Barriers and facilitators in implementing evidence-based practice: a parallel crosssectional mixed methods study among nursing administrators

Abstract
Background Evidence-based practice (EBP) is a cornerstone of quality healthcare, yet a significant gap persists
between nursing administrators’ advocacy for EBP and its clinical adoption, particularly in resource-constrained
settings.
Aim This study investigates barriers and facilitators to EBP adoption as perceived by nursing administrators in Saudi
Arabian hospitals to inform tailored interventions. Design: A parallel mixed-method, cross-sectional design was
employed.
Methods A total of 385 nursing administrators from 12 stratified hospital types in the Northern Region of Saudi
Arabia completed structured surveys assessing EBP barriers and facilitators. Semi-structured interviews with 40
purposively sampled participants provided qualitative insights. Data were analyzed using descriptive, correlational,
and thematic approaches.
Results Key barriers included insufficient staffing and time resources, particularly in private and specialized hospitals
(mean=4.05, SD=1.46, p<0.05). Supportive organizational policies (p=0.015) and leadership experience significantly
influenced EBP adoption. Barriers, such as resource constraints, were negatively correlated with willingness to adopt
EBP (r = -0.17 to -0.35), while multifaceted strategies explained 27% of the variance in implementation intentions.
Qualitative findings highlighted that 92% prioritized patient care quality, while 80% emphasized cost-benefit
trade-offs.
Conclusion This study highlights the critical role of organizational support, leadership advocacy, and tailored
interventions in overcoming EBP barriers. Gender diversity among administrators and the influence of hierarchical
dynamics in Saudi Arabian healthcare settings provide novel insights for improving EBP adoption