Skip to main content


3 in 4 Nurse Leaders Spend 10% or Less of Their Budgets on Evidence-Based Practices

By Jennifer Thew RN  
   March 08, 2016

Nurse leaders may believe in the power of evidence-based practices, but more than 50% say EBP is practiced at their organizations "not at all" or "somewhat." The way forward is to quantitatively demonstrate value, says one advocate.

What do Santa Claus and evidence-based practice have in common? Believing in them doesn't mean they exist. If you're scratching your head over this riddle's answer, let me explain. I'll even use evidence on EBP to help make my point.

In 2012, a study published in the Journal of Nursing Administration reported that nurses ranked resistance from nurse leaders and nurse managers as one of the top five barriers to implementing EBP. Now a new study published in Worldviews on Evidence-Based Nursing has found that, while chief nurse executives say they strongly believe EBP results in high-quality care, only 3% of the 276 CNOs and CNEs ranked EBP as a top priority. And 74% reported that they allocated zero to 10% of their annual operating budgets to build and sustain EBP in their organizations.

More than 50% said EBP is practiced at their organizations "not at all" or "somewhat."

"These chief nurses believe in EBP. Their top two priorities are quality and safety," says the author of both studies, Bernadette Melnyk, RN, PhD, CPNP/PMHNP, FAAN, FANP, associate vice president for health promotion, university chief wellness officer, and dean of the College of Nursing at The Ohio State University in Columbus.

"But there's a major disconnect because they don't see evidence-based practice as a direct pathway to get their organizations to high quality and safety. So that's a big problem."

A big problem indeed. Especially when you look at one of Melnyk's other findings—chief nurses reported that more than one-third of their hospitals were not meeting benchmarks for NDNQI measures.

So what is contributing to this disconnect that threatens the quality of patient care? And how can nurse leaders overcome it?

Melnyk and her colleague Mary Nash, RN, PhD, FAAN, FACHE, chief nurse executive, OSU Health System and assistant dean, OSU College of Nursing, spoke with me about the causes and solutions to this EBP paradox.

Getting to Know EBP
When I went to nursing school in the mid-to-late 1990s, EBP wasn't quite yet a "thing." Interest in EBP began to pick-up steam when, in 2003, the IOM set a goal that 90% of healthcare decisions would be evidence-based by 2020.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

Get the latest on healthcare leadership in your inbox.