The first element is evidence, constituting sources of knowledge obtained from various resources. When assessing the evidence, factors to be assessed include research, clinical experience, patient experience, and local data. The second element is context , which refers to the characteristics of the setting in which PARiHS is implemented. Under context, the culture of the setting, leadership’s role, and how services are evaluated are examined. The third element is facilitation . Facilitation is described as a way to help people change and acquire new knowledge and skills. Facilitators must understand their roles and purpose and have the necessary skills and attributes. In summary, there are numerous models and frameworks for EBP. Organizations should choose one that best fits their respective philosophies, priorities, and goals. Successful implementation of EBP in nursing requires enthusiasm, commitment, and skill. Continuing education endeavors should include updates on EBP and how it impacts patient care and job performance. EBP impact on patient care and job performance EBP is essential to the enhancement of quality and safety in healthcare. Without EBP, healthcare professionals do not implement patient care consistently. They are at risk for variations in care that could negatively impact patient outcomes (Kerr & Rainey, 2021). Unfortunately, healthcare organizations across the United States continue to struggle with applying EBP. Organizational factors such as lack of time to find, appraise, implement, and evaluate evidence are key barriers to the EBP process, along with nurses lacking the authority to change care procedures in practice. Nurses in the clinical environment use organizational policies and protocols to guide best practices and tend to do it the way it was always done. Many nurses find it challenging to interpret research findings because of the jargon used in the statistical presentation of research results (Kerr & Rainey, 2021). Experts suggest that to focus on EBP, organizations must take the following steps (Melnyk & Fineout-Overholt, 2019): ● Develop the right organizational culture. ● Provide continuing education regarding EBP. ● Encourage nurses to take the lead in EBP, promote the professional nursing practice, and focus on EBP. ● Adopt EBP models and frameworks. ● Promote an interprofessional approach. The right organizational culture The “right” culture identifies EBP as an organizational imperative. Organizational leadership must identify EBP as a top priority and provide the resources to educate all staff members in its implementation. Implementation of EBP should be part of employees’ performance evaluations (Henry et al., 2017). Ideally, EBP in nursing is a patient-centered, holistic approach to patient care. The organizational culture must support nurses’ and other healthcare professionals’ ability to utilize research to close the gap between theory and clinical practice. Effective implementation of EBP has been shown to decrease errors, injuries, and adverse patient outcomes (Melnyk & Fineout- Overholt, 2019). Provide continuing education regarding EBP Nurses make up the largest workforce in the US healthcare system. They practice in all types of healthcare settings, and nursing provides 24 hours per day patient care in inpatient and outpatient settings. Implementation of EBP relies on their ability and willingness to establish EBP environments. A gap exists between education and practice. As part of undergraduate education, nursing students are exposed to EBP and taught that EBP is necessary for safe, quality patient care and job performance. After graduation, as they become part of the “real world” of licensed nursing practice, newly licensed nurses must deal with the culture of the organizations that employ them. Some cultures embrace EBP; others do not. Nurses must be competent in the implementation of EBP to promote its implementation. Such competency cannot be
Self-Assessment Quiz Question #3 The EBP model that focuses on problem-focused and knowledge-focused triggers to question nursing practice is: a. Johns Hopkins Nursing Evidence-Based Practice model. b. The Iowa Model of Evidence-Based Practice. c. The Stetler model. d. The Star Model of Knowledge Transformation. Self-Assessment Quiz Question #4 As part of the implementation of EBP, the nursing department is assigning mentors to help nurses develop EBP skills. The model that overtly emphasizes the importance of mentors is: a. ARCC. b. PARiHS. c. CStar Model of Knowledge Transformation. d. The Iowa Model. achieved and maintained without ongoing continuing education (Li et al., 2021). Covid-19 has undoubtedly changed many aspects of nursing care and practice. Nurses do not practice by the same standards they did 15 years ago or even 3 years ago, in some instances (Duncan et al., 2021). Continuing education provides nurses with up-to-date information to apply to their practices to improve patient outcomes and professional job performance. Demonstration of competency has been part of nursing performance evaluations for several years. Competency in EBP should be part of the job performance evaluation for all healthcare professionals. Competency cannot be attained without education, and education will not be effective unless nurses genuinely want to learn about and support EBP (Fu et al., 2020). Any EBP competency must be aligned with the EBP process and be part of the ongoing evaluation of the nurse’s job performance evaluation. The ultimate goal of EBP continuing education is to ensure that EBP is the standard of care delivered by healthcare professionals across the country and around the world (Melnyk & Fineout-Overholt, 2019). EBP and professional nursing practice As previously noted, nurses comprise the largest workforce in healthcare practice in the United States. Nurses should thus take the lead in promoting and implementing EBP (Melnyk & Fineout- Overholt, 2019). The National Academies of Sciences, Engineering, and Medicine (the National Academies)—formerly known as the Institute of Medicine (IOM)—has consistently called on nurses to take on a more significant role in America’s healthcare system (Wolters Kluwer, 2018). In 2008, The Robert Wood Johnson Foundation (RWJF) and the National Academies launched a 2-year initiative to assess and facilitate the transformation of the nursing profession. The initiative has four key points (Wolters Kluwer, 2018): ● Nurses should practice to the full extent of their education and training. ● Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. ● Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States. ● Effective workforce planning and policymaking require better data collection and information infrastructure. These goals correlate with the EBP initiatives. By using the scientific inquiry that forms the foundation of EBP, nurses can and should take leadership roles not only in EBP, but also in all aspects of the country’s healthcare delivery systems.
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Book Code: AUS3024
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