Nurse Residents: A structured approach for creating change agents in the use of evidence-based practice

Monday, 18 November 2013: 2:05 PM

Reetta Stikes, MSN, RNC-NIC, CLC
Nursing Education and Research, University of Louisville Hospital, Louisville, KY
Cathern S. Velasquez, DNP, RN, CPHM
Nursing Edcation and Research Dept., University of Louisville Hospital, Louisville, KY

Learning Objective 1: The learner will be able to discuss use of Diffusion of Innovations Theory to change the culture of health care organizations to embrace evidence-based practice.

Learning Objective 2: The learner will be able to identify three strategies for implementing a successful nurse residency program curriculum for evidence-based practice.

To assure the delivery of quality care, nurses need to acquire skills that allow them to be leaders, use evidence-based practice (EPB) at the point of care, and impact changes that result in improved outcomes (IOM, 2010).  Nurses receive academic knowledge related to research and EBP processes. However, there is an identified gap between the receipt of knowledge and application of these concepts (IOM, 2010). A structured approach to implementation of EBP has been shown to be effective in creating an organizational culture for EBP (Wallen et al., 2010).

This project evaluates the impact of providing a structured step-by-step EBP curriculum to new graduate nurses during their Nurse Residency Program (NRP) as a vehicle for translating new knowledge into practice and promoting a culture of clinical inquiry.

Using the Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines (Newhouse, Dearholt, Poe, Pugh & White, 2007), a structured curriculum was devised to assist the Nurse Resident to develop and implement an EBP project in their practice setting. The prescribed step-by-step curriculum provides preparation for translating evidence into practice, development as change agents, and leaders of innovative practice.

Roger’s Diffusion of Innovations Theory (1962) provided the framework for adoption of EBP.  Nurse Residents acquire the knowledge and skills necessary for early adoption of EBP. Engagement occurs through project implementation while successful completion reinforces the innovation of EBP. Confirmation is achieved, resulting in self-efficacy and continued adoption of EBP innovations.

Evaluation included successful implementation of unit-based EBP projects by Nurse Residents, exploration of impact of the projects on identified organizational metrics, and the examination of processes supporting clinical inquiry.

Since 2009, the program has facilitated over 80 projects resulting in measureable improvements to organizationally focused metrics.  Fifteen projects resulted in policy changes.  Roger’s theory provides an effective framework for continued adoption of EBP.