title: Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review.
abstract: OBJECTIVE
  The purpose of the present study is to examine the barriers and facilitators to evidence-based practice (EBP) using Shortell's framework for continuous quality improvement (CQI).
  
  
  BACKGROUND
  EBP is typically undertaken to improve practice. Although there have been many studies focused on the barriers and facilitators to adopting EBP, these have not been tied explicitly to CQI frameworks.
  
  
  METHODS
  CINAHL, Academic Search Premier, Medline, Psych Info, ABI/Inform and LISTA databases were searched using the keywords: nurses, information literacy, access to information, sources of knowledge, decision making, research utilization, information seeking behaviour and nursing practice, evidence-based practice. Shortell's framework was used to organize the barriers and facilitators.
  
  
  RESULTS
  Across the articles, the most common barriers were lack of time and lack of autonomy to change practice which falls within the strategic and cultural dimensions in Shortell's framework.
  
  
  CONCLUSIONS
  Barriers and facilitators to EBP adoption occur at the individual and institutional levels. Solutions to the barriers need to be directed to the dimension where the barrier occurs, while recognizing that multidimensional approaches are essential to the success of overcoming these barriers.
  
  
  CONCLUSIONS
  The findings of the present study can help nurses identify barriers and implement strategies to promote EBP as part of CQI.
authors.affiliation: Arizona State University, Phoenix, AZ, USA. nan.solomons@gmail.com
authors.forename: Nan M
authors.initials: NM
authors.lastname: Solomons
authors.forename: Judith A
authors.initials: JA
authors.lastname: Spross
mesh_terms: D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing; D055317:Evidence-Based Practice / Q000193:education / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D033181:Information Dissemination; D009718:Nurse Administrators / Q000458:organization & administration; D024802:Nurse's Role / Q000523:psychology; D015399:Nursing Research / Q000193:education / Q000458:organization & administration*; D057184:Practice Patterns, Nurses'; D017009:Professional Autonomy; D058996:Quality Improvement / Q000458:organization & administration*; D012107:Research Design; D017748:Time Management; D017749:Total Quality Management / Q000458:organization & administration*