title: What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review.
abstract: BACKGROUND
  The responsibility to implement evidence-based practice (EBP) in a health care workplace does not fall solely on the individual health care professional. Organisational barriers relate to the workplace setting, administrational support, infrastructure, and facilities available for the retrieval, critique, summation, utilisation, and integration of research findings in health care practices and settings.
  
  
  OBJECTIVE
  Using a scoping review approach, the organisational barriers to the implementation of EBP in health care settings were sought.
  
  
  METHODS
  This scoping review used the first five of the six stage methodology developed by Levac et al. (2010). The five stages used are: 1) Identify the research question; 2) identify relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results. The following databases were searched from January 2004 until February 2014: Medline, EMBASE, EBM Reviews, Google Scholar, The Cochrane Library and CINAHL.
  
  
  RESULTS
  Of the 49 articles included in this study, there were 29 cross-sectional surveys, six descriptions of specific interventions, seven literature reviews, four narrative reviews, nine qualitative studies, one ethnographic study and one systematic review. The articles were analysed and five broad organisational barriers were identified.
  
  
  CONCLUSIONS
  This scoping review sought to map the breadth of information available on the organisational barriers to the use of EBP in health care settings. Even for a health care professional who is motivated and competent in the use of EBP; all of these barriers will impact on their ability to increase and maintain their use of EBP in the workplace.
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia. Electronic address: brett.williams@monash.edu.
authors.forename: Brett
authors.initials: B
authors.lastname: Williams
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.
authors.forename: Samuel
authors.initials: S
authors.lastname: Perillo
authors.affiliation: Department of Occupational Therapy, Monash University, Victoria, Australia.
authors.forename: Ted
authors.initials: T
authors.lastname: Brown
mesh_terms: D055317:Evidence-Based Practice; D019983:Guideline Adherence; D058016:Health Facility Administration; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D015279:Organizational Culture
keywords: Communication barriers; Culture; Evidence-based medicine; Evidence-based practice; Health care work environments; Organisational culture