Columbus Publishers

International Journal of Nursing and Health Care Science

Volume 02: Issue 09

Guthrie DR.

While the standard DOH format requirements of our policies require statutory authority be cited, they do not enforce review/citation of evidence-based practice. The one change in our required template would make a huge difference	2

### Table 4:

Free Text Responses by Barriers Scale Factors.

### Discussion and Implications

The purpose of this study was to identify the barriers to evidence uptake into policies amongst public health professionals at a healthcare organization. The findings are consistent with previously published literature. The respondents in the study reported characteristics of the organization as a major barrier and therefore a potential source of change for the implementation of research findings. Rogers diffusion of innovation [13] identifies the social system as having influence over the process in which a new innovation is adopted. The social system can also influence the rate at which new innovations are communicated. This is a top ten barrier communicated in the literature [12]. Studies cite feelings of non-empowerment to implement changes as the top barrier to evidence uptake [12], while administrative influence interfering with evidence uptake was reported as a top 10 barrier in previous literature [12]. These findings are also similar to Funk, et al. [14] original research on barriers to research utilization, which identify clinicians perceptions of the organizational characteristics as a major barrier to research utilization with insufficient authority to change practice among the top-cited barriers.

One noteworthy finding was a number of respondents who replied "No-Opinions" or did not indicate a response, particularly to those questions regarding characteristics of the innovation and characteristics of the communication. These questions focus on the quality and presentation of the evidence. The highest rate of non- response/no-opinion was in relation to the following two items: “The evidence-based reports/articles have methodological inadequacies" (42.9%) and “The conclusions drawn from the evidence are not justified” (53.6%). This implies that the respondents may not be familiar enough with research to have formed an opinion regarding methods or to evaluate results. This is further supported by the rank ordering of the barriers, in which a lack of awareness of the research was the top indicated adopter barrier to evidence uptake, as well as one of the top ten barriers overall. This self-report of lack of awareness provides valuable information for program planning.

The administrators also reported that the relevant literature is not compiled in one place (53.6%), evidence based reports /articles are not readily available (42.9%), and statistical analyses are not understandable (35.7%). These results may reflect a difficulty with understanding evidence-based/best practice articles and reports as well as difficulty accessing the reports. Guo, et al. [16] observed that administrators are more motivated to meet targets rather than read or evaluate research. Indeed, administrators may refer to their professional experience and peer groups as a primary source of knowledge rather than external evidence-based findings. Finally, Guo, et al. [16] expressed that administrators may be susceptible to consultancy regarding best practice not grounded in validated empirical evidence.

The healthcare organization has internet access. Although the administrators are reporting that the relevant literature is not compiled in one place, or that evidence based reports /articles are not readily available, it is. All that is needed are the skills to access and search electronic databases such as PubMed or Google Scholar which are readily available on the World Wide Web. The administrators already have recommended solutions (Table 5). Three major themes identified from the “Facilitators of evidence uptake” question, in priority were upper- administrative support, multi-disciplinary discussion, and access to evidence-based/best practice research. Pendell and Kimball [17,18] make observations that mirror these themes regarding facilitation of evidence uptake.

Access to peer review articles on-line, discussion among multi-disciplinary teams of experts and defined process for including evidence-based research into policy revision/development.
By in from management I really think it has to come from the top. If managers value EBP and give staff time to participate in it then it will facilitate the use of EBP in public health. Time isn’t big of an issue in public health as it would be ina hospital or clinic setting; instead the biggest barriers here are access to EBP and the buy-in from management
Collaboration and cooperation from others, recognizing that subject matter experts for policies should be able to take the lead
division support, timelines, access to articles.