1. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Strategies to Overcome Barriers to Evidence-Based Practice: What Nurse Leaders Need to Know! Douglas M. Turner, PhD, MSN, RN, CNE, NE-BC, NEA-BC Patricia Fedorka, PhD, RNC-OB, C-EFM, CNE DNP Faculty Chamberlain College of Nursing

2. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Mandatory Disclosure I have no financial relationships to discuss and I will not discuss off label use and/or investigational use in my presentation. 2

3. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Presentation Objectives By the end of this presentation, the participant will be able to: –Identify the most common barriers to implementation of evidence-based nursing practice at the microsystems level –Describe effective strategies to overcome barriers to the implementation of evidence-based nursing practice at the microsystems level –Devise a plan that best promotes evidence-based practitioners in a specific facility/organization 3

4. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The Process 2. Formulation of PICOT Question 3. Evidence Review 4. Implementation of Evidence 5. Evaluation & Monitoring 1. Problem Identification 4

5. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The Problem: Nursing Care Not Based on Evidence Safe Effective Care Current Best Practice Barrier- Free Setting Direct- Care Buy-In Support of Leaders 5

6. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The PICOT Question In nurses practicing at the microsystems level what are barriers to the adoption of evidence-based practice as well as strategies to overcome the identified barriers? 6

7. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Systematic Review Process Evidence Review CINAHL Cochrane Reviews Joanna Briggs Institute Library PubMED Process Evidence Collected Meta-synthesis Barriers Identified Strategies Identified 7

8. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The Evidence 8 MotivationKnowledgeTime

9. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The Answers 9 Encouragement Support Time

10. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn The Implications & Recommendations KSA’s Meaningful professional development Opportunities to work with skilled evidence-based practitioners Sincere encouragement Realistic support Meaningful recognition Time Realistic support Negotiable release from direct-care Support to producing measurable outcomes (accountability) 10

11. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Where to Go From Here Assessment Barriers Perceptions General knowledge and skill levels Planning Strategies Motivation Professional development 11

12. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Summary By the end of this presentation, the participant will be able to: –Identify the most common barriers to implementation of evidence-based nursing practice at the microsystems level –Describe effective strategies to overcome barriers to the implementation of evidence-based nursing practice at the microsystems level –Devise a plan that best promotes evidence-based practitioners in a specific facility/organization 12

13. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn Questions? 13

14. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn References Boström, A.-M., et al. (2012). "Commentary on Brown CE, Ecoff L, Kim SC, Wickline MA, Rose B, Klimpel K and Glaser D (2010) Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses. Journal of Clinical Nursing 19, 1944-1951." Journal of Clinical Nursing 21(19/20): 2995-2996. Breimaier, H. E., et al. (2011). "Nurses' wishes, knowledge, attitudes and perceived barriers on implementing research findings into practice among graduate nurses in Austria." Journal of Clinical Nursing 20(11/12): 1744-1756. Brown, C. E., et al. (2010). "Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses." Journal of Clinical Nursing 19(13/14): 1944-1951. Brown, C. E., et al. (2009). "Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center." Journal of Advanced Nursing 65(2): 371-381. Dalheim, A., et al. (2012). "Factors influencing the development of evidence-based practice among nurses: a self-report survey." BMC Health Services Research 12(1): 367-376. Egerod, I. and G. M. Hansen (2005). "Evidence-based practice among Danish cardiac nurses: a national survey." Journal of Advanced Nursing 51(5): 465-473. Gerrish, K., et al. (2007). "Factors influencing the development of evidence-based practice: a research tool." Journal of Advanced Nursing 57(3): 328-338. 14

15. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn References Hannes, K., et al. (2007). "Barriers to evidence-based nursing: a focus group study." Journal of Advanced Nursing 60(2): 162-171. Kim, S. C., et al. (2013). "Regional Evidence-Based Practice Fellowship Program: Impact on Evidence-Based Practice Implementation and Barriers." Clinical Nursing Research 22(1): 51-69. Koehn, M. L. and K. Lehman (2008). "Nurses’ perceptions of evidence-based nursing practice." Journal of Advanced Nursing 62(2): 209-215. Mills, J., et al. (2011). "Factors affecting evidence translation for general practice nurses." International Journal of Nursing Practice 17(5): 455-463. Nai Ming, L., et al. (2010). "The place and barriers of evidence based practice: knowledge and perceptions of medical, nursing and allied health practitioners in malaysia." BMC Research Notes 3: 279-286. Omer, T. (2012). "Research Utilization in a Multicultural Nursing Setting in Saudi Arabia: Barriers and Facilitators." Journal of Nursing Research (Lippincott Williams & Wilkins) 20(1): 66-73. Solomons, N. M. and J. A. Spross (2011). "Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review." Journal of Nursing Management 19(1): 109-120. 15

16. ©2014 Chamberlain College of Nursing, LLC. All rights reserved. 0914ccn References Tagney, J. and C. Haines (2009). "Using evidence-based practice to address gaps in nursing knowledge." British Journal of Nursing 18(8): 484-489. Vanhook, P. M. (2009). "Overcoming the barriers to EBP." Nursing Management 40(8): 9-11. Wallis, L. (2012). "Barriers to Implementing Evidence-Based Practice Remain High for U.S. Nurses." American Journal of Nursing 112(12): 15-15. Wang, S.-C., et al. (2012). "Psychometric testing of the Chinese evidence-based practice scales." Journal of Advanced Nursing 68(11): 2570-2577. Winch, S., et al. (2005). "Read, Think, Do!: a method for fitting research evidence into practice." Journal of Advanced Nursing 50(1): 20-26. Yadav, B. L. and G. M. Fealy (2012). "Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice." Journal of Psychiatric & Mental Health Nursing 19(2): 116-122. 16