Resistance from nursing leadership may prevent nurses from incorporating evidence-based practices into patient care, according to a recent Ohio State University study.
The study describes evidence-based practice as making decisions about patient care that are based on well-designed clinical research. This type of practice may improve patient care while decreasing healthcare costs.
The researchers surveyed more than 1,000 nurses nationwide. The participants ranged in age from 21 to 79, and 93 percent were female. Nearly 56 percent had advanced degrees, while 44 percent held only undergraduate degrees. The average number of years in practice for the participants was 24.
Respondents were asked to rank a variety of barriers to evidence-based practices. The top barriers included resistance from nursing leadership, politics within the organization, and an organizational culture that avoids change.
The survey participants were also asked what would help them implement evidence-based care into their practice. The most popular answers included education, access to information, and organizational support.
Interestingly, "the respondents with more education tended to have more confidence in implementing evidence-based practice," OSU said in a press release on the study. Nurses who had been in practice for many years were less interested in learning more about such practices. "This was a distressing finding," said Bernadette Melnyk, dean of the College of Nursing and chief wellness officer at OSU and lead author of the study.
And it's a huge problem. 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.
According to Melnyk, "widespread cultural change" is needed in healthcare and in nursing education; a lot of teachers are focusing on research methods, rather than implementing research into clinical practice.
In addition, many of the nurses participating in the survey said their leaders are resistant to change when it comes to evidence-based practices.
"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 donít walk the talk," Melnyk said. "Unless we have some drastic changes in both our clinical practice environment as well as our education systems, it's going to be a long haul until every clinician in this country consistently delivers evidence-based care."
Are you incorporating evidence-based practices into your oncology practice? If not, what challenges are you facing?