Impact of not adhering to Evidence-Based Practice Guidelines
Inter-professional teamwork has been indicated to be a key approach to ensuring optimal and safe quality healthcare service delivery in healthcare settings. Nurses play a prime role in such collaboration where they are to demonstrate appropriate skills and competencies. A key challenge faced by an inter-professional team within the organization is lack of evidence-based practice among the team members. Evidence-based practice has been denoted as the approach for making appropriate decisions regarding patient care and providing care on the basis of clinical expertise together with relevant research existing on the topic. The present paper discusses the highlighted problem and its impact on the organization, patients and the nursing profession. It then outlines possible evidence-based interventions for the problem. The potential barriers to change that might come from the organization, patients and colleagues are also highlighted. Strategies to overcome barriers and resistance to change are pointed out successively. Lastly, a plan to implement the evidence-based interventions is described.
Lack of competency and determination to adhere to evidence-based practice guideline has become a crucial concern for the proper functioning of the inter-professional team in the organization. Evidence-based practice involves the collection, evaluation and implementation of evidence for improving patient care and the consecutive outcomes (LoBiondo-Wood & Haber, 2017). In an inter-professional team, it is expected that the members would work in collaboration to implement best care strategies for benefits of the patients. Such a practice respects the patient’s preferences, values and unique situation. The impact of lack of evidence based practice is far-reaching, encompassing the organization and patients. The most distinct result is poor patient outcomes, less patient safety and decreased quality of life of patients. Since patients are health consumers in the contemporary era, there is a demand for improved treatments together with enhanced safety. Evidence-based practice ensure both and strives to standardize practice, delivering predictable outcomes. Providing the best care is the hallmark of an inter-professional team, where nurses are to direct care as per scientific research. In the absence of such a practice, patients do not receive the consistent interventions that are aligned with recent research recommendations (DiCenso et al., 2014). In addition, lack of evidence-based practice leads to increased healthcare costs and increased chances of medical complications. If evidence-based practice is applied, then the demands on care resources are less, thereby lowering healthcare costs.
The theory of evidence-based practice is to be perceived as an inter-disciplinary approach aiming at the high quality care and improving accountability for health practices. Such a practice also promotes lifelong learning (Fleiszer et al., 2016). Each member of the inter-professional team must come forward to promote evidence-based practice at the organizational level. The first step would be to cultivate a spirit and enthusiasm for inquiry. The existing practice guidelines are to be challenged to seek better possible procedures and clinical methods. Questions are to be put forward the answer to which can lead to better patient outcomes. The next step would be to search for the best available evidence that addresses the research questions. Evidence are to be availed from the large pool of resources available in the electronic databases and library. Critically appraising the evidence is then crucial. Integration of the evidence gathered with care expertise, and patient values are important. Evidence alone would not be adequate for justifying the practice change. Patient assessment data and patient values are crucial components of evidence-based practice (Melnyk et al., 2014).
Interdisciplinary Approach to Evidence-Based Practice
Barriers and challenges to implement evidence-based practice might arise from multi-dimensions, including the organization, patients and team members in an inter-professional team. Several factors have been identified in this regard throughout literature. The most important barrier from the organization’s end is part of the training and delivery system. The organization might not reinforce the knowledge gathered by professional into the clinical setting. Lack of financial support might be an issue that would demotivate the professionals to adhere to evidence based practice guidelines. The other factors related to the setting’s context include learning culture, resources, and work load. For promotion of evidence-based practice, professionals require utmost support to control organizational and interpersonal factors intervening in the ability to avail their whole potential (Khammarnia et al., 2015).
The barriers associated with the inter-professional team are noteworthy. These are related to information constraints, provider attitude and interpersonal relationships. Though evidence can be gathered, the team members might not have appropriate skills or time to implement them. They might rule out a suitable option for treatment due to lack of knowledge and skills (Barría & Mauricio, 2014). Barriers associated with the healthcare consumers are also noteworthy. By definition, evidence-based practice is a shared decision making process through which evidence pool is to complement the patient’s preferences. In certain cases, the patients might not be giving consent to receive treatment based on guidelines for such practice. The requests put forward by them might also lead to conflict with the recommendations in guidelines.
Time available and role strain acts as major barriers to implementing concepts of evidence-based practice. The suitable way of eliminating this issue would be to distribute task burden among the professionals so that each can consider engagement in evidence-based practice without time constraints. Lack of knowledge about the utilization of evidence-based practice guidelines is a key issue. The ideal mechanism for learning is through a full-staff approach. The organization must come forward to support the initiative. The desired mindset can be achieved with opportunities for individual development (Gitlin et al., 2015). The setting is to provide adequate training to the care professionals so that they are in a position to consider bringing about the change. Approaching the department of health for funding of training sessions would be a noteworthy approach.
Resolution of interpersonal conflict would be another strategy to successful adherence to evidence-based practice regulations. Sessions are to be conducted with the professionals so that they are able to sole their interpersonal issues and work in collaboration. Motivation is of prime importance when it comes to bringing about a change in practice. Clinical leaders must come forward to motivate and encourage the professionals in this regard. They are to take the accountability of guiding the care providers on how to reduce inter-personal conflicts and work in collaboration (Scurlock-Evanset al., 2014).
Barriers and Challenges to Implement Evidence-Based Practice
The first step in implementing evidence based practice would be to form a sub-team with members of the inter-professional team. The purpose would be that members of this team would be responsible for ensuring that all members adhere to the proposed change. Professionals would include physicians, nurses, and technicians, and they would implement and evaluate the change. Formation of the team would be possible when agreement takes place. The second step would be to implement a pilot practice change. This would help in identification of issues arising due to adherence to evidence-based practice before the change is spread extensively. Evaluation of the pilot project is the process that carries out an evaluation of whether the goals of implementation have been accomplished. Lastly, the changes are to be monitored, and reports of performance and quality improvements are to be noted. The results of the same are to be shared with the rest of the organization for learning and promotion of evidence-based practice culture (Ginter et al., 2018).
Conclusion
Lack of evidence-based practice in the inter-professional team is a key concern revolving around patient care quality and safety. The need of evidence-based practice is felt across organizations for improving service delivery. The challenges arising in due course are multifactorial and involve patients, care providers and the organization. While strategies are present that can be used for addressing the barriers, the process requires support from both the organization and the team members. It is expected that when implemented when an appropriate manner, evidence-based practice change would be highly advantageous.
References
Barría, P., & Mauricio, R. (2014). Implementing Evidence-Based Practice: A challenge for the nursing practice. Investigacion y educacion en enfermeria, 32(2), 191-193.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.
Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M. C., & Denis, J. L. (2016). Nursing unit leaders’ influence on the long?term sustainability of evidence?based practice improvements. Journal of nursing management, 24(3), 309-318.
Ginter, P. M., Duncan, J., & Swayne, L. E. (2018). The Strategic Management of Healthcare Organizations. John Wiley & Sons.
Gitlin, L. N., Marx, K., Stanley, I. H., & Hodgson, N. (2015). Translating evidence-based dementia caregiving interventions into practice: State-of-the-science and next steps. The Gerontologist, 55(2), 210-226.
Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to implementation of evidence based practice in Zahedan teaching hospitals, Iran, 2014. Nursing research and practice, 2015.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Melnyk, B. M., Gallagher?Ford, L., Long, L. E., & Fineout?Overholt, E. (2014). 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, 11(1), 5-15.
Scurlock-Evans, L., Upton, P., & Upton, D. (2014). Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions. Physiotherapy, 100(3), 208-219.
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