Barriers and Strategies for Overcoming Them

In nursing, the sustainability of evidence-based practice (EBP) matters a lot since it leads to the delivery of quality healthcare services for improved patient outcomes. Therefore, it is important for any proposed practice change to be effectively implemented in order for it to continue influencing the intended outcomes for a long period of time. To achieve this, the change project should be compatible with the culture of the organization that is supporting it (O’Donnell et al., 2016; Wheatley et al., 2017). Proposed EBP projects sometimes fail to achieve their goals due to certain barriers that interfere with their sustainability. Examples include financial constraints, limited access to internet, computer illiteracy, lack of time, and language barrier (Mathieson et al., 2019; Sharplin et al., 2019). It is important for project teams to come up with effective strategies through which these barriers can be addressed.

Barriers to EBP Change

The current practice change project pertains to embracing initiatives the can lead to effective disease control and prevention among marginalized groups. One of the major barriers that are likely to prevent the project from obtaining desired results six months to one year from now is the varying healthcare needs of the targeted groups (O’Donnell et al., 2016; Mathieson et al., 2019). There are many marginalized groups that the proposed project targets. These include racial minority groups, disabled individuals, elderly persons, mentally challenged people, veterans, commercial sex workers, refugees, the extremely poor, gay, lesbian, bisexual and transgendered (GLBT), and those who come from very remote regions (O’Donnell et al., 2018; Baah et al., 2019). All these people do not have the same health needs. This is due to their different levels of social and economic disadvantaging. Therefore, it should not be assumed that the proposed change can effectively meet the needs of each of the targeted groups.

Another serious barrier interfering with the sustainability of the project at hand is lack of financial resources (O’Donnell et al., 2016; Sharplin et al., 2019). Many of the targeted marginalized populations are underserved by healthcare professionals as well as healthcare facilities. This makes it difficult for many of them to access healthcare services of high quality for better healthcare outcomes. This means that there is need to recruit enough healthcare providers, and construct more facilities. Unfortunately, there is no enough money that can be used to make such important changes. This means that some of the expected outcomes of the project may end up not being achieved as planned.

Strategies for Overcoming the Barriers

There are various strategies that can be used to overcome the barriers identified above for the achievement of project sustainability. For the barrier of the varying healthcare needs of the marginalized groups, it is important to first understand the needs of each group (Mathieson et al., 2019; Sharplin et al., 2019). After this, the project team can then implement changes that help to address those needs. It is necessary to recruit different healthcare workers who are knowledgeable in the unique care needs of each of the marginalized population (Western Institute of Nursing, 2016; Mathieson et al., 2019). For instance, there is need to recruit geriatricians for the elderly, gynecologists for sex workers, and community health workers for people ling in remote areas. Apart from this, it is also necessary to construct different types of healthcare facilities that cater for the needs of each marginalized group (Sharplin et al., 2019). These may include veteran hospitals, geriatric hospitals, mental health facilities, and mobile clinics.

The barrier of financial constraints can be addressed through a supplementary budget (Sharplin et al., 2019). Through this budget, the project team can get additional funds from the government. This money can be useful in the implementation of the change that has been proposed. Apart from a supplementary budget, the team can seek the help of non-governmental organizations, faith based organizations, donors, and other well-wishers (Mathieson et al., 2019). All these parties can be an important source of funds for the implementation of the project.


Baah, F. O., Teitelman, A. M., & Riegel, B. (2019). Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health – An integrative review. Nurs Inq., 26 (1): e12268. doi: 10.1111/nin.12268.

Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Prim Health Care Res Dev., 20: e6. doi: 10.1017/S1463423618000488

O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016). Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. Int J Equity Health, 15 (197).

Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., Bonner, R., Dabars, E., & Eckert, M. (2019). Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context. Healthcare (Basel), 7 (4): 142. doi: 10.3390/healthcare7040142

Western Institute of Nursing. (2016). Creating a Nursing Force for Change. Retrieved from

Wheatley, L., Doyle, W., Evans, C., Gosse, C., & Smith, K. (2017). Integrated Comprehensive Care – A Case Study in Nursing Leadership and System Transformation . Nurs Leadersh, 30 (1): 33-42. doi: 10.12927/cjnl.2017.25107.

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