Based on this review several gaps in our understanding
of EBP barriers, facilitators and interventions can be
identified. These descriptive studies did not link EBP to
CQI process improvement and their relationship to
CQI, or to patient and institutional outcomes.
There is a need for more research to understand how
well the interventions address EBP barriers in the short
term and whether effects persist. What individual and
institutional factors support and sustain changes in
EBP? How do changes in EBP affect CQI processes and
patient and institutional outcomes? The literature
describes several models for implementing EBP, however,
the authors found no studies comparing the success
or failure of these models by environment/setting.
The most frequently used instrument among the
selected studies was the BARRIERS instrument which
was created to address research utilization using Rogers
Diffusion of Innovations Theory. However, much of the
literature was atheoretical. More studies guided by
theory and using instruments that are theoretically
based and psychometrically sound are needed in order
to strengthen our understanding of EBP, CQI, and
barriers and facilitators.
Lack of time to read and seek out literature was a
common theme throughout these studies. Managers and
institutions should look at the availability of EBP and
determine the best ways to implement those practices
on site. Sites such as TRIP (http://www.tripdat