Administration and Policy Considerations in Implementing EBP
Cheryl Riley-Doucet, PhD, RN, Nursing, Oakland University, Rochester, MI, USA
Administrative support is well known as an essential component in the implementation process of EBP (Pettengill, Gillies, Clark, 1994). The Stetler Model (1992, 1995) will be the framework for discussing issues such as: establishing a new culture of EBP; creating educational opportunities for organizational members, and sustaining that shift through ongoing formative evaluation and revisions in the system infrastructure. Following an extensive review of literature on barriers to translating evidence into practice, Berenholtz and Pronovost (2003) demonstrated how teamwork, redundancy and reducing the complexity could be applied to improve implementation of desired recommendations for practice. They emphasized the importance of the role of leadership to influence desired changes in practice. One unique way to influence change in practice while incorporating the principles of evidence-based practice is through the Research Utilization Model first proposed by Stetler and Maram (1976) and refined by Stetler (1994). The Research Utilization Model used in practice by Stetler (2001) is a practitioner-oriented and specifically focuses attention on application of research findings to routine clinical practice. The six phases of Stetler’s (2001) Research Utilization Model (Preparation, Validation, Comparative evaluation, Decision-making, Translation/Application and Evaluation) will serve as a guide for implementation of evidence-based practice initiatives. Stetler (2001) points out that organizational change is an additional aspect of the translation/application phase of the RU Model. We propose use of the Stetler Model as a way to reinforce the desired changes through the development of routine organizational structures, systems, and processes that will reinforce and support the desired behaviors on an ongoing basis (Stetler, et al., 1998). It is important to use specific strategies that will encourage implementation of research-based recommendations and ensure changes in practice.