Question
The National Academy of Medicine (formerly the Institute of Medicine) championed the goal that 90% of clinical decisions will be evidence-based by 2020. A recent systematic review of the published literature indicates that evidence-based practice (EBP) implementation remains deficient despite an ongoing effort to increase implementation. Discuss two barriers that might hold nursing practice from achieving this goal and suggest ways in which the identified barriers may be addressed.

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
RESPONSE
Despite ongoing efforts to integrate evidence-based practice (EBP) into clinical decision-making, its implementation remains sub-optimal. Two significant barriers to achieving the National Academy of Medicine’s goal of 90% evidence-based clinical decisions are a lack of time and heavy workloads and resistance to change due to ingrained practices or lack of EBP knowledge.

One of the most frequently cited barriers is time constraints and workload demands. Nurses often work in fast-paced environments with high patient loads, leaving little time to research and implement new evidence-based interventions. A study by Saunders et al. (2019) found that nurses perceive a lack of protected time for EBP activities as a major hindrance. Addressing this barrier requires institutional support, such as providing dedicated time during shifts for EBP activities, integrating decision-support tools into electronic health records (EHRs), and offering continuing education programs during work hours.

Another common barrier is resistance to change due to entrenched habits or insufficient knowledge about EBP. Many nurses continue to rely on traditional practices or personal experience rather than the latest research findings. This resistance is often due to a lack of confidence in interpreting research or a perception that EBP is complex and difficult to implement (Melnyk et al., 2022). To combat this issue, healthcare organizations should foster a culture of lifelong learning by offering mentorship programs, EBP workshops, and access to user-friendly research summaries. Additionally, leadership support and role modeling by nurse managers can help normalize EBP adoption.

By addressing these barriers through education, organizational support, and systemic changes, nursing practice can move closer to fully integrating EBP into clinical decision-making.

References

Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2022). The state of evidence-based practice in US nurses: Findings from the National EBP Competencies Survey. Worldviews on Evidence-Based Nursing, 19(1), 3-14. https://doi.org/10.1111/wvn.12592

Saunders, H., Stevens, K. R., Vehviläinen-Julkunen, K., & Doody, O. (2019). Nurses’ readiness for evidence-based practice: A concept analysis. Journal of Advanced Nursing, 75(8), 1623-1634. https://doi.org/10.1111/jan.14003