Creating an Organizational Infrastructure as a Solid Foundation to Support EBP

Excellence through EBP begins with senior leadership creating a culture that transforms evidence into action through inspired nurses caring for patients and families. The vision for EBP must be outlined in an institution’s mission, vision, and strategic plan. The relevance and importance must be visible, internally and externally, to achieve safe, high-quality patient- and family-centered care. Iowa’s journey began in the 1980s with the first EBP project focused on improving pain management that predated The Joint Commission’s regulatory standard. In 1989, a collaboration between visionary nurse leaders at the University of Iowa Hospitals and Clinics and the University of Iowa College of Nursing formalized joint sponsorship of an office to support research and EBP innovation while addressing patient needs. The Iowa Model of Evidence-Based Practice to Promote Quality Care was a groundbreaking early innovation that continues to guide EBP processes across the world. The chief nursing officer (CNO) strategically invested in EBP in order to demonstrate a clear impact through improved quality health care, staff development, and dissemination to the global nursing community. The CNO supported nurse leaders to provide EBP mentoring, programs, and resources for nurses and interdisciplinary teams. Shared governance and its structure were promoted with each committee having functional responsibilities supporting EBP. EBP projects and outcomes were, and continue to be, consistently reported within departmental, divisional, and unit committees. Consistent reporting supports coordination, identification of additional clinical issues, project progress, problem-solving, spread of EBP, and recognition of staff nurses and teams. This reporting was recognized as important, not only internally but externally as well, to create a venue for sharing and learning with clinicians across the world. In 1994, the first National EBP Conference provided an opportunity to learn about leading-edge EBP topics from national leaders and nurse-led practice changes and to engage in active networking. Important lessons learned in these formative years for creating an EBP culture will be presented including use of a multi-phased plan, the right infrastructure, and an organizational systems approach; including nurses from all roles, the interdisciplinary team, and key stakeholders; evaluating work for continuous improvement, demonstrating a return on investment, and watching for new opportunities; and to always mentor clinicians.