Implementing Evidence-Based Practice and Nursing Research in the Community Hospital Setting: Barriers and Outcomes

Friday, 11 July 2008: 9:10 AM
Kathleen M. White, PhD, RN, CNAA, BC , Graduate Instruction, The Johns Hopkins University School of Nursing, Baltimore, MD
Jane Shivnan, MScN, RN, AOCN , The Insitute for Johns Hopkins Nursing, Baltimore, MD

Learning Objective 1: The learner will be able to describe the implementation of evidence-based practice and research in a community hopsital setting using a nurse researcher model.

Learning Objective 2: The learner will be able to identify measurable outcomes for successful implementation of evidence-based practice.

Purpose: Evidence-based practice and nursing research are thought to take place in university schools of nursing and large academic medical centers. And yet, many community hospitals are building infrastructures to provide the resources to make these activities possible. The purpose of this paper is to describe the process to promote the use of evidence-based practice in community hospital settings.

Theoretical Framework: The Johns Hopkins Nursing Evidence-based Practice Model and Guidelines have been adopted by several community hospitals in different geographic locations. Use of the model in two locations will be described.

Methods: Building an infrastructure for EBP and nursing research must be approached with planning in the community hospital setting. The two community hospitals have used specific processes and encoutered different barriers to timplementation. Methods to encourage the use of "best practices" have included: inservice education in the form of workshops and other more specific classes, inclusion in orientation, mentored projects, journal clubs; facilitation with the IRB process; inclusion of EBP in procedures and policies; competencies for clinical nurses at all levels; and resources to support these activities.

Results: The community hospitals have demonstrated increased EBP project involvement. Nursing researchers have been hired part time or as consultants to support these activities. EBP and research have been disseminated by nurses at each of the hospitals.

Conclusions and Implications: EBP adds to the culture of critical thinking & ongoing learning for nurse clinicians. The hospitals are growing an environment where evidence supports clinical and administrative decisions, and building a community of scholarship.