Paper
Thursday, July 12, 2007
Using a "Learn-Reflect-Apply-Sponsor" Model to Support EBN Implementation
Janet Houser, PhD, RN, Health Services Administration and Management, Regis University, Denver, CO, USA, Christine A. Sorensen, RN, MSN, CCRN, Education, Presbyterian/St. Luke's Medical Center, Denver, CO, USA, and Karen R. Dawson, MSN, RN, Medical Specialty Services, Poudre Valley Hospital, Fort Collins, CO, USA.
| Learning Objective #1: Describe the use of a model based on reflective learning and mentoring to implement EBN |
| Learning Objective #2: Discuss the advantages of an academic/practice collaboration in supporting implementation of the Learn-Reflect-Use-Sponsor model for EBN |
Implementation of evidence-based nursing (EBN) requires education for staff that focuses on identifying, appraising, and/or creating research. Although education may stimulate enthusiasm, long-term commitment to EBN requires more than a single strategy. Success is dependent upon nurses having sufficient time to reflect on the research process. Nurses also need access to nurse scientist consultants and internal systems for the mentorship of bedside scientists. This case study reports the experience of two hospitals that used an academic/practice collaboration to apply a Learn-Reflect-Apply-Sponsor model of EBN implementation. The first stage involves in-depth education for key EBN champions in research appraisal skills, design of bedside science projects, and systematic review processes. Many organizations expect that learning will automatically result in implementation, but staff need time to internalize the experience and identify personal opportunities for EBN involvement. This reflection period also requires an evaluation of organizational processes that support or constrain EBN. Next, key staff apply the principles to a project designed collaboratively. This involves planning a study, guiding a systematic review, and creating an internal resource manual. The manual includes easy to use tools for appraising research, creating a practice guideline, and advising others in the selection and design of a bedside science project. Through monthly meetings with a nurse scientist, the nurses learn to design a research study in a “safe” setting. EBN nurse champions in turn sponsor projects and mentor bedside sciences. This facilitation process enables the organization to reach a critical mass of nurses with the requisite skills and enthusiasm to support EBN for the long term. Nurses from organizations at differing stages of the process provide their perspective on the approach to implementation. The primary requisites for success include leadership support and patience, as full implementation of EBN processes and initiation of projects may take up to 3 years.