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Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature Review

Background: Evidence-based practice is important in improving the overall quality of patient care, enhance nursing practice and increase the confidence in decision-making. Evidence-based practice is a technique used in solving clinical issues regarding patient care by integrating well-designed evidence with patient preferences, patient assessments, and health professionals. This review aims to explore barriers that confront nursing in the implementation of evidence-based practice. Consequently, by determining some of the barriers to the implementation of EBP among nurses, health care systems can form solutions that allow the health centers to avoid such issues and execute the approach among health care providers. Methods: peer review was undertaken following a literature search in the databases involved CINAHL, MEDLINE and EBSCO Web of Science databases. Included studies were from October 2018 to December 2018, English language and peer-reviewed studies that aimed to explore the organizational and individual barriers within the healthcare setting. The quality appraisal tool was used to appraise all the included studies. Results: A total of 12 studies were included. Six studies were quantitative, five studies were qualitative, and one study used mixed methods. Four organizational barriers to implementing Evidence-based practice among nurses were found by reviewing the literature which is ("lack of support and supervision", "lack of training" and "education", "limited resources” and “time restriction”). While, four main themes were considering as an individual barrier to implementing Evidence-based practice among nurses: ("lack of nurses' knowledge", "skills and awareness regarding use the Evidence-based practice", "lack of professional characteristic", "nurses' attitude and experience in using" and "language barrier in using or implementing Evidence-based practice"). Conclusions and implications for future practice: Nursing administrators and educators have the main role to facilitate evidence-based practice implementation among nurses, therefore; the findings of this review can help to overcome the identified barriers. Training and education are important to enhance the knowledge and skills of nurses to use evidence-based practice. Time management, providing the required resources and adequate supervision can facilitate the implementation of evidence-based practice which positively influences the quality of care. For further research, it is very fruitful to investigate the common barriers of EBP in one specific culture such as the middle eastern culture. Furthermore, future research may focus on barriers of implementing EBP related to the patients and their families.

Implementation, EBP, Barrier, Obstacle, and Challenge

Munirah Alatawi, Eman Aljuhani, Fatimah Alsufiany, Kawakeb Aleid, Rehab Rawah, et al. (2020). Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature Review. American Journal of Nursing Science, 9(1), 35-42.

Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. B. M. Melnyk, L. Gallagher-Ford, L. E. Long, and E. Fineout-Overholt, "The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs," Worldviews on Evidence-Based Nursing, vol. 11, no. 1, pp. 5-15, 2014.
2. S. Majid et al., "Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers," Journal of the Medical Library Association: JMLA, vol. 99, no. 3, p. 229, 2011.
3. T. W. Reader, A. Gillespie, and J. Roberts, "Patient complaints in healthcare systems: a systematic review and coding taxonomy," BMJ Qual Saf, vol. 23, no. 8, pp. 678-689, 2014.
4. A. Sharma et al., "Using digital health technology to better generate evidence and deliver evidence-based care," Journal of the American College of Cardiology, vol. 71, no. 23, pp. 2680-2690, 2018.
5. C. Boswell and S. Cannon, Introduction to nursing research. Jones & Bartlett Learning, 2018.
6. B. M. Melnyk et al., "The First US Study on Nurses’ Evidence-Based Practice Competencies Indicates Major Deficits That Threaten Healthcare Quality, Safety, and Patient Outcomes," Worldviews on Evidence-Based Nursing, vol. 15, no. 1, pp. 16-25, 2018.
7. L. Wallis, "Barriers to implementing evidence-based practice remain high for US nurses," AJN The American Journal of Nursing, vol. 112, no. 12, p. 15, 2012.
8. B. Johnston et al., "Exploring the barriers to and facilitators of implementing research into practice," British Journal of Community Nursing, vol. 21, no. 8, pp. 392-398, 2016, doi: 10.12968/bjcn.2016.21.8.392.
9. R. R. DeBruyn, S. C. Ochoa-Marín, and S. Semenic, "Barriers and facilitators to Evidence-Based Nursing in Colombia: Perspectives of nurse educators, nurse researchers and graduate students/Barreras y facilitadores en la práctica de la Enfermería Basada en la Evidencia en Medellín, Colombia," Investigación y Educación en Enfermería, vol. 32, no. 1, p. 9, 2014.
10. C. A. Bowers, "Barriers to Implementation of Evidence-based Practices in a Critical Care Unit," Nelson Mandela Metropolitan University, 2014.
11. M. A. Kalaldeh, R. Watson, and M. Hayter, "Jordanian intensive care nurses' perspectives on evidence-based practice in nutritional care," British Journal of Nursing, vol. 23, no. 19, pp. 1023-1029, 2014, doi: 10.12968/bjon.2014.23.19.1023.
12. Å. Renolen and E. Hjälmhult, "Nurses experience of using scientific knowledge in clinical practice: a grounded theory study," Scandinavian Journal of Caring Sciences, vol. 29, no. 4, pp. 633-641, 2015, doi: 10.1111/scs.12191.
13. S. Sidani et al., "Nurses’ Perceptions of Interventions for the Management of Patient-Oriented Outcomes: A Key Factor for Evidence-Based Practice: Perceptions of Interventions," Worldviews on Evidence-Based Nursing, vol. 13, no. 1, pp. 66-74, 2016, doi: 10.1111/wvn.12129.
14. S. Kc, P. R. Subramaniam, and S. Paudel, "Barriers and Facilitators of Utilizing Research Among Nurses in Nepal," Journal of continuing education in nursing, vol. 47, no. 4, pp. 171-179, 2016, doi: 10.3928/00220124-20160322-07.
15. W. Gifford et al., "When east meets west: a qualitative study of barriers and facilitators to evidence-based practice in Hunan China," BMC nursing, vol. 17, no. 1, pp. 26-11, 2018, doi: 10.1186/s12912-018-0295-x.
16. P. Jordan, C. Bowers, and D. Morton, "Barriers to implementing evidence-based practice in a private intensive care unit in the Eastern Cape," Southern African Journal of Critical Care, vol. 32, no. 2, pp. 50-54, 2016.
17. M. Khammarnia, M. Haj Mohammadi, Z. Amani, S. Rezaeian, and F. Setoodehzadeh, "Barriers to implementation of evidence based practice in zahedan teaching hospitals, iran, 2014," Nursing research and practice, vol. 2015, pp. 357140-5, 2015, doi: 10.1155/2015/357140.
18. J. Farokhzadian, R. Khajouei, and L. Ahmadian, "Evaluating factors associated with implementing evidence-based practice in nursing," Journal of Evaluation in Clinical Practice, vol. 21, no. 6, pp. 1107-1113, 2015, doi: 10.1111/jep.12480.
19. E. Azmoude et al., "Midwives’ Attitude and Barriers of Evidence Based Practice in Maternity Care," Malaysian Journal of Medical Sciences, vol. 25, no. 3, pp. 120-128, 2018, doi: 10.21315/mjms2018.25.3.12.
20. D. Polit and C. Beck, "Essentials of nursing research: Appraising evidence fornursing practice," ed: Wolters Kluwer/Lippincott/Williams Wilkins Health, Philadelphia, PA, USA, 2014.
21. D. Dang and S. L. Dearholt, Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau, 2017.