Evidence-based care gets short shrift.

• Position: Nursing

Serious barriers prevent nurses from implementing evidence-based practices that improve patient outcomes, suggest the results of a survey published in the Journal of Nursing Administration. When survey respondents ranked these barriers, the top five include resistance from nursing leaders and nurse managers--a finding that has not been reported in previous similar studies--as well as politics, and organizational cultures that avoid change. When asked what would help them implement evidence-based practice, respondents reported education, access to information, and organizational support among their top needs.

Evidence-based practice refers to making decisions about patient care that are based on the best evidence produced by well-designed clinical research. Numerous studies have suggested that evidence-based care can reduce patient complications and decrease health care costs by as much as 30%. Overall, a little more than half of respondents report that evidence-based practice is used consistently in their organization, but only about one-third indicate their colleagues regularly use these practices.

The respondents with more education tend to have added confidence in implementing evidence-based practice. However, the longer nurses have been working in health care, the less interested they are in learning more about evidence-based...