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All Journal MAHESA : Malahayati Health Student Journal Malahayati International Journal of Nursing and Health Science
Pranata, Yodha
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Dentistry Health Professions Nursing Public Health

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From Theory to Practice: A Qualitative Scoping Review on Nurses' Barriers in Implementing Evidence-Based Practice in Hospitals Pranata, Yodha; Yuflih, Athaya Zafira; Saputra, Rizky Lukman; Mutiarasani, Ajani; Wiguna, Yutika; Hartati, Tita
MAHESA : Malahayati Health Student Journal Vol 5, No 7 (2025): Volume 5 Nomor 7 (2025)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v5i7.18886

Abstract

ABSTRACT Evidence-based practice (EBP) is essential for improving healthcare quality and clinical outcomes. However, nurses face significant barriers to implementing EBP in hospital settings, ranging from individual knowledge gaps to systemic challenges. Addressing these barriers is crucial for bridging the gap between research and practice. This scoping review aims to identify and synthesize qualitative evidence on the barriers nurses face in implementing EBP in hospitals and to provide actionable insights to guide policy and practice improvements. A qualitative scoping review was conducted using a systematic search strategy across four databases (Scopus, PubMed, EBSCOhost) based on the PCC framework. Articles were included if they employed a qualitative design, focused on nurses' experiences with EBP, and were available in full text. Nine articles meeting the inclusion criteria were analyzed thematically using the Braun and Clarke approach. Thematic analysis revealed key barriers to EBP implementation: Lack of Institutional and Managerial Support, Time Constraints in Implementing EBP, Lack of Access to Resources and Information, Knowledge and Training Gaps in EBP, Tradition-Based and Intuition-Based Practice Culture in EBP, Low Motivation and Self-Confidence in Implementing EBP, and Barriers in Language and Understanding of Scientific Evidence.  Overcoming barriers to EBP in nursing practice demands a multifaceted approach that combines policy support, resource allocation, and capacity building. These strategies are vital for fostering a culture of evidence-based care in hospital settings. Keywords: Evidence-Based Practice (EBP), EBP Implementation, Nursing Barriers, Healthcare Implementation
Refractory hyperglycemia in a geriatric patient with diabetic ketoacidosis: A critical care nursing case report Pranata, Yodha; Winara, Winara; Rizkianti, Intan; Maryam, Nina; Prawesti, Ayu
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 7 (2025): Volume 8 Number 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i7.1005

Abstract

Background: Refractory hyperglycemia in diabetic ketoacidosis (DKA) presents a critical challenge in geriatric patients due to multifactorial physiological and clinical complexities. Early recognition and integrated management are essential, with critical care nursing as a pivotal component. Purpose: This case report aims to describe and analyze the multifactorial causes of refractory hyperglycemia in a geriatric DKA patient, highlighting the importance of early detection, comprehensive correction, and collaborative nursing roles. Method: A descriptive analytic approach was employed to examine the clinical course of a 75-year-old woman with DKA and persistent hyperglycemia. Data were collected from direct patient observation, systematic physical examinations, laboratory assessments, imaging, and multidisciplinary clinical records. Daily therapeutic interventions and patient responses were meticulously documented. Results: Persistent hyperglycemia resulted from several interacting factors: the impact of glucocorticoids on glycemic control, effects of severe pulmonary infection on insulin resistance, the role of electrolyte disturbances in exacerbating hyperglycemia, the relationship between heart failure and diuretic use, the impact of malnutrition and sarcopenia on insulin resistance, and the need for an integrated therapeutic approach. Each factor contributed to increased insulin resistance and complicated glycemic control. Conclusion: Optimal management of refractory hyperglycemia in elderly DKA patients requires early identification and simultaneous correction of underlying factors, supported by intensive critical care nursing and multidisciplinary collaboration.
Co-Authors Ayu Prawesti Priambodo Hartati, Tita Maryam, Nina Mutiarasani, Ajani Rizkianti, Intan Saputra, Rizky Lukman Wiguna, Yutika Winara, Winara Yuflih, Athaya Zafira