American Journal of Nursing Research
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American Journal of Nursing Research. 2016, 4(2), 25-33
DOI: 10.12691/ajnr-4-2-1
Open AccessA Clinical Study

Nurses’ Perceptions and Barriers for Adoption of Evidence Based Practice in Primary Care: Bridging the Gap

Magda M. Mohsen1, , Nahla Ashour Safaan1 and Omayma M. Okby2

1Community Health Nursing, Faculty of Nursing, Menoufia University, Egypt

2Pediatric Nursing, Faculty of Nursing, Menoufia University, Egypt

Pub. Date: March 19, 2016

Cite this paper:
Magda M. Mohsen, Nahla Ashour Safaan and Omayma M. Okby. Nurses’ Perceptions and Barriers for Adoption of Evidence Based Practice in Primary Care: Bridging the Gap. American Journal of Nursing Research. 2016; 4(2):25-33. doi: 10.12691/ajnr-4-2-1


Evidence Based Nursing is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient preferences. The aim of this study was to investigate nurse's perceptions and barriers to adopt evidence based practice in their Primary Care setting. Design: descriptive correlation design was used. Setting; this study was conducted in: 1) Maternal & Child Health Centers Governorate (2) Faculty of Nursing- Menoufia University. The sample (1) A convenience sample of 120 clinical nurse specialists who have a bachelor degree in nursing science and working in MCHC was selected. (2) A convenience sample of 80 academic faculty educators who finished their Master or/ Doctorate degree in nursing were selected. Tools; a structured questionnaire to collect Socio-demographic data such as: age, educational level and experiences. II. Nursing' Attitudes towards Evidence-Based Practice and Perceptions of its Related Barriers Questionnaire: It was developed by the researchers based on the current related literatures. This tool measures Nurses' perceptions and barriers for adoption of evidence-based practice. The results of this study; All nurses had a positive attitude toward EBP; the total mean score of nurses' was 7.38±1.73 having a maximum of 10 and minimum of 5. Two third of nurse' educator and clinical nurse specialists (73.8.0 % and 85.8 % respectively) reported that they had insufficient time at work place to search & read research articles. Conclusions: This study revealed a positive attitude among nurses toward EBP. But it was found that several barriers were hindering nurses from adopting EBP. Recommendations: to close the gap between research findings and nursing practice; A) Education and training are required on evidence-based nursing. B) Increase time availability to conduct online search C) Equipped the health facilities with new informatics infrastructure.

Nurses’ Perceptions- Barriers to Evidence Based Practice

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[1]  Schmidt, J. M. (2009): Evidence-based practice for nurses. Sudbury: Jones and Publishers.
[2]  Melnyk BM, Fineout-Overholt E, Fischbeck Feinstein N, Li H, Small L, Wilcox L, et al., (2004): Nurses' perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews Evidence Based Nurs. 1(3):185-93.
[3]  (AHRQ) Agency for Healthcare Research and Quality (2006). National health care quality report. Rockville, MD: AHRQ.
[4]  Canadian Health Services Research Foundation (2005): Lever aging Knowledge: tools & strategies for action. Report of the 7th CHSRF Annual Invitational Workshop, Montreal, Quebec; March 3.
[5]  Green, L. W., Glasgow, R. E., Atkins, D., & Stange, K. (2009). Making evidence from research more relevant, useful, and actionable in policy, program planning, and practice. American Journal of Preventive Medicine, 37 (1), 1.
[6]  Chien WT, Bai Q, Wong WK, Wang H, Lu X. (2013): Nurses' perceived barriers to and facilitators of research utilization in mainland china: a cross-sectional survey. Open Nurs J; 7: 96-106. (5): 314-22.
[7]  Kajermo, KN, Undén, M., Gardulf, A., Eriksson LE, Orton ML, Arnetz BB, et al. (2008); Predictors of nurses' perceptions of barriers to research utilization. J Nurs Manag; 16 (3): 305-314.
[8]  Houser, J., Oman, K. S., Donnelly, P., Shuster, R. (2011): Evidence-Based Practice in Health Care pade1-2 Kevin Sullivan Acquisitions.
[9]  Straus S., Richardson W.S, Glasziou P, Haynes R.B. (2005): Evidence-based Medicine: How to practice and Teach EBM (3rd ed.), Edinburgh: Churchill Living- stone.
[10]  Dawes M, Summerskill W, Glasziou P, Carta-bellotta A, Martin J, Hopayian K, et al. (2005): Sicily statement on Evidence-Based Practice. BMC Med Educ. 5(1):1.
[11]  Ciliska D. (2005): Educating for Evidence-Based Practice, Journal of professional nursing: official journal of the American Association of Colleges of Nursing, 21(6):345-50.
[12]  Guyatt GH, Haynes RB, Jaeschke RZ, Cook DJ, Green L, Naylor CD., Wilson MC, Richardson WS. (2000): Users’ guides to the medical literature: XXV. Evidence-based Medicine: principles for applying the users’ guides to patient care. Evidence-Based Medicine Working Group. JAMA. Sep13; 284 (10):1290-6.
[13]  Ferguson LM, Day RA. (2007): Challenges for new nurses in Evidence-based practice. J Nurse Manag. 15:107-13.
[14]  Upton D, Upton, P. (2006): Development of Evidence-Based Practice Questionnaire for Nurses. J Adv. Nurs, 53 (4):454-8.
[15]  Pravikoff DS, Tanner AB, Pierce ST. (2005); Readiness of U.S. Nurses for Evidence-Based Practice. Am J Nurs. 105(9):40-51.
[16]  Alper BS, Hand JA, Elliott SG, Kinkada S, Hauan MJ, Onion DK, Sklar BM. (2004): How much effort is needed to keep up with the literature relevant for primary care? J Med Libr Assoc. Oct; 92(4):429-37.
[17]  Griffiths JM, Closs SJ, Bryar RM, Hostick T, Kelly S, Cooke J. (2001): Barriers to research implementation by community nurses. Br J Community Nurse, 6(10):501-10.
[18]  Solomons NM, Spross JA. (2010): Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review. J Nurs Manag. Jan;19 (1):109-20.
[19]  O’Connor S, Pettigrew CM. (2009): Barriers perceived to prevent the successful implementation of evidence-based practice by speech and language therapists. Int J Lang Commun Disord. 44(6):1018-35.
[20]  Asadoorian J, Hearson B, Satyanarayana S, Ursel J. (2010); Evidence based practice in dental hygiene: exploring the enhancers and barriers across disciplines. Can J Dent Hyg, 44(6):271-6.
[21]  Mclnerney P, Suleman F. (2010); Exploring knowledge, attitudes, and barriers toward the use of evidence-based practice amongst academic health care practitioners in their teaching in a South African university: a pilot study. Worldviews Evid Based Nurs. 7(2):90-7.
[22]  McKenna HP, Ashton S, Keeney S. (2004): Barriers to evidence-based practice in primary care. J Adv Nursing; 45(2):178-89.
[23]  International Council of Nurses ICN. (2007): Position Statement on Nursing Research.
[24]  Hagbaghery, MA. (2007): Nurses' perceptions of evidence-based nursing: a qualitative study. Feyz Journal of KUMS.;11(2):44-52
[25]  Al Hadid, L.A., Hasheesh, M.A., Al Momani, M. (2011).Validating a tool that explores factors influencing the adoption of principles of evidence-based practice. Journal of Nursing Education, 50(12), 681-687.
[26]  Mohsen, M.M., Abdalla W. H. & Abd-Elrazek A. A. (2004). A Study of Research Utilization in Nursing Practice: Is it applicable? Bulletin of Institute of Public Health Alexandria University, Vol.34, No. 1.
[27]  Johnston, J.M., Leung, G.M., Fielding, R., Tin, K.Y.K., Ho, L.M. (2003); the development and validation of a knowledge, attitude and behavior questionnaire to assess undergraduate evidence-based practice teaching and learning. Medical Education, 37 (11), 992-1000.
[28]  Ozsoy SA, Ardahan M. (2008): Research on knowledge sources used in nursing practices. Nurse education today, 28(5):602-9.
[29]  Majid, A., Foo, S., Luyt, B., Zhang, M., Theng, Y., Chang, Y., Intan A. (2011): Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers, J Med Libr Assoc 99(3).
[30]  Shafiei,E., Baratimarnani,A., Goharinezhad,S., Kalhor,R., Azmal, M., (2014): Nurses’ perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran. Medical Journal of the Islamic Republic of Iran (MJIRI), Vol. 28.135.24.
[31]  Breimaier, H. E., Halfens, R. JG and Lohrmann, C. (2011): Nurses’ wishes, knowledge, attitudes and perceived barriers on implementing research findings into practice among graduate nurses in Austria. Journal of Clinical Nursing, 20, 1744-1756.
[32]  Thompson D.S., Estabrooks C.A., Scott-Findlay K.M. & Wallin L. (2007) Interventions aimed at increasing research use in nursing: a systematic review. Implementation Science 2 (15), 1-16.
[33]  Eizenberg, M.M. (2011): Implementation of evidence-based nursing practice: nurses’ personal and professional factors? Journal of Advanced Nursing, 67(1), 33-42.
[34]  Heydari, A., Zeydi, A. E. (2014): Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review. Journal of Caring Sciences, 3(4), 265-275.
[35]  Seyyedrasooli, A., Zamanzadeh, V., Valizadeh, L., and Tadaion, F., (2012): Individual Potentials Related to Evidence-Based Nursing among Nurses in Teaching Hospitals Affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. J Caring Sci.; 1(2): 93-99.
[36]  Eberhart, A.(2014): Quality Improvement Needs Assessment for Evidence-Based-Practice Readiness in Primary Care. Presented as Partial Fulfillment of the Requirements for the Degree Doctor of Nursing Practice, in the Graduate School of the Ohio State University.
[37]  Hussein, A.H.M., Hussein, R. G. (2013): The Attitudes and Barriers towards Evidence-Based Practice among Nursing Educators. Journal of American Science; 9(12).
[38]  Shemy G. & Eizenberg M. (2004): The influence of academic education on attitudes of nurses toward nursing research. Guf Yeda 1(1), 35-41.
[39]  Veeramah V. (2004) Utilization of research findings by graduate nurses and midwives. Journal of Advanced Nursing 47(20), 183-191.
[40]  Rodgers S.E. (2000) A Study of the utilization of research in practice and the influence of education. Nurse Education Today20, 279-287.