DQ 2 :Discuss two barriers that might hold nursing practice from achieving its goal
The prompt supplies the numbers: a 90% target against roughly 15% in practice. A barrier that explains a few points cannot explain a gap of seventy-five, and that arithmetic should shape which two you choose.
Editorial process
Last reviewed · August 18, 2026
A 90% goal against a 15% reality — why the gap persists
Start from the size of the gap, because it disciplines the answer. The Institute of Medicine set 90% of clinical decisions to be evidence-based by 2020 and the figure the prompt quotes is around 15%. That is not a shortfall explained by individual nurses being insufficiently motivated. It is the signature of a system in which the translation of research into practice is nobody's defined job. The most-cited figure in this literature is the seventeen years it takes for research to reach routine practice, and the reason is structural: producing evidence is funded, and translating it is not. Choose barriers of that magnitude and say why they are large enough to account for what we observe, because a post that attributes a seventy-five-point gap to nurses lacking time has picked a real obstacle and the wrong order of magnitude. Nothing about that arithmetic is a criticism of individual nurses, and the post is stronger for saying so before it names anything.
Two barriers worth developing, with remedies that match their scale. First, the absence of a translation infrastructure: there is no role in most organisations whose job is to move a published finding into a policy, a protocol or an order set, so it happens only when an individual chooses to make it happen. The remedy is structural — a nursing research or practice council with delegated authority, an EBP fellowship, or a standing agenda item where new guidance is triaged. Second, access and appraisal capacity: many nurses have no database access after graduation and no protected time or skill to appraise what they find. The remedy is institutional subscription, embedded librarian support and appraisal training built into orientation rather than offered as an optional course. Both remedies cost money and neither is a motivational intervention, which is the honest conclusion this prompt is steering you toward.
Likely learning objectives
- Use the size of the stated gap to constrain which barriers are plausible.
- Identify structural rather than individual explanations for the research-practice gap.
- Propose remedies matched to the scale of the barrier.
- Cite the origin of the 90% goal accurately.
Assignment instructions
Read the full question
Review every instruction before using the planning guidance that follows.
NRS 493 Topic 1 DQ 2 DQ 2 :Discuss two barriers that might hold nursing practice from achieving its goal Assessment Description The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020. According to HealthyPeople.gov, the United States is currently at approximately 15%. Discuss two barriers that might hold nursing practice from achieving this goal and suggest ways in which identified barriers may be addressed.
Turn the brief into deliverables
- 01An account of the gap between the 90% target and current practice.
- 02Two barriers, each large enough to explain part of that gap.
- 03The mechanism by which each barrier operates.
- 04A remedy matched to each barrier's scale.
- 05Sources for the target and the current figure.
Two barriers, each with an addressable mechanism
The size of the gap
State the target, the current figure, and what a gap that size implies.
What the assessor is likely looking for
An inference drawn from the magnitude, not just the numbers repeated.
Barrier one: no translation infrastructure
Explain that moving evidence into practice is nobody's defined role.
What the assessor is likely looking for
The absence of a role or process, named.
Barrier two: access and appraisal capacity
Describe post-graduation loss of database access and appraisal skill.
What the assessor is likely looking for
A concrete access problem rather than a general skills claim.
Remedies at the right scale
Match each barrier with a structural or institutional remedy.
What the assessor is likely looking for
A remedy that changes a structure, with a cost implied.
What your own organisation could start with
Bring the analysis down to one achievable local action.
What the assessor is likely looking for
A local action consistent with the structural diagnosis.
Where the 90% target and the gap figures come from
Recommended databases
- PubMed Central
- CINAHL Complete
- Agency for Healthcare Research and Quality
- Adelphi University Libraries
Search sequence
- 1.Find the source of the 90% target rather than quoting it second-hand.
- 2.Look for evidence on the research-to-practice time lag and its causes.
- 3.Read a study of nurse managers on EBP barriers for the organisational view.
- 4.Check what database access nurses in your setting actually have.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nursing managers' perspectives on facilitators of and barriers to evidence-based practice: A cross-sectional study
Nursing Open (Wiley), via PubMed Central · 2023
Nursing managers on the facilitators of and barriers to EBP — the organisational-level diagnosis.
Effects of Work Engagement and Barriers on Evidence-Based Practice Implementation for Clinical Nurses: A Cross-Sectional Study
Healthcare (MDPI), via PubMed Central · 2024
Work engagement and barriers to EBP implementation among clinical nurses.
Nurses' roles in changing practice through implementing best practices: A systematic review
Health SA Gesondheid · 2022
A systematic review of nurses' roles in implementing best practice, and where the process breaks.
Nursing Professional Development Evidence-Based Practice
StatPearls, NCBI Bookshelf · 2023
Evidence-based practice in nursing professional development — where translation is supposed to sit.
The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care©
University of Iowa Health Care · 2017
The Iowa Model, an example of the translation infrastructure whose absence is the first barrier.
Review before submission
Common mistakes
- Choosing barriers that could not explain a gap of this size.
- Framing the problem as nurses lacking motivation or interest.
- Proposing education as the remedy for a structural barrier.
- Quoting the 90% goal without saying where it came from.
Submission checklist
- Do your barriers plausibly account for a gap this large?
- Is at least one barrier structural rather than individual?
- Does each remedy operate at the same level as its barrier?
- Have you cited the source of the 90% target?
- Have you avoided blaming frontline staff for a system outcome?
Use this guide to plan and review your own work. Follow your institution's rules and read Brinevia's academic-integrity policy.
Written by
Maren Caldwell
MSN, RN, CNE
Medical-surgical nursing, pharmacology and NCLEX preparation
Maren is a registered nurse with over 15 years of clinical and educational experience in medical-surgical nursing. She writes on NCLEX preparation, patient care fundamentals, pharmacology and evidence-based practice.
Reviewed by
Dr. Tessa Redmond
DNP, RN, CNE
Evidence-based practice and clinical education
Tessa is a doctorally-prepared nurse educator. She reviews Brinevia content for clinical accuracy and alignment with current evidence-based guidelines.