The Obstacles or Barriers to Implementing Evidence-Based Practice in Nursing

Topic 4 DQ 1
What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information.
Example below
when it comes to implementing evidence based practice strategies, experienced nurses tend to have a mantra of “This is how we do it here” or “We've always do it this way”. These 2 statements are one of the barriers to implementing EBP. Attitudes are hard to change. Even after experienced nurses are shown or told a best practice way to do something, they still ask “Why do we have to change?” “The average age of nurses is 47, and they were educated at a time when evidence-based practice was not well integrated into educational programs”, according to Dr. Bernadette Melnyk, PhD, RN (Caldwell, 2012). Healthcare seems to be constantly but, not always consistently changing. The need to change with it must and should come from nursing. We are on the frontlines, if you will of patient care.
I used to get perturbed when someone behind a desk tells me “We have to do it this way. We need to change.” As a newer nurse, I did not always understand this thought process. As I have continued my education, I understand and believe that there may be a new or better way to do something. Newer nurses today tend to question an experienced preceptor. Unfortunately, many experienced older nurses see this questioning as a challenge or the new nurse is “showing off.” This is not the case in many of these situations. BSN nurses have been taught about evidence-based practice thru their education. How can we, as advanced practice nurses, whether we are educators, informatics nurses or Nurse Practitioners overcome these barriers? I always like to say that, we need to Educate, Educate, Educate! well, what about those who think that their ways of doing things are the BEST? How can we get the message across? And, even with the educational piece, sometimes it's not having the knowledge that is the problem, it's applying the learned information. For instance, I find it fascinating talking to smokers about diseases relating to smoking. They can give me a 2hr lecture on their family members, friends and neighbors who died from complications relating to smoking, but yet they continue the maladaptive behavior. I think we have a lot of work to do as advance healthcare professionals.
Reference
Caldwell, E. (2012). Nurse Leader Resistance Perceived as a Barrier to High-Quality, Evidence-Based Patient Care. Retrieved from: http://researchnews(dot)osu(dot)edu/archive/nursesurvey.htm
Re:Topic 4 DQ 1
There are many barriers to the implementation of evidence based practice (EBP). Fidelity has been identified as one barrier. Iswang and Prelock (2015) describe this as “adherence to the program protocol and competence or quality of intervention delivery” (p. s1822). The intervention or evidence should be implemented as it was intended. A challenge associated with this is that protocol must be adapted to the setting in which it will be implemented without compromising fidelity. The practitioner must be agreeable to the implementation even if it is not congruent with personal beliefs or way of doing things. Melnyk & Fineout-Overholt (2015) describe, “Careful adherence to the steps in the new guidelines or procedures or fidelity of the intervention must also be monitored” (p. 301).Iswang and Prelock (2015) also speak of adoption. This is not too dissimilar to fidelity. Adoption is also called usability. This refers to the practitioner's readiness to assimilate the intervention (Iswang & Prelock, 2015). When the evidence and adoption of it is fully supported by managers, leaders, and supervisors, then the project is likely to be more successful (Melnyk & Fineout-Overholt, 2015).
References
lswang, L. l., & Prelock, P. A. (2015). Bridging the gap between research and practice: Implementation science. Journal Of Speech, Language & Hearing Research, 58(6), S1818-S1826.
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA.: Wolters Kluwer