Barriers, challenges, and strategies Essay

Most clinical health plow workers ar aw be that achieving the paradigm of indicate-based pull session (EBP) is the gold star model that nonpargonil strives for in his/her clinical expend. EBP is expected of health foreboding clinicians and has become a synonym for superior attention both by the governing body of health vexation and its consumers (Brim & antiophthalmic factor Schoonover, 2009). This essay allow for define EBP for harbors. The restraints, challenges and strategies to employing testify-based care for suffice (EBNP) testament be discussed with reference to relevant and arbitrary literature. As headspring, the relevance and the links that EBNP has with the clinical area of Intensive Care progress behind be discussed. EBP is the integration, by clinicians, of clinical expertness which is meticulous, explicit and uses current clinically appraised overlord receiveledge (Eizenberg, 2011 Kenny, Richard, Ceniceros, & angstrom unit Blaize, 2010).EBP accommodates unhurried preferences, views and value while also guiding, conducting, validating and answering health care workers clinical judgements, works, and questions (Eizenberg, 2011 Kenny et al., 2010 Matula, 2005 Wolf, 2005). EBP is a process of asking a clinical question attempting for clinical shew critically appraising this evidence and thence expertly integrating this evidence with longanimouss values, views and preferences evaluation of how the diversitys to traffic pattern get had on outcomes and finally disseminating the results that the EBP or commute had on patient outcomes (Melnyk, Fineout-Overholt, Stillwell, & vitamin A Williamson, 2010). The commentary of EBP and EBNP and the implementation of EBNP appear to be simple and easily fulfill however, EBNP implementation is far removed from macrocosm easy (Brim & angstrom Schoonover, 2009 Cullen, Titler, & vitamin A Rempel, 2011 Eizenberg, 2011 Kenny et al., 2010 Tolson, Booth, & adenine Lowndes, 2008). care for query has uncovered numerous challenges and barriers which the implementation of EBNP aspects. These challenges and barriers idler be classified as a look, a clinician, an organisational, a breast feeding lord barrier, and non least patient barriers (Fernandez, Davidson, & vitamin Aere Griffiths, 2008 Gerrish et al., 2011 Hutchinson &Johnston, 2006 Ross, 2010).Eizenberg (2011), Gerrish et al. (2011), and Ross (2010) show that obligates face enquiry and clinician barriers that include non having the sentence, skills and knowledge to critically critique and/or synthesise re inquisition literature, unable to effectively use and search databases electronically, hold negative views toward research and impression research is too complex, as well research at times is not clear on how to implement the findings and findings go off be contradictory. Due to these barriers, take ups tend to depose on synthesised evidence such(prenominal) as evidence-based protoc ols, policies and procedures (Gerrish et al., 2011). Eizenberg (2011) and Gerrish et al. (2011) also base that nurses prefer to bring instruction through trio parties such as their colleagues, the workplace, through patient care experience, and the knowledge they received from their nursing info. Eizenberg (2011) put in that the organisation is the greatest factor in successful EBNP implementation.The organisation controls approach shot and the work out to and for evidence resources such as computers with lucre access, a well-equipped library, and access to educational opportunities in EBNP procedures and theory (Eizenberg, 2011). The barrier of not having the place to alter a nursing set also lies with the organisation a nurse whitethorn fool the necessary research knowledge and experience to effectively diverge practice but gougenot implement practice change due to the organisation not crowing him/her the authority to add change (Eizenberg, 2011). Few nursing st aff members are give(p) the opportunity to insert in the development of evidence-based policies and procedures therefore, most nurses are not engaged to hold up EBP.Ross (2010) further found organisational barriers such as the organisation giving priority to different goals (for example overindulgence sick leave) over EBNP, the organisation may perceive that the staff are not rakey or willing to implement EBNP, and that the organisation believes EBNP is unachievable. These organisational barriers prevent EBNP macrocosm accomplished and to the greater extent of not being implemented. A barrier of nursing barter relates to the medical dominance of healthcare as such, nurses are not afforded the power, authority, autonomy and appraise from colleagues for nursing practice that the status of being a profession decrees (Brim & Schoonover, 2009 Eizenberg, 2011 Gerrish et al., 2011).A further nursing profession barrier is it tail assembly be difficult to instill enthusiasm or tuition to the highest degree an EBNP if overturn is high there is a shortage of experienced nurses and hold water from colleagues is missing (Gerrish et al., 2011 Mark, Latimer, & Hardy, 2010). Due to high turnover and staff shortages, nurses are unable to leave the bedside and submit limited time to participate in EBNP projects such as journal clubs, or to attend training in EBP, PICO (Population/Intervention/Comparison/Outcome), and database searches (Brim & Schoonover, 2009 Brown, Johnson, & Appling, 2011). draws, as Kenny et al. (2010) found were hesitant to change their practice if the change would perceivably outgrowth an already heavy workload. Brim & Schoonover (2009) found that some nurses believed EBNP to be an optional operate of action as they were never shown a clear direction of what EBNP is essential to nursing and his/her practice. One of the main premises of EBNP is that the evidence and the values and beliefs of the patient/s are synthesis ed together to form an EBNP which is foremost gold for a positive outcome for the patient/s (Fernandez et al., 2008).Such factors as handling, travel, and prescription costs denial of diagnosis brusque knowledge level of disease and strategies to hang risk factors lack of social jump and cultural issues can all potentially become barriers to implementing an EBNP for a patient or patients (Fernandez et al., 2008). The high acuity of an intensive care unit (intensive care unit) patient satisfyingly affects a nurses tycoon to search a database for answers (Brim & Schoonover, 2009 Kenny et al., 2010). An answer to a question is usually aimed right away or momentarily therefore, intensive care unit nurses depone on experience, colleagues, and knowledge of evidence-based policies, procedures and guidelines (Eizenberg, 2011 Gerrish et al., 2011). I know I rely heavily upon in-services, experience, and communicate with the ICU clinical confine Educators and Nurse Educators wh o will do a literature search to acquire information or answers to a question I have posed but once over again this evidence/information has been synthesised by others and is third hand and I have not fully practiced EBN (Eizenberg, 2011 Gerrish et al., 2011).To sift and challenge this barrier I do try and read the clinical information the educator obtained at a posterior date usually at star sign or on a break. Strategies to overhaul these challenges and barriers abound from EBP and EBNP journal articles and books. Some of the leading strategies are for the organisation to fully tolerate EBNP through infrastructure, strong leadership from nurse managers and/or modernistic practice nurses, and by ensuring a context in which EBNP can flourish (Gerrish et al., 2011 Tolson et al., 2008). The infrastructure needs to let access to a computer which can access online databases. Infrastructure needed to be in place includes a staffed evidence based nursing library with a libraria n able to educate nurses on the process of EBNP (Pochciol & Warren, 2009). The added challenge is to have EBNP info accessible to the nurse at the patients bedside (Pochciol & Warren, 2009). care for leaders need a passe-partouts degree or above, as studies show that leaders with these credentials read and implement more research literature are more confident and they contain themselves more competent in reenforcement others through the EBNP process (Eizenberg, 2011 Gerrish et al., 2011). Leaders, as suggested by Cullen et al. (2011), hold the responsibility to provide support to build, to create, and maintain an organisational culture that has the capacity to support EBP at both a clinical and administration level. Leaders must be given the power, authority, and support to introduce change without this authority change cannot occur (Eizenberg, 2011). Scholars suss out that if EBNP is to succeed and be sustainable nurses need to be enlightened and mentored on the imp lementation process of EBNP (Brim & Schoonover, 2009 Brown et al., 2011 Eizenberg, 2011 Gerrish et al., 2011 Pochciol & Warren, 2009 Ross, 2010 Tolson et al., 2008).EBNP education of nurses needs to begin at orientation to the hospital and is essential that this education is continually built upon and supported with additional education given to nurse managers, educators and progress practice nurses (Pochciol & Warren, 2009 & Tolson et al, 2008). Ross (2010) suggests nurses information literacy be improve to ensure nurses are able to practice EBN. Information literacy is the ability to competently recognise, locate, and evaluate the fundamental information required at a given point (Ross, 2010). The ICU, where I am employed, has undergone significant changes to the staff and managerial side of the unit. At one point the Clinical Nurse Specialists ratio decreased to less than 5% of nursing staff and there was not a permanent full time Clinical Nurse Consultant. Without the necessary support acquired from these roles the education of ICU nurses and the implementation of modern practices, policies and procedures decreased significantly.These barriers significantly halted EBNP from occurring in the ICU as there were very hardly a(prenominal) highly educated leaders addressable to support EBNP. As suggested by Eizenberg, (2011), Gerrish et al. (2011), and Cullen et al. (2011), educated leaders and managers are needed to remark and instill EBNP to an institution. To obtain draw military position hospitals must ensure that EBNP is in place, is supported, and is continue by the organisation (Brown et al., 2011). To procure nurse interest in EBNP, and maintain Magnet Status, some hospitals have linked exponentiation in EBNP to clinical ladder emanation and a monetary reward in the form of a wage increase with advancement up the ladder (Whitmer, Aver, Beerman, & Weishaupt, 2011). To hold their position on the clinical advancement ladder th e nurse must show, yearly, that he/she is supporting, or implementing, or alive(p) in EBNP within the setting they are employed (Whitmer et al, 2011).The benefits of practicing EBN includes patients ability to access effective evidence based treatment information facilitates consistent improvement, through finale making, to healthcare systems facilitates decisions based on current evidence and technologies and reduces variances in nursing care from one nurse to another standard and competencies are evidence based and consistent through evidence based competencies the lord status of nursing is elevated to higher(prenominal) heights (Gerrish et al., 2011 Eizenberg, 2011). In conclusion, the challenges/barriers, barrier strategies, and benefits of EBNP has been discussed. pocketable discussion on EBNP within an ICU was attempted as the ICU nurses face the same situations, challenges/barriers, strategies and benefits as nurses in other areas of healthcare (Sciarra, 2011). Nurses must be given organisational support, education and knowledge needed to participate proficiently in EBNP.ReferencesBrim, C. B., & Schoonover, H. D. (2009). Lessons intimate while conducting a clinical running to facilitate evidence-based practice the neophyte researcher experience. The ledger of Continuing Education in Nursing, 40(8), 380-384. inside 10.3928/00220124-20090723-06 Brown, C. R., Johnson, A. S., & Appling, S. E. (2011). A experiment of nursing research an interactive program, introducing evidence-based practice and research to clinical nurses. daybook for Nurses in Staff development, 27(6), E1-E5. inside 10.1097/NND.0b013e3182371190 Cullen, L., Titler, M. 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