Inculcating Evidence-Based Practice in a Facility

Friday, 20 July 2018

Anne Burnett, DNP
Veterans Health Care System of the Ozarks, Fayetteville, AR, USA
Raquel K. Alvarado, DNP, RN, NE-BC
Veterans Health Care System of the Ozarks/Veterans Health Administration, Fayetteville, AR, USA

Evidence-Based Practice (EBP) is the current, best method, for direct care staff to use translating research into practice (Correa-de-Araujo, 2016; Hain & Kear, 2015; Ingham-Broomfield, 2015; Melnyk & Fineout-Overholt, 2015; Schuette, 2015). There have been multiple studies into the barriers staff face using EBP. These barriers include time, resources, leadership buy in, skills with data base searches, and motivation. Some of them are relatively easy to overcome such as access to research in a system with computer and internet access.

The questionnaire results will be used to expand existing tutorials and develop material to target the staff’s stated needs for EBP implementation tools. The final outcomes will be assessed with a repeat questionnaire and a simple count of how many direct care staff submit abstracts and participate in professional conferences compared to the current participants.

This project is about using research to develop an action plan to overcome the barriers of ‘lack of knowledge about the process’ and ‘lack of support implementing practice change’. Both these barriers are rooted in the current nursing administration demographic. In other words, nurses whose academic degree was prior to required core curricula began including EBP in the coursework, are more likely to be in administrative positions now or senior nurses in direct care positions. These nurses help shape the next (two) generations of nurses through example and leadership. The premise is, if the senior nurses in a facility do not use or encourage EBP, then the newer nurses who had the courses will not use it. There is also a paradox for the newer graduates having these advanced skills using research while their unit level preceptors, who have advanced clinical skills, may not. The project is being developed by two DNP graduates, one of the Nurse Managers, and the EBP Chair at the facility using multiple resources available.

PICOT: Will an educational initiative to develop and increase direct-care nurses’ knowledge and attitudes about evidence-based practice (EBP) result in increased participation in EBP activities?

The first step for the project, after Institution Review Board (IRB) approval, is using an anonymous, voluntary questionnaire (Survey Monkey) for the staff to self-assess the barriers. The second step is expanding an existing EBP Preceptor development course from 30-minute lunch and learn sessions to four weeks, two-hour sessions. The target first group is current nurse managers and second group, senior staff nurses. These nurses are currently in positions of authority on the units and should be the key drivers for EBP development.

The preceptor development program is a brief, targeted tutorial introducing the attendees to the resources available at the facility and a review of the basics of EBP as a care improvement methodology.