Lack of support hinders evidence-based nursing

By Sarah Guy, medwireNews Reporter

The reasons US nurses do not conduct evidence-based practice (EBP) include a lack of support from their organization, resistance among their seniors, and a lack of education, show survey results.

The data also show that the longer nurses have been in clinical practice, the less likely they are to perceive EBP knowledge and skills as important, report the researchers in the Journal of Nursing Administration.

"These findings have important implications for nurse executives, leaders, managers, and educators who are in key positions to build a supportive culture for EBP and to provide the time, educational skills building sessions, and resources necessary for staff nurses to implement evidence-based care," write Bernadette Melnyk (The Ohio State University, Columbus, USA) and team.

Indeed, they emphasize that if nurse executives and leaders are not engaging in EBP - a problem-solving approach to clinical decision-making that incorporates evidence from well-designed studies - it follows that their staff will not be engaging in it either.

Of the 1015 nurses aged an average 47 years who responded to the Likert scale-based survey, over half (53.6%) agreed that EBP was consistently implemented in their organization, but only around a third (34.5%) agreed that their colleagues implemented it.

Significantly more nurses without master's degrees indicated that it is important to gain more knowledge and skills in EBP and, in fact, education (114/1015) was most frequently cited as the one thing that would help the most in daily implementation of EBP, followed by access to information (100/1015).

Melnyk and co-researchers also found a significant negative correlation between number of years in clinical practice and the perceived importance of gaining knowledge and skills in EBP and interest in receiving more EBP-related education.

"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," commented Melnyk in a press statement.

"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," she concluded.

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