Leading EBP into the Future: Horizon Scanning and Innovation

Friday, 24 July 2015: 4:10 PM

Kirsten Hanrahan, DNP, MA, BSN, ARNP, CPNP-PC
Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA

Through horizon scanning and innovation, the journey to excellence takes EBP into the future. Nurses’ roles supporting EBP have continued to expand in recent years. Staff nurses function as change agents, serve as clinical experts applying EBP, and represent all clinical areas on shared governance committees. Committee members make EBP actionable in patient care, bring clinical issues forward, help find resolutions, and actively share information bidirectionally between clinical area colleagues and committee members. Building on Bandura’s theory of self-efficacy, a tool to measure nurses’ confidence (self-efficacy) associated with EBP and execution of EBP was developed, the EBP Self-Efficacy Scale. This tool is used to target EBP education and training. Additional tools and resources, used internally and externally, have been developed to increase EBP self-efficacy and EBP skills. Implementation science has been used to guide development of a model specifically addressing the implementation step and a guidebook for the EBP process to direct teamwork toward sustained EBP improvements. EBP resource booklets that distill key information to the essential elements for busy nurse leaders to use “on the go” have also been developed. Concurrent to creating an EBP culture, time and attention have been focused on creating EBP resources to ensure safe and healthy working conditions for nurses. One resulting EBP initiative was development of a practical and innovative program to support nurse adoption of evidence-based physical activity strategies and mindfulness through simple three minute follow-along video segments readily accessed through the institution’s intranet. Sustaining an EBP culture requires a multifaceted approach with ongoing support to question practice, obtain resources and expertise to find the answer, use effective strategies when implementing a practice change, communicate practice updates at the unit level or across the system, and demonstrate an impact that is meaningful to patients, families, staff, and the organization. Staff members are supported to implement EBP through training, mentoring and resources and through EBP that focuses on promoting quality care and safe, healthy work environments. Successes are celebrated in high profile forums valued by clinicians, colleagues, and senior leaders as each success sets a high bar for excellence to follow and supports continued innovation. As always with innovation and change, the next phase of the journey will involve looking for challenges just beyond the horizon and focusing concerted efforts on improving the patient experience, their self-care, and health promotion.