DQ 1

Comment 1

An internal method for dissemination of my EBP project results would be scheduling a short meeting with nurse managers of the unit to discuss the findings through questionnaires and interviews. External may be to schedule meeting which includes the nurse managers and staffing personnel. The importance of including all these persons in one meeting would be to provide a connect with the data and information that is discussed daily with regard to staffing and the hiring of nurses to fill vacant positions. Providing visual displays of the research that provides a clear picture showing the impact of nurse turnover and the orientation process. This meeting would be a platform for discussion and information that involves staffing, hiring and retention of staff and the impact on the unit/facility. According to  the  Agency for Healthcare Research and Quality (AHRQ) (2014),  all dissemination should have a purpose and promote the project development. This can be accomplished by raising awareness, informing and educating, engaging and involving, and promotion of the results.

Staffing levels and nurse retention is in the news daily and involving the community in discussions would offer clarification. Yes, the community is aware of the shortage, but do they know what avenues of change are taking place in the facility that hopefully will affect their healthcare now and in the future.

Strategies of communication for each group focuses on the delivery of information. Internal information transfer is effective through conversation and visual evidence. External needs to be concise and factful with a clear plan of implementation that is also visual. Time constraints for both groups is evident so many short meetings for the internal dissemination would benefit both staff and the managers/leaders of the nursing unit. The external group would also have time limitations so being concise and thorough with a limited time frame is a challenge.

Comment 2

An important part in delivering “high-quality patient care is nursing implementation of evidence-based practice (EBP); institutional leadership, such as nurse managers (NMs), plays an integral role in the implementation of EBP on nursing units” (Kueny, Shever, Lehan, & Titler, 2015, p.1). Thus, one internal method would be meeting with the NM of the unit to discuss my research findings regarding the implementation of acuity based tools specific for the unit to adjust staffing appropriately to improve patient outcomes, improve quality of care and decrease nurse burnout. Addressing the importance of measuring acuity, provide different tools that measure acuity and how to implement the use of these tools with proper education and directions. NMs are an important part of driving change, they can lead EBP projects, provide resources and educational activities to promote change and schedule workshops to assist nurses with the changes.  According to Kueny et. al (2015), “NMs have the potential to remove some of the autonomy in decision making for EBP recommendations” (p. 37). NM’s can help with culture of expectations, empowering their nurses to implement EBP to improve patient outcomes and improve nurse burnout.

An external method would be contacting a professional nursing organization, such as the American Psychiatric Nurses Association (APNA). Contacting the APNA via the internet would provide me with feedback on the next steps I need to take. Becoming a member of APNA or joining a committee, would allow me to take action addressing the importance of using acuity based tools in measuring safe staffing levels to improve patient outcomes and improve quality care. There is a lack of studies or research regarding staffing inpatient geriatric psychiatric units. The APNA (2015), encourages nurse researchers to study both populations, in order to establish specific nurse-to-patient ratios for inpatient psychiatric units and to foster the development of innovative, effective, recovery-oriented and safe-staffing models. Thus, it would be beneficial to address these populations, providing evidence that implementation of acuity based tools for safe staffing levels has improved patient outcomes.

Strategies for communication would be different for internal methods versus external methods. Internal methods require a more personal approach, addressing the problem, reviewing evidence for solutions to the problem with the NM, outlining the project, asking for feedback, projected costs involved to implement EBP, time constraints, and required nursing education on implementing acuity based tools for the unit. Promoting nursing feedback and shared governance in the decision making process and areas that need to be addressed in regards to safe staffing and equitable nurse workloads. External methods require a less formal approach, writing to APNA, would require addressing the problem, providing a solution with evidence based research, evaluating nursing practice, quality of care, improving nurse’s mental health, minimizing nurse burnout, reducing health care cost, and improving patient outcomes.

DQ 2

Comment 1

An important challenge to any evidence-based practice project evaluation is whether it was effective. I came across an article discussing the use of a premortem plan to identify outcomes and their success. In the healthcare arena we have all heard of postmortems where we discuss what happens after a sentinel event or adverse patient outcome. A premortem addresses the anticipated failures of the project before implementation. By doing this we can develop strategies that would aid in successful implementation according to Ginex (2018).

Since my project relates to staff retention and turnover on the night shift, seeing staff be successful using mentor/mentee programs after the original orientation period would offer proof the program change is working. Evaluating the cost of orientation and the cost of loosing qualified staff due to inadequate or ineffective orientation would also provide positive feedback and data. Follow up interviews with staff who have left or changed shifts would offer information related to differences in shift orientations. Also, the number of staff participating in mentor/mentee program would show the level of acceptance and commitment to the project change.

Comment 2

One way that I would evaluate whether my project made a difference in practice would be to implement some of my findings, such as talking with the DON and supervisor of my facility about scheduling equal nurse-to-patient ratios. I currently work on a sub-acute unit of my facility and there are about 6 patients that have pressure ulcers and all of them are at risk for pressure ulcer development. I have worked at the facility for a year and some pressure ulcers have developed while those residents were in the facility. All of the resident require total care and to ensure that they are changed and turned in a timely manner, there must be an appropriate staff-to-patient ratio. This means that each nurse should not have more than 7 patients because, they also only have on CNA. Each CNA has up to 14 patients, so they heavily rely on the assistance of the nurses. If the nurses feel overworked, then it shows in their patient care and the residents are at more risk for pressure ulcer development. According to Hartmann, Mills, Pimentel, Palmer, Allen, Zhao, and Snow (2018), positive interactions between the staff and patients contributes to better quality care and better patient outcomes.

I would also talk with the wound care nurse, DON, and supervisor to provide in-services to teach the staff how to implement the wound care orders properly. The wound care nurse only works from 0800-1630 and although he tries to change the dressings every day, the orders also include changing the dressing PRN if they become soiled. Many of the wounds are located on the sacrum region. All of the residents are incontinent of bowel and bladder and require total care. Orders constantly change depending on the status of the wound and there have been times when the dressing gets soiled and requires changing. I often work the even shift and there are times where I do not see the wound care nurse. I and my coworkers that work the evening and night shift have needed to change the dressing based on the order in the MAR. there have been times in which the directions of the order were unclear and/or we did not have the correct supplies. The wound care nurse only works during the week, so if we do run out of supplies, we do not have access to the storage unit that has them or the facility has run out. When there is a change in an order, it would be very helpful if the wound care nurse holds in-services to show the nurses how to perform the dressing change and make sure that at least half of the nurses from the evening and night shift know how to change it as well, so they can help their co-workers if needed. Knowing how to properly change the dressings improves wound healing and prevent worsening of the wound.

 

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I put 4 comment here because in this class the teacher ask for (4 comments only) no 6 as in the previous class. You can write 75 words in each and if you know about the theme or comment and you have substantive answer like your own comment you can write without references. Thanks.

Comment 1

Six articles that I have chosen to summarize for my research include the following:

1. Establishing a Nurse Mentor Program to Improve Nurse Satisfaction and Intent to Stay. This article used Benner’s novice to expert theory as a tool to develop a nurse mentor program in an Emergency Department.  The Benner Theory is focused on five levels of expertise five levels of proficiency: * novice * advanced beginner * competent * proficient * expert and the process nurses use to mature in the nursing profession. The nurses volunteered feedback about their experience in the nurse mentor program (Jones, 2016).
2. Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. This paper summarizes and reviews the strategies that support retention of nurses through creation and enhancement of positive work environments in the clinical setting (Twigg, D., & McCullough, K., 2014).
3. 2018 National Health Care Retention & RN Staffing Report . This article looks at the value hospitals put on their staff and the correlation to commitment, confidence, and engagement. Hospitals believe that retention is a key strategy and the focusing of enhancing the culture that supports this belief (Colosi, B., March 2018).
4. The impact of nurse residency programs in the United States on improving retention and satisfaction of new nurse hires: An evidence-based literature review.      A focus on entry level newly graduated nurses and the work conditions that may affect retention and satisfaction with job. This literature is aimed at the use of a one-year nurse residency program compared to the traditional orientation and its effects on turnover rates (Eckerson, C. M., 2018).
5. Factors related to the intention to leave and the decision to resign among newly graduated nurses: A complete survey in a selected prefecture in Japan  This study looks at the factors related to intention to leave and the decision to quit among newly graduated nurses (Tei-Tominaga, M., 2012).
6. An Evidence-Based Protocol for Nurse Retention  This article focuses on nurse leaders and the positive relationship and the effects on employee retention and satisfaction (Gess, E., Manojlovich, M., & Warner, S., 2008).

Strengths related to using these articles for research are that they all portray relevant information regarding the retention of newly hired nurses and data related to staff retention. The information received from participants would be confidential, so views could be given free from judgement or fear of retaliation.

Weakness may be related to the amount of information specific to night shift retention. A Potential weakness may be finding willing participants to collect enough data to form a conclusion.

Comment 2

Chen, Y. Y., Chi, M. M., Chen, Y. C., Chan, Y. J., Chou, S. S., & Wang, F. D. (2013). Using a criteria-based reminder to reduce the use of indwelling urinary catheters and decrease urinary tract infections. American Journal of Critical Care, 22(2), 105-114.
The article intends to reveal criteria based reminders are useful in the diagnosis and cure of urinary tract infections.
Strength: This article is only focused on urinary catheters and discusses every minute detail
Weakness: It does not mention other vital methods for prevention
Clarke, K., Tong, D., Pan, Y., Easley, K. A., Norrick, B., Ko, C. … & Stein, J. (2013). Reduction in catheter-associated urinary tract infections by bundling interventions. International journal for quality in health care, 25(1), 43-49. DOI: http://dx.doi.org/10.1093/intqhc/mzs077
            The author here proposed interventions to prevent urinary tract infections.
Strength: the author has not lengthened the article despite proposing several things
Weakness: Without any substantial comparison, an author has regarded one intervention as best of all others
Gould, C. V., Umscheid, C. A., Agarwal, R. K., Kuntz, G., & Pegues, D. A. (2010). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control & Hospital Epidemiology, 31(04), 319-326.
 
This article is based on the prevention types for catheter-associated urinary tract infections
Strength: It describes all reasons which may lead to the development of infection
Weakness: it does not figure out ways in which this infection may get severe
Hebden, J. N. (2014). Nurse-directed catheter removal protocols to prevent catheter-associated urinary tract infection: Strategies for implementation. American journal of infection control, 42(6), 670
The article provides deep insights into how individuals can benefit from nurse-directed catheter removal protocol
Strength: It helps gain insights into types of urinary tract infections that patient can encounter
Weakness: it does not declare a suggested method to be an effective one
Magers, T. L. (2013): Using evidence-based practice to reduce catheter-associated urinary tract infections. AJN The American Journal of Nursing, 113(6), 34-42.
            The author has mentioned real life and practices to reduce catheter-associated urinary tract infections
Strength: The author motivates its prevention
Weakness: substantially, no prevention methodologies are mentioned
Parry, M. F., Grant, B., & Sestovic, M. (2013). Successful reduction in catheter-associated urinary tract infections: focus on nurse-directed catheter removal. American journal of infection control, 41(12), 1178-1181.
            In this article, Author has discussed and tried to measure the role of a nurse in catheter removal
Strength: the charts and diagrams presented are viable for understanding pain units
Weakness: It has less practical implication due to the non-addition of any possible solution

Comment 3 3DQ2

Two methods for evaluating evidence would be Randomized Controlled Trials and Observation research. The Observational research such as surveys and qualitative studies can be a platform for informing practice. This type or research measures but does not control the variables. Randomized studies between control groups is random (Reinhardt, 2010). This design is the random assignment of study participants to either a group that receives the treatment being studied (the “treatment group”) or a group that does not receive the treatment (the “control group”).

We may also need to determine whether the article supplies Qualitative vs Quantitative information. Depending on what type of data is required to defend the hypothesis.

Quantitative – Quantitative research is measurable and uses data and statistics to form basis for hypothesis (Grove, Gray, and Burns, 2015).

Qualitative- “Qualitative research is a systematic approach used to describe experiences and situations from the perspective of the person in the situation. The researcher analyzes the words of the participant, finds meaning in the words, and provides a description of the experience that promotes deeper understanding of the experience” (Grove, Gray, and Burns, 2015).  This type of research is based on perception and emotions.

Comment 4

For the evaluation of evidence, the use of quantitative and qualitative methods is the ones on which a medical practitioner can rely. In qualitative methods, use of literature is made along with previous studies to provide viable arguments. Comparatively quantitative methods are wise enough to generate data and compare statistics and then coin any particular verdict to the evidence. One cannot say that one is superior over others as both come with pros and cons. Qualitative methods often make use of interviews and often believes in professional advice for generating the result. They do not go into any in-depth study to find out if opinions are valid or error-free. Quantitative method is known for conducting data and experiments and processing the data while correlating them to reach a possible solution (Creswell, 2007). Hence regarding medical aspects, quantitative data is more appropriate to rely on than qualitative analysis. Qualitative methods, however, is essential for increasing knowledge about any aspect. Though for proper evaluation and for proving a point, the need of quantitative analysis has reached to a higher point, without numerical data, it is not wise to make health care related decisions as it directly affects a life.
Evaluating different evidence methods: There are several methods of evaluating evidence methods are present, but the two most common methods of evaluating evidence are Meta-Analyses and Systematic Reviews. These two methods can help in the determination of the relevance and validity of the evidence. During the evaluating evidence both these systematic reviews and meta-analyses methods as well as similar and different.
Similarities:
Both the Systematic Reviews and Meta-Analyses are considered the highest quality of evidence for clinical decision making and can be used above all the other methods of evaluating evidence.
Both the methods for evaluating evidence are similar because they involve the collection of data from different sources and summarizing all the evidence and results of the studies.
Differences:
While systematic review collects and summarizes all the empirical evidence, the meta-analysis uses statistical methods to summarize the results of the studies.
Second, Meta-analysis is a statistical method used to combine the numerical results from such studies, if it is possible to do. On the other hand, a systematic review is a formal, systematic and structured approach to review all the relevant literature on a topic.
Third, the rationale for Meta-analysis is that through the combination of samples from different studies the overall sample size is increased, while the rationale for systematic reviews is that when data is pooled together from different sources, greater reliability would be obtained.
Creswell, J. W., & Plano Clark, V. L. (2007). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage
Melnyk BM, Fineout- Overholt E, Mays MZ. The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews Evid Based Nurs. 2008;5(4):208-216.

 

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Comment 1

Diane Black is a register nurse who represents Tennessee in Congress.  Mrs. Black was the first woman to chair the influential House Budget Committee. She serves on the House Ways and Means Committee and was quick to establish herself as a leader.  She is focused on dismantling the president’s health care law and advancing true market-based, patient-centered reforms that will bring down the rising cost of care by increasing private sector competition and consumer choice.Her goal was to reform the U.S. tax code which has not been initiated in over twenty five years. She was selected to chair the Ways and Means Education and Family Benefits Tax Reform Working Group during the 113th Congress.  During her career as a nurse, she saw a loophole in the Patient Protection and Affordable Act (PPACA)that allowed some higher paid middle class Americans to receive Medicaid benefits. She pointed out that the PPACA, unintentionally, would allow a couple who made close to $60,000 in income to qualify to receive Medicaid benefits. This loophole would allow for individuals whose incomes were up four hundred percent of the federal poverty level to also qualify to receive Medicaid benefits. The PPACA set a new income formula to calculate the income levels and make the determination for Medicaid eligibility. This formula did not include incomes received from all Social Security benefits including Supplemental Security Income, Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance to Needy Families, and public housing.  After her election to Tennessee representative, Mrs. Black started lobbying to change the bill H.R 2576. She made her claim that Medicaid should only be used for those who are in the most need and Medicaid needed to get back in line with all other public assistance. Mrs. Black made her claim to Congress that by passing her bill that America would save $13 billion dollars over ten years. She made it clear that they would be saving this money without taking away any benefits from anyone who currently has Medicaid. Mrs. Black’s bill was passed and signed into law. She was the first member of Congress to have legislation signed into law that repeals the health care provision in Obamacare.

Comment 2

Congresswoman Mrs. Deb Soholt is some of the current nurses who are currently serving in Congress. Mrs. Deb Soholt is an RN and also a senator in South Dakota (American Nurses Association, 2015). She is a Senate for South Dacota congressional District 14 before joining politics.
She had sponsored several bills that have influenced health care. For example, “the Senate Bill 61 is to update, revise, and repeal certain provisions relating to nurse practitioners and nurse midwives” (South Dakota Legislature, n.d.). The bill can help redefine the role and function of nurse practitioners and nurse midwives to change the health care delivery and resolve the health provider shortage. Health care can be more accessible and affordable.
The nurse role gives the legislators the ability to understand and recognize nursing and health care issues. Therefore, the legislators who are also nurses can use the political power to alter and guide the direction of health care delivery in an optimal way. Health policies at the state level impact the health and safety of the state’s residents, as well as lead the nursing and other health professions’ scope, practice, and performance through the state’s professional practice acts (Cherry & Jacob, 2016) “The federal government’s role in health care includes significant funding for health and disease prevention and research; supplemental funding for education for health professionals, including nurses and physicians; and paying for individual health care services “(Cherry & Jacob, 2016, pg. 400). Therefore, the legislators in the federal level will focus on these categories to shape health care delivery.
She firmly believes that there is a strong need for more healthcare professionals in Congress. After all, health care is at the forefront of many political debates. Since she was the nurse, she sees the importance of having lawmakers with the healthcare background, that way the issues could better be addressed. In 2011 she was the first to engage in the debate on the Affordable Care Act.

Comment 3

The legislator that I consider to answer the above question is Erin Murphy. Murphy has a long career advocating on legislation related to health care and childcare issues.  As a nurse, Murphy serves as state representative in the Minnesota of Representatives. The new elected representative participated on the Health and Human Services Finance Committee.

In that capacity, she was instrumental and active to help craft reforms to “Minnesota’s health care system that aimed to expand access to affordable coverage and care” (Diane, S., 2017).  The legislator has worked on various health care reforms such as women’s health, affordable childcare, and expanding access to health care for school employees.

One of the bills that Murphy sponsored and supported is the “Health Care Homes.” This specific bill is part of a “statewide health care reform initiative” (2017). The legislation embraces and endorses a health care strategy that focuses primarily on prevention, self-management, and community services. This health care model guarantees better outcomes and quality of life people with chronic and acute health conditions.    

 

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Comment 1

First, knowing what a
CNL does is important to know why they need to meet certain requirements. The
American Association of Colleges of Nursing (AACN) describes the role as “a
point-of-care leadership and provides care in situation of particular
complexity” (Point-of-Care, n.d.). A CNL is someone that “identifies ways to
improve the quality of patient care by consistently evaluating patient outcomes,
assessing cohort risk, changing care plans, advocating for change and mentoring
fellow nurses” (Clinical Nurse Leader, n.d.). Other responsibilities of a CNL is
to provide care coordination for patients with complex needs, implementing evidence-based
practice, instituting quality improvement measurements, and coordinating
lateral interdisciplinary care that includes disciplines as diverse as
occupational and physical therapy (Point-of-Care, n.d.). In order to fulfill these
job requirements, one must possess strong problem solving and critical thinking
skills, the desire to work closely with patients, and the willingness to mentor
fellow nurses (Clinical Nurse Leader, n.d.). Academically, the CNL must also
earn a minimum of an Master’s of Science degree in Nursing (MSN) in the
Clinical Nurse Leader program as well as taking and passing the CNL certification
from the Commission on Nurse Certification.   

A CNL’s role or influence
in patient care is through implementing and ensuring that care delivery is
safe, evidence-based, and targeted towards optimal quality outcomes (Reid &
Dennison, 2011). The intent of the new implementation of a CNL is to promote patient
safety but also to incorporate the CNL’s focus on safety and to provide
front-line care instead of being in a back hall, disconnected from the eyes and
ears of the medical staff.

Comment 2

The role of clinical nurse leader (CNL) began in 2003-2004 due to the quality and safety reports of the Institute of Medicine. Clinical nurse leaders are prepared for direct clinical leadership to provide safe, evidence-based care and ensure that the patients get optimal healthcare. Clinical nurse leaders have multiple roles in the workplace. CNLs collect and evaluate treatment results and develop solutions to improve the outcome of patient care, evaluate the safety of the workplace, wnsure that the facilities are up-to-date on the latest research, and also provide patients with direct care and education. In order to become a clinical nurse leader, and BSN must be obtained followed by a Master’s of Science Clinical Nurse Leader program. Once completed a CNL certification test must be taken and passed.

There are multiple ways that they can ensure the safety of the patients. By providing direct patient care and education, CNLs are able to educate patients on their treatment plan and educate them on how to continue their treatment plan once they are discharged from the hospital. They can also ensure the safety of the patient by educating them on their medications. For example, they can teach them what each medication is for, the appropriate times to take each medication, any side effects they may experience, along with the correct dose of the medication they are taking. Safety is not just something that needs to be taken in to consideration while the patient is in the hospital, but once they are home.

Comment 3

A Clinical Nurse Leader (CNL) is expected to have a master’s degree level of education or higher. CNLs play an active role in “designing, implementing and evaluating client care by coordinating, delegating and supervising the care proved by a healthcare team at the clinical level, as opposed to the administrative level, as is the case with other nursing leadership roles” (GNE, 2018, para. 4). CNLs must be competent and knowledgeable as a part of the nursing team. The American Association of Colleges of Nursing (AACN) board acknowledges that the role of the CNL is multi-faceted and their education needs to have components of liberal arts and sciences, professional values, core competencies, core knowledge, and role development (GNE, 2018). CNLs should prepared in quality improvement, interdisciplinary team care, patient-centered care, evidence-based practice and the utilization of informatics (GNE, 2018).  Clinical nurse leadership education focuses on policy and organization, nursing leadership, outcomes management, and care management. After completing a CNL education program, to be CNL certified a registered nurse, must hold a current NR license, hold a master’s degree, complete a minimum of 400 clinical hours within their formal education program, and complete a minimum of 300 clinical hour in a clinical immersion experience in the CNL role (GNE, 2018). CNLs are expected to be educated in advanced nursing knowledge to provide the best care, while improving patient outcomes with the latest innovations in health care.

A CNL can address minority health issues in health care. For example, a CNL overseeing the care of diabetic patients on a hospital unit may notice some discrepancies in outcomes. The CNL works as a leader to evaluate the patients, to see if there is a relationship between ethnicity-related issues and outcomes. The CNL can review the literature to see if this clinical issue has been previously identified within this particular minority patient population. Then, the CNL can develop and implement a plan of care to improve health outcomes for those patients.

 

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Comment 1

Google is probably one of the first places we think to look for answers on just about every topic. Starting a research paper with a google search may provide good ideas for brainstorming. This may be problematic however when looking for credible references because you don’t always know where the information originated from or if the source can be trusted for accuracy. Seeking out peer reviewed articles from scholarly sources is a much better way to build a quality assignment.

You can find these articles through Google or Google Scholar though many times you will have to pay for the full text or subscribe to a specific service. Fortunately, Grand Canyon University has many scholarly databases available to us at no cost in the library! Two GCU library scholarly databases that are helpful for locating quality research studies and journal articles are Health Source: Nursing/Academic Edition and CINAHL Complete. The library website has a search engine that is subject specific. This means that your results will be more tailored to what you are looking to write about and you will find more relevant sources for your topic. Articles can also be filtered by year, subject and full text availability.

Comment 2

Resources undoubtedly play an ever-increasing as well as an integral part in the timely accomplishment of research goals and objectives. For this EBP project and considering the topic which I have selected for this GCU course, I am of the opinion that Nursing and Health Science database available at GCU library can turn out to be a valuable asset. Other than that, the Administration for Health Care resource is another credible database that I can rely on for the research in GCU courses. Both of them tend to collectively support in fulfillment of knowledge and statistical documentation needed to complete the EBP GCU project. I consider them much better than Google Scholar and internet searches because they are incredibly focused and not maligned. The data and information uploaded here are verified and worth being relying on (Antelman, 2006). When doing medical researches, one has to consider the authenticity of articles because they might impact the lives of individuals.

Moreover, these databases are also useful because they are flooded with nursing-related issues rather than other articles also. Hence it becomes relatively easier to scroll through the articles and gather information than to waste time in finding the correct articles. Use of keyword search makes the experience more appropriate.

Please NOTE this comment is the other theme. 1 DQ 2

Comment 3

The Institute of Medicine has stated a goal that 90 percent of clinical practice be evidence based by the year 2020. This is exciting because use of evidence-based practice helps to develop the scientific aspect of nursing, produce clinical practice guides and keep knowledge up to date! Despite these benefits, use of EBP in the United States healthcare delivery system is currently at around 15 percent. Two barriers that may be holding us back from adopting EPB into our workplace are insufficient knowledge of the research process and lack of support at the organizational level to change the practice (Barria, 2014).

Some ways to facilitate increased awareness and adoption of EPB include: positive attitude toward research, time dedicated to reading professional journal articles, support of autonomy in nursing, collaboration with other disciplines and attending professional conferences or workshops. Implementing EPB on an organizational level involves promoting a culture of shared governance, responsibility, balanced work load and resources. Leaders and administrators play a key role by modeling evidence-based decisions and supporting the infrastructure which represents the organization’s mission, philosophy and strategic plan (Barria, 2014).

 

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