Barriers to implementing evidence-based nursing practice from the hospitals' point of view in China: A regional cross-sectional study

Abstract

Background: There is a widespread international agreement that healthcare should be based on high-quality evidence; however, bridging the gap from evidence to practice is still problematic. Although barriers to the implementation of evidence-based nursing practice have been identified, most studies have focused on clinical nurses' perceptions of the barriers to evidence-based nursing practice, with a lack of investigation into barriers from the hospitals' viewpoint.

Objectives: To identify existing barriers to implementing evidence-based nursing practice from the hospitals' viewpoint.

Design: A descriptive study employing a regional cross-sectional survey.

Settings and participants: A convenience sample of 91 hospitals in Guangdong Province, China.

Methods: The survey used an online questionnaire containing basic hospital information and an open-ended question. Descriptive statistics were used to analyse basic hospital data. Responses to the open-ended question were analysed with thematic analysis.

Results: The sample consisted of 89 valid responses to the open-ended question. Five themes were identified: (1) knowledge (70.8 %); (2) environmental context and resources (42.7 %); (3) social influences (7.9 %); (4) intentions (7.9 %); and (5) beliefs about capabilities (1.1 %).

Conclusion: Introduced early in 2001, China has embraced evidence-based nursing for more than 20 years. However, lack of knowledge is still the top barrier to implementing evidence-based nursing practice in hospitals in China. The findings indicate a need for more evidence-based nursing practice teaching strategies towards further enhancing clinical nurses' and nursing managers' evidence-based nursing practice beliefs, knowledge, and skills.

Keywords: Barriers; Cross-sectional study; Evidence-based nursing practice; Hospitals; Implementation.