Exploring Barriers to Evidence-Based Nursing Practice in a Developing Yet Promising Nation: A qualitative Study from China

Background: Evidence-based nursing practice (EBNP) has emerged as a key strategy for improving healthcare services across various countries. However, the effectiveness of its implementation is substantially influenced by contextual factors within the health environment. While numerous barriers have been explored within advanced healthcare systems, the situation in China, where the development of EBNP is progressing slowly despite high demand of medical services, has not been adequately examined. This study aims to identify the barriers to implementing EBNP from an integrated perspective and to provide insights that can assist policymakers in designing effective strategies for the implementation of EBNP in China. Methods: A descriptive qualitative approach was employed, utilizing in-depth semi-structured interviews. We conducted interviews with 71 participants, including educators, hospital managers, nursing directors, and nurses from 18 Chinese provinces. Content analysis was performed using an inductive approach. Results: Thirteen barriers to implementing EBNP were identified across educational, organizational, and operational levels. Key barriers include the lack of collaboration between university and hospital to establish EBNP platform, insufficient courses to obtain EBNP knowledge and skills, and lack of performance incentives for EBNP. Respondents highlighted that the gap between theoretical and clinical practice in medical education plays a fundamental role in obstructing the successful implementation of EBNP. Conclusions: This study underscores the barriers to EBNP implementation from an integrated perspective, addressing challenges at educational, organizational, and operational levels. Our findings provide valuable implications for enhancing the implementation of EBNP in China and similar contexts, offering guidance for future policy development and healthcare practices.