The pilot program was designed to empower frontline nurses to function as change agents applying evidence-based care in daily practice; expand infrastructure support for nurses serving as change agents; and foster professional growth through exemplary professional practice. The Office of Nursing Research and EBP partnered with the clinical nursing directors to identify emerging frontline nurse leaders to participate in the program and select a priority topic from the list provided. Throughout and after the program, the frontline nurse collaborated with their nurse manager and a nurse leader.
Pre-requisite readings and an online EBP module were completed by the frontline nurse-nurse leader pairs. The partners attended a 1-day training program and hands-on workshop covering change theory, application of implementation science, change agent role, key evidence for their selected topic, and development of an action plan (Dogherty et al., 2014; Iowa Model Collaborative, 2017).
The EBP Change Champion role is multifaceted and includes: assist with adapting practice recommendations; tailor implementation plan to fit the local setting; share knowledge, rationale, and resources with peers; train, demonstrate, use, and role model the practice change; provide just-in-time encouragement and troubleshoot problems at the point-of-care; provide continuous feedback to frontline nurses; engage and update leaders to work through issues; collaborate with interprofessional team members; and make changes in the documentation system to support EBP (Abdullah et al., 2014; Cullen & Adams, 2012; Cullen et al., 2018; Fleuren, van Dommelen, & Dunnink, 2015; Hauck, Winsett, & Kuric, 2013; Kaasalainen et al., 2015).
Twenty-one frontline nurse-nurse leader pairs participated in the program. Immediate post-program evaluation results (1-4 Likert scale; 1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree) demonstrated participants found benefits of the program; program materials were useful (mean 3.5), prepared them to be an EBP Change Champion (3.4), understand implementation strategies to use to implement and sustain change (3.4), sufficient topic information provided to develop an implementation plan (3.6), and stimulated innovative thinking (3.6).
Partners chose one of two follow-up sessions to attend at 1-2 months post-program. Thirty-two participants reported on their change champion role, topic, assistance needed, and implementation strategies used to date. Common themes regarding the change champion role included the need to: connect with nurse manager to plan non-patient care time, identify early adopters, collect baseline data, and recruit others to participate. Review available evidence and observe clinicians to determine current practice were the top two topic-related themes. Some of the post-program assistance needed was to secure access to data, find policies/procedures/protocols, and have an additional follow-up meeting in a few months as a whole group. Finally, the reported implementation strategies used crossed all four phases, create awareness and interest, build knowledge and commitment, promote action and adoption, and pursue integration and sustained use, of the Implementation Strategies for Evidence-Based Practice (Cullen & Adams, 2012; Cullen et al., 2018). Dedicated work time and unit follow-up promoted these change champion activities.
Patients and families benefit when nurses lead EBP improvements in collaborative teams to improve outcomes. This EBP Change Champions pilot program provided an innovative approach to support nurse-led EBP improvements. Formal training is one of the key elements in a comprehensive EBP program to facilitate nurse-led EBP across the care continuum.
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