More than one-third of hospitals aren't meeting National Database of Nursing Quality Indicators performance metrics, a new Ohio State University study on chief nurse executives finds.
At the same time, it showed that evidence-based practice – a care-delivery approach that integrates problem solving, best practices, clinician expertise and patient preferences – is a low priority across the United States.
Although multiple studies show evidence-based practice results in high-quality care, improved patient outcomes and lower costs, and nurse executives recognize its effectiveness, implementation is relatively low.
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"EBP isn't being implemented to the state that it really needs to be to accomplish high quality healthcare safety and cost," said Bernadette Melnyk, MD, dean of Ohio State University's College of Nursing. "There's a major disconnect between the priorities of chief nurses and evidence-based practice."
While the majority of surveyed nurses placed quality and safety as top priorities, EBP was ranked at the bottom. Melnyk said this suggested that nurses "don't truly understand that EBP is a direct path to get their hospitals to quality safety and reduce costs."
A lack in budget allocations is one of the major reasons for this gap, the survey found. Hospitals and CNEs aren't investing resources into this evidence-based culture to help implement EBP measures for a care foundation.
"Hospitals need to invest in getting all providers and clinicians, really up to scale in EBP," Melnyk said. "Then create a culture and environment that support their clinicians to consistently practice this way.
"There are a lot of barriers that exist in the healthcare system; there are misconceptions, politics and the tradition of 'that's the way we do it' that's alive and well in many institutions across the U.S," she added.
When most Americans head to the hospital, they assume they're getting evidence-based care, but that's not the reality, the report suggests. Nurse executives need EBP education and skill-building to implement the practice, the survey found. But furthermore healthcare systems need to support staff to utilize EBP.
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Research shows EBP teamwork leads to better care quality and outcomes, but hospital must promote the practice as essential and expect clinicians to implement them.
"We also need to get academia up, where they're creating students steeped in EBP and they come into a healthcare environment where that is expected," Melnyk said.