Background: Evidence implementation is the most challenging part of evidence-based nursing. In China, a series of evidence-implementation projects have been carried out in the past 5 years, using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. A total of 7 hospitals, 27 wards and 616 nurses were involved.
Objectives: To ascertain barriers to compliance with best practice and strategies to overcome these barriers; and, to evaluate the outcomes of evidence implementation from a patient , nurse and organisational perspective.
Methods: This study is a pooled analysis of 34 evidence-implementation projects. Content analysis was used to extract data from the original reports and structured interviews were used to describe nurses' experiences.
Results: 125 barriers were mentioned among 34 projects and 11 themes were extracted. The most common barriers were nurses' lack of knowledge or skills; nurses' lack of instruments to assess or record; patients lack of knowledge or skills; increased workload or limited human resources; lack of nursing procedures or workflows; and, lack of multidisciplinary co-operation. 200 strategies were used to overcome the barriers and 7 themes were extracted. These were nurse education via multiple materials; introducing or developing instruments; patients' education via multiple materials; building nursing procedures or workflows, building multidisciplinary co-operation, introducing/developing equipment or facilities; and increasing human resources and rewards. The average compliance to best practice was raised significantly from 32.1% to 93.1%. In 34 projects, 8 improved patient outcomes, 19 increased patient knowledge or skills, 32 increased nurse knowledge or skills, and 33 revised nursing procedures or workflows.
Conclusions: These projects led to improvements in nursing practices and patient outcomes. Various strategies, such as an effective training programme, simple and clear assessment instruments, and multiple education materials, can facilitate implementation of best evidence into clinical practice.