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Lesson 12
Strategies for Implementing Evidence-Based Practice©
Jean Cody, MS, RN
LEARNING OBJECTIVE
The learner will be able to identify strategies for organizational implementation of evidence-based practice.
OVERVIEW
There are several ways to bring evidence into your organizational system. One way is to add evidence into your every day practice; for example, you can do this by reading and critiquing journals, participating in unit and hospital wide committees, and asking questions about your practice. Every time there is an opportunity to review evidence supporting practice, or to improve our system by adding an evidence base, we are bringing evidence based practice to our organizations. Another way to add evidence based practice to your organization is to develop, implement, and disseminate an evidence based project.
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Evidence-based practice is similar to going on a journey. You are planning a trip to a place you have never been before. The trip requires some planning; it is a journey over hills and down into valleys. You have studied the travel map and carefully marked your departure point, where you will stop and stay on the journey, and you have determined your final destination point. You must decide what the time lines are for your trip. You have carefully picked your co-pilot (mentor). Usually a mentor has a personal interest in your success, is open and honest with feedback, and has expertise to help you in your journey. With your mentors’ help, you will need to assemble a team to help you with your journey. After this planning, you are ready to begin your journey! (See Lesson 9)
On the average, it takes 18 months from beginning to end for an evidence based project. That includes developing the question, assembling the mentor and team, obtaining data, piloting the practice change, evaluating the effectiveness of the change, maintaining the change and disseminating the results of the project. The crucial element keeping the project together and moving forward is an EBP project map.
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An EBP project map includes project objectives, what steps are involved with the objectives, and who is responsible for completing objectives.
One important piece of this map includes how your particular project will move through the organization. For example, you want to look at the evidence supporting your current practice of central venous line removal. In evaluating the evidence, it becomes clear that several components of this practice need to be revised to be in line with the evidence. This particular evidence based practice project needs to travel through various areas; nursing leadership and evidence based practice councils (to keep colleagues updated, for critique and support), infection control (will this practice change increase infection rates?), and the pharmacy and therapeutics committee (addition of an antiseptic ointment to the removal site). Each evidence based practice project map will be unique, and involve different people and committees based on the PICO question (See Lesson 4).
Strategies to implement evidence based practice into your organization include finding opportunities to incorporate evidence into every day nursing practice. A key strategy to successfully implementing an evidence based practice project in your organization is to utilize an EBP project map. This map will help keep your project on its’ journey to the final destination: implementing evidence into nursing practice!
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