BARRIERS TO TRANSLATING RESEARCH INTO PRACTICE AND POLICY
The obstacles that prevent the translation of research into practice are many and complex. These barriers can be summarized into two categories: individual characteristics and systems or organizational factors.
Individual barriers that have been reported include insufficient knowledge about the research process, lack of competence in reading and evaluating research or scientific articles and reports, lack of time, lack of knowledge of statistical analyses, and sometimes lack of authority to change practice (Ubbink et al., 2013; Weng et al, 2013). Organizational or system barriers that have been described are lack of access to research, inadequate resources to implement change, and lack of support from staff and colleagues (Ubbink et al, 2013; Weng et al, 2013).
APRNs prepared at the master's level and doctorate of nursing practice (DNP) level are taught to critique research, initiate EBP initiatives, and translate findings into practice; however, educational preparation alone does not seem to be sufficient to result in the application of research into practice. Some studies suggest that attitudes toward EBP may be as important as educational preparation in the implementation of research into practice (Stokkel, Olsen, Espehaug & Nortvedt, 2014; Ubbink et al., 2013).
Clinical information must filter down to individual clinicians and cross disciplines (Newhouse, 2008). The lack of interprofessional collaboration compromises research efforts between disciplines (e.g., biological sciences and physical sciences) and prevents the transmission of research data from one discipline to another. Although the different interests among various health care disciplines are justified, the artificial boundaries and turf issues created by different professions impede the flow of information and obscure the one commonality or unifying factor that should be improving patient care.
System / Organizational Barriers
Many health care institutions, whether they are hospitals or primary care clinics, frequently spend resources on acquiring and using new and innovative medical equipment and developing new procedures to improve patient care. Failure to invest in human technology such as the development of behavioral interventions, prevention strategies, or quality improvement programs or the failure to develop processes that support nurses and others in the evaluation of interventions and policy development are examples of implementation failure (Rangachari, Rissing, & Rethemeyer, 2013). Without infrastructure support, nurses, particularly APRNs, may perceive that they do not have the authority or organizational support to develop or evaluate new models of care.
Although many institutions have adopted electronic technology in their medical records with the intent of consolidating patient information and reducing errors, little technology is incorporated into the systems that directly access the clinical research or clinical practice guidelines that may improve patient care. Computer information systems that are integrated into electronic medical records are often underused, in part because practicing clinicians are often not engaged in the development of these systems.
SOLUTIONS: A ROLE FOR APRNs
The solutions for translating research into practice and policy are as diverse and multifaceted as the barriers. Proposed solutions can be examined at three levels: the micro level (individual clinician and patient), the meso level (systems or organizations), and the macro (economic and political) solutions (Scott, 2007).