Question

Discuss what strategies you could implement to create an evidence-based practice culture in your workplace. What steps can you take after leaving school to continue your evidence-based practice learning?

Answer 1

1.strategies which can be implemented  to create an evidence-based practice culture at workplace

• Education-

  Timing, educational level, relevant topics, and supplemental resources are considerations that may impact the successful uptake of EBP by clinical nurses. The perceived importance of the topic is the first step in gaining and keeping nurses' interest. For example, discharge planning may resonate with nurses because it reflects an area of focus for the family and patient. Furthermore, best practices at the point of discharge support fiscal responsibility by avoiding preventable readmissions through planning and anticipated need for support.Although important, even the most interesting and relevant topic won't garner the interest of nurses if education is offered when the workload doesn't permit attendance or when anxiety about meeting daily tasks haunts attendees during an educational session. Offering a variety of class options supports nurses when they can both attend and be focused on the content.To provide exposure to assessing EBP, students identify a nursing procedure that's of interest to them. The student conducts a literature review and evaluation. The findings are synthesized and compared with the institution's procedure. A recommendation is made; in some cases, this is taken to the appropriate councils for further consideration. Formal poster or podium presentations of EBP projects and practice changes are shared at a conference held by the university, with hospital staff in attendance.

• Peer involvement-Teamwork provides an opportunity to ignite nurses' passion for the EBP process and outcomes. EBP drives best nursing practices through evidence and strengthens autonomy when clinical nurses play a role in making practice decisions.

  For issues requiring updated evidence, a referral to the nursing research council (NRC) is made. Our NRC meets monthly, with membership made up of clinical nurses from diverse units within the medical center. An EBP subcommittee of the NRC, under the direction of a nurse educator and PhD student, addresses issue forms and questions about current practice. The subcommittee also conducts EBP reviews.Findings and recommendations are reported to the NRC, quality improvement council, and/or practice council as appropriate. Ultimately, outcomes are reported to the executive council to confirm current practice or recommend a change in practice based on evidence and the practice council's approval. In the absence of strong consistent findings, a research project is recommended to generate new knowledge.

• Leveraging expertise-Both internal and external experts provide support for EBP while offering motivation and building confidence for our clinical nurses.Skills to critique evidence were taught at breakout sessions to immediately apply knowledge and internal experts were available to guide nurses through the process. And at our annual nursing research conference, motivational experts share EBP experiences with attendees.

• Evaluation of EBP culture- Changes in education and outreach are frequently prompted by clinical nurses. After each program is conducted, attendees are asked to provide an evaluation, which includes an opportunity to write in comments. Evaluations are reviewed jointly by the nurse educators and researchers. Group EBP projects with topics that resonate with clinical nurses have been successful at our institution based on the number of participants and completed projects, as well as participants' interest in staying engaged in a workgroup focused on final translation of the recommendations. Moving forward, we plan to monitor the needs assessment survey to see if specific approaches are impacting the confidence of clinical nurses related to EBP. We're open to the possibility that modification of current programs may be warranted or repeat sessions may better serve our nurses. We value their feedback and are committed to exploring all suggestions.

• Be the spark-The triplet of clinical issues, emerging innovations, and constant generation of evidence-based publications necessitates the evolution of nursing practice. The standard for use of current EBP nursing practice has been set, along with the challenge to engage all nurses providing care. The suggestions put forth begin with engaging students in EBP in preparation for professional expectations. Various methods for educating and engaging clinical staff members provide a diverse approach, which includes cascading information throughout the institution. Group projects and the development of EBP scholars offer the opportunity for professional growth and leadership development by leveraging internal and external EBP experts. An evaluation of success should be incorporated whenever possible. Such measurement may deliver evidence to support educational practice changes or spark innovative methods to engage clinical nurses in EBP.

  2.STEPS take after leaving school to continue your evidence-based practice learning:

• Understand the data. While some evidence-based practices and treatments are applicable to multiple clinical contexts, in other instances, the data behind an evidence-based practice may not translate to your organization. "What if the evidence-base is constructed from different patient populations, hospitals with different structures or cultures, or countries with different regulatory environments and payment structures.In those situations, leaders need to adapt the evidence-based practices to fit their organization. And that requires understanding the data, Luciano and colleagues write.Even after the practice is implemented, leaders should continue the data collection process so they can reassess and make modifications as needed, according to Luciano and colleagues.

• Consider your resources. Similarly, every organization has different resources at their disposal, making it likely that leaders will need to modify evidence-based practices to fit the resources that are available to them..
• Establish patient-centered goals. When implementing a new evidence-based practice, health care leaders need to identify goals based on patient-centered outcomes, according to the Luciano and colleagues. For example, many hospitals have the goal of reducing inpatient length of stay. If the change leaders focus just on the inpatient length of stay itself, they may create a program that rushes the patient out of the hospital before they are ready If instead the goal is to optimize recovery … the focus shifts to the patient experience, and reduction in inpatient length of stay is simply the residue of a provider and patient-friendly program.
• Identify your preferences. Finally, leaders should note that health care providers' personal preferences often determine whether an organization will adopt a new practice, according to Luciano and colleagues.offering training on new tools or techniques can give care providers the opportunity to ask questions about them and get more comfortable using them.