Managers and Evidence-Based Care

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Are nurses at the manager level barriers to the implementation of nursing care based on best practice? A survey published in the Journal of Nursing Administration seems to suggest so.

The survey, which was answered by 1,015 American Nurses Association members, found that there many barriers to the implementation of evidence-based practice are still present. The following are some of the results of the survey:

– Respondents cited nurse managers and leaders who are resistant to change, politics and organizational cultures steeped in the past as being barriers to change.

– Organizational support, access to information and education regarding best practices were cited as being factors needed to implement change.

– Just over half of the respondents reported that their organization used evidence-based practice to guide their care, while only approximately one-third of the respondents stated that evidence-based practice was used consistently by their colleagues.

– Nurses who were more highly educated were more comfortable implementing evidence-based practices the more experienced the nurse was, the less interested the nurse was in learning about and implementing evidence-based practices
46.4% of survey respondents agreed that research study findings were routinely implemented to improve patient care and patient outcomes.

– 76.2% stated that it was important to receive further education regarding how to make use of research in order to implement evidence-based practices.

So what does this survey mean in terms of nurse managers? Most nurse managers are highly experienced (read “older”), which makes sense — one cannot be a leader of nurses without having gained some real world experience. However, older nurses were trained at a time when nursing education focused on how to perform nursing research, rather than how to interpret and implement the results of nursing research. This means that some nurse managers may become entrenched in the traditional ways of doing things, and may be resistant to change, including implementing care practices based on best evidence.

This is not to say that all nurse managers are resistant to change: you can teach old dogs new tricks! What it does mean is that nursing educators must ensure that nurses graduating in today’s world know and understand the principles of evidence-based practice, and that they are fully prepared upon graduation to implement best practice in their workplace of choice upon graduation.

Managers who were educated before there was an emphasis on evidence-based care must take it upon themselves to learn how to interpret research findings and ensure that best practice is being encouraged and implemented at the organizational and management level. This may mean taking advantage of the expertise of newer nurses who are coming into the work force with this knowledge freshly in their minds. Creating a committee to review evidence-based practice and including a mix of experienced and inexperienced nurses may go a long way in creating a culture that encourages the implementation of changes towards improved patient care and outcomes.

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