DOJONR - DePaul Online Journal of Nursing Research

Barriers of Patient Advocacy Role in Clinical Nursing Practice: An Integrative Review of the Literature

Caroline Oliveira, DePaul University
Joseph D. Tariman PhD, DePaul University


Aims and Objectives: The goal of this study is to identify the barriers of patient advocacy in the current clinical nursing practice environment.

Background: Nurses play a vital role regarding patient advocacy and it is a competency required by the American Association of Colleges of Nursing. In order to be an effective advocate, nurses must understand all aspects of advocacy role as well as identify the barriers to advocacy encountered in contemporary nursing practice.

Design: An integrative literature review study design.

Methods: Computer-based searches using CINAHL Complete, PubMed, Health Source: Nursing Academic Edition, and SAGE Journals were conducted yielding nineteen studies. These studies included reports of barriers to advocacy from nurses who have been practicing as a registered nurse in a hospital setting. Data were analyzed using conventional content analysis in order to create a thematic summary of the barriers.

Results: The barriers of patient advocacy fall in 5 different categories: management barriers, nursing role barriers, institutional barriers, physician/nurse relationship, and personal barriers.

Conclusion: There are many potential barriers to the performance of nursing advocacy role. These barriers pose significant problems in the area of personal, professional, and job satisfaction among the nurses. The most commonly cited barrier was the lack of support from administration.