Discussion: Creating a Culture of Evidence-Based Practice

 

An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

 

To prepare:

 

Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

Reflect on how nurses can disseminate findings from evidence-based practice research.

 

Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources.

 

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with aIDitional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and aIDitional sources.

Make a suggestion based on aIDitional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing aIDitional insights or contrasting perspectives based on readings and evidence.

 

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 30, “Disseminating Evidence: Reporting Research Findings”

 

In this chapter, the focus is on actually reporting on the research findings and how to determine the best approach for reaching the desired audience. The chapter also includes tips on how to organize the information and describes what is usually included in such reports.

Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254.

Retrieved from the Walden Library databases.

 

This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.

Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225.

Retrieved from the Walden Library databases.

 

In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. AIDitionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.

Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.

Retrieved from the Walden Library databases.

 

This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.

Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209.

Retrieved from the Walden Library databases.

 

In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In aIDition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.

Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53.

Retrieved from the Walden Library databases.

 

The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.

Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157.

Retrieved from the Walden Library databases.

 

This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.

Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390.

Retrieved from the Walden Library databases.

 

This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.

Steurer, L. M.(2010). An evidence-based practice scholars program: One institution’s journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143.

Retrieved from the Walden Library databases.

 

The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In aIDition to the program’s development and implementation, the article highlights lessons learned.

 

Media

Laureate Education (Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 9 minutes.

 

Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.

 

 

Accessible player

Laureate Education (Producer). (2012c). Disseminating findings. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 2 minutes.

 

In this video, Dr. Kristen Mauk offers advice for nursing students and practitioners in disseminating the findings of their research and evidence-based practice projects. She identifies many options for dissemination that are available to nurses.