Barriers to getting evidence into practice

The barriers to getting evidence into practice are often the ‘opposite’ from the enablers. Identifying potential barriers is the first important step to implementing change in practice; just one barrier can seriously impede the successful implementation of change.

The following examples illustrate how these factors influence clinical decision making in practice:

• Despite good evidence for a new treatment, ‘Wunderdrug’, this medicine is not available to the general population due to financial constraints.
• A pregnant woman declines to give consent to the administration of an evidence-based prophylactic human blood product, due to cultural and religious beliefs.
• There is strong evidence that early mobilisation on stroke units improves outcomes for patients. However, the lack of physiotherapists in small centres may make this standard difficult to implement.
• Evidence supports the use of bottle feeding where the mother of a baby is HIV positive. However, there are inadequate facilities in some communities to ensure a safe bottle feeding practice such as clean water and washing facilities.

Identifying the barriers and enablers to evidence-based practice in your own workplace is an important step in applying evidence successfully to practice.