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Evidence-based practice (EBP) has become central to nursing practice and is actively promoted in both nursing education and real-world procedures to ensure that the latest and most accurate scientific data, clinical expertise, and methods of healthcare delivery are incorporated into practice. However, there are inherent barriers present at institutional and individual levels to adopt EBP. These may be systemic or cultural factors in the workplace that do not support change or promote nursing enhancing their knowledge. In addition, practitioners may lack access to appropriate technology, computer systems, or databases to engage in research or adopt EBP practices. Time management can be a barrier as well as nursing workflow and scheduling simply does not allow the time to engage in research or advocacy for EBP. Individual factors may be a lack of knowledge regarding conducting high-quality research as well as a lack of personal motivation for improvement (Tacia, Biskupski, Pheley, & Lehto, 2015). One can promote the adoption of EBP in the organization by advocating and establishing interdisciplinary communication. Commonly, support from physicians and management is vital for successful EBP implementation. Driving these initiatives through petitions and conference is important.
The use of 12-hour nursing shifts is becoming increasingly common in hospitals across the world. This tendency became a standard due to management approaches that view such long shifts as an opportunity to reduce interruptions and handovers that are often detrimental to care delivery while increasing productivity in overlaps that occur between shifts. Some view it as beneficial for nurses as well since compressed working week results in more days off, increased flexibility, and lower commuting costs. However, evidence from large-scale studies, such as the one by Dall’Ora, Griffiths, Ball, Simon, and Aiken (2015) suggests several negative outcomes as a result of such long shifts. Shifts that are 12 hours and longer are directly associated with job dissatisfaction, extreme burnout, high turnovers, and overall disgruntlement with work schedule flexibility. Psychological well-being suffers as well as physical fatigue are common symptoms of burnout in 12-hour shifts.
This can lead to adverse outcomes ranging from medical error and decreased quality of care to economic loss and increased turnover rates. Such evidence suggests that managers and hospital administrations should reconsider traditional scheduling and routines. In the context of nursing shortages, overtime may persist, but other strategies should be implemented regarding managing handovers and disruptions. Furthermore, policymakers should be influenced to provide greater funding and improved regulation for nursing practice.
References
Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9), 1-7. Web.
Tacia, L., Biskupski, K, Pheley, A., & Lehto, R. H. (2015). Identifying barriers to evidence-based practice adoption: A focus group study.Clinical Nursing Studies, 3(2), 90-96. Web.
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