, one can and will do better. Once staff is educated, goals need to be realistic and there must be opportunities for everyone to get involved. Implementing EBP will take education, time, teamwork, and collaboration.
Melnyk B.M, Fineout-Overhold E, Gallagher-Ford L, Kaplan L (September, 2012). The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. 42(9):410-7.
Pravikoff D. S, Tanner A.B, Pierce S.T(September, 2005). Readiness of U.S. nurses for evidence-based practice. American Journal of Nursing. (9)41.