Nurses are expected to use the best evidence available to achieve the best
patient outcomes possible (Krugman, 2003). Many organizations have come
to appreciate the link between EBP and positive patient outcomes as a result
of changing reimbursement policies. Third-party payers are demanding the
implementation of policies, processes, and practices that have the greatest
potential to contribute to the best outcomes. When organizations support EBP,
the potential exists to balance costs as well as benefits to patients (Wurmser,
2009). The reason this balance is important has to do with the limited resources
being experienced in health care today. Payers, in an effort to conserve their
expenditures, are interested in knowing where their dollars are being spent.
They want to know what patients are getting for their money (Wurmser, 2009).
This does not mean payers are interested only in the dollar value; they are
also interested in the quality of the care. In other words, a balance needs to be
achieved between quality and cost of care. If the cost is low but patients are
continually being readmitted because they did not receive appropriate care in
the beginning, nothing would be gained. Conversely, high cost does not neces-
sarily translate into quality care.Nurses’ Belief Systems Related to Practice
Nurses are no different from most humans when asked to make changes.
For many people, change is difficult. Some might react by outright refusal
to change. Others pretend to go along with the change but in reality are not
in favor of it. Some totally embrace the change. Studies indicate that nurses
from around the world generally have a positive attitude toward research
(Akerjordet, Lode, & Severinsson, 2012; Moreno-Casbas, Fuentelsaz-Gallego,
Miguel, Gonzalez-Maria, & Clarke, 2011), but they often feel that there are
significant barriers. Some nurses, while having been exposed to research in
their basic programs, have in the ensuing years done little with the knowledge
they gained in school. For others, no formal instruction related to research
was required, making the ability to read, understand, and analyze research a
skill that was never developed (Polit & Beck, 2016). Creating educational op-
portunities for nurses to learn about EBP will help to overcome this barrier.Research-Related Barriers
Research-related barriers make it difficult for the nurse at the point of care to
understand, interpret, and/or use the research. Because the ability to replicate
a study and achieve the same results means a nurse can have greater confidence
in applying the evidence to practice, it would seem there is a need to conduct
and disseminate research findings in a way that bedside nurses can understand.
Unfortunately, this is not the case because, for most practicing nurses, the
complex statistics and research jargon act as barriers to understanding research434 CHAPTER 16 Transitioning Evidence to Practice