Leading the EBP Transformation in a Large Academic Medical Setting; Creating a Sustainable EBP Infrastructure

Nursing Research demonstrates the effectiveness of evidence based practice to inform nursing practice.  Utilizing evidence based practice is linked to cost effective quality healthcare outcomes.  Challenges however, exist in implementing and sustaining evidence based practice changes in hospital settings.  It has been noted that the use of EBP by frontline staff nurses “leaves considerable room for improvement” (Parahoo, 2000). One barrier to staff nurse lack of involvement in EBP includes lack of expertise and time. Clinical Nurse Specialists have unique expertise in facilitating clinical practice changes through their knowledge of quality indicators and best practice initiatives.  In a large academic medical center, the clinical nurse specialists were centralized under the Director of health system nursing quality. The team agreed that evidence based practice needed to become a prominent piece of their job.  Each Clinical Nurse Specialist attended a 5-day EBP immersion program in either September or December, 2012.  The EBP immersion program provided the team the tools and skills necessary to develop a PICOT question, search and synthesize the evidence, and develop and implement the best practice initiative on their units.  As a result of the EBP immersion, a large cadre of EBP mentors were developed for the organization.  As EBP mentors, the CNS will have a unique ability to impact quality at both the unit and medical center level.