Exploring the enablers and barriers to implementing evidence-based practice in acute stroke care

Abstract

Research Question: What are the nurses’ perceived enablers and barriers to implementing evidence-based practice in acute stroke care?” Background: Evidence-based acute stroke nursing care is crucial for mitigating cerebral harm and enhancing recovery prospects. In this context, nurses are pivotal in the multidisciplinary stroke care team, contributing significantly to delivering tailored care regimens aligned with established protocols. Aims: The study aims to assess nurses' knowledge of evidence-based practice (EBP) and acute stroke care, identify the barriers and enablers to implementing EBP in the area, and enhance nurses' practices and care for stroke patients. Methodology: The study employed a two-phased mixed-method design combining positivist and interpretive approaches. Nurses from a Neuro-medical ward and an Accident and Emergency Department were invited to participate. In the first phase, 26 nurses participated in three audio-recorded focus group discussions. These discussions were transcribed verbatim and analysed using thematic analysis. In the second phase, 33 nurses (27% response rate) completed Likert Scale questionnaires. The responses were subjected to descriptive analysis and graphically presented to illustrate patterns and trends. Results: The study highlighted barriers and enablers to implementing evidence-based practice in acute stroke care. Barriers included disparities in EBP knowledge, lack of training, resistance to change, and resource constraints. Conversely, enablers included a supportive learning environment and structured guideline development in the A&E department, availability of senior neurologists, knowledgeable staff in stroke-prone areas, staff incentives, and reflective practices. Conclusion: The study's recommendations offer a strategic approach to overcoming challenges in acute stroke care. They emphasise the importance of education, community engagement, and organisational support for enhancing healthcare effectiveness. By implementing these recommendations, the study anticipates significant positive impacts on patient outcomes. Key suggestions include targeted education and training, bolstering organisational support, promoting structured guideline development, and implementing motivational practices to encourage evidence-based practice adoption.