Leaders pursue buy-in on evidence-based practice
The staff's commitment is crucial for the process
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By Eileen P. Williamson, MSN, RN
EDITOR'S NOTE: Eileen Williamson, MSN, RN, is the former senior vice president and chief nurse executive at OnCourse Learning. Williamson continues to write for Nurse.com and serve in an advisory role.
Since its founding, our profession has searched for better ways to use scientific evidence in patient care to improve outcomes. Nurses know it works because they’ve seen the results that can be achieved when research findings are applied to practice.
CNOs work on promulgating information on EBP throughout their organizations. They know the value of practice models that use research and what they can mean for patients. They appreciate that staff buy-in is crucial for EBP to work, and they take responsibility for providing staff with the tools they need. They know their nurse managers and directors need to buy into it for it to work at the staff level, and they design education programs to help this along.
In many organizations where CNOs have done all of these things, however, there’s still a struggle to get staff to embrace EBP as a standard part of their practice. Why? What are some of the stumbling blocks they might be encountering?
Research on the problem has shown that many healthcare organizations are challenged by the implementation process. There’s an enormous amount of time, work and money involved in implementing EBP throughout an organization and everyone on the leadership team has to get on board and be part of the role modeling and staff engagement work that’s involved.

One study, "The Strengths and Challenges of Implementing EBP in Healthcare Systems," conducted in February 2016, evaluated EBP implementation across a diverse nine-hospital system. About 6,800 RNs were surveyed to learn about their attitudes and perceptions toward organizational readiness for implementation of EBP.

With a 24% response rate, survey findings mirrored previous research in which nurses favor EBP, but struggle with barriers in implementation. The survey also showed nurses reported their ability to implement EBP as extremely low.
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In many organizations … there’s still a struggle to get staff to embrace EBP as a standard part of their practice. Why?”
— Eileen Williamson, RN
Patient care units are busy and complex, sometimes even hectic and frenetic. Nurses concern themselves with patient care, safety issues and giving timely, quality care. They work with interprofessional teams and communicate with families, all the while making sure their documentation is done. All of these duties are good and they’re part of an ever-evolving role, but they also can be challenges to making EBP a strong and integral part of nursing practice.
Our leader and founder, Florence Nightingale, is hailed as one of the earliest scientists to use the scientific principles of statistics in her work to improve sanitary conditions for hospitalized soldiers during the Crimean War.

We’ve come a long way from that work and the findings she published on it in one of her early writings, "Notes on Matters Affecting Health, Efficiency, and Hospital Administration of the British Army" to what we now call evidence-based practice.
EBP and the ways in which it is being defined, taught and implemented has grown immensely, but there’s still more to be done. The journey continues.
More than one-third (36%) of respondents worked at two of the system's Magnet-designated hospitals, and Magnet RNs reported more resources and held more positive beliefs about their hospital's organizational readiness for EBP.

Nurses with advanced nursing degrees, certification, and who serve in leadership roles were favorable toward EBP. Younger RNs with fewer years in practice were more likely to have positive beliefs toward EBP and embedding it into the organizational culture.
Results like these indicate we’re moving ahead, but more needs to be done and more questions need to be answered. If CNOs are establishing evidence-based practices for various patient conditions, are they being implemented every time a patient with one of those conditions is admitted? If they’re setting standards, providing education, engaging nurses in research projects and working on making them feel positive about the EBP concept, are there other stumbling blocks that need to be addressed?
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Contents
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Be a driving force behind EBP
Learn why evidence is a must when it comes to quality patient care.
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evidence-based practice
Nurses cross into research
Nurses are doing the digging to find answers to their practice questions.
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Get to the root of it
Master the basics of EBP and learn how to start your own project.
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Research feeds good practice
Turn a patient care idea into practice by starting with solid research.
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You hold the power
Bedside nurses have the ability to make significant practice changes.
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Making the grade
Evidence is a moving target. Be ready to adjust EBP policies.
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Protect the children
Pain management is a big deal when it comes to the littlest patients.
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evidence-based practice
Meet a wound care expert
RN Nancy Morgan tells you what really works wound care.
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evidence-based practice
FREE CE: What's new in EBP?
Learn the latest about ICU sedation, CLABSIs, and more.
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EBP blasts make an impact
A nurse successfully expands healthcare access for her patients.
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Fuel career satisfaction
Use new evidence to transform your old practices.
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CE Catalog
Boost your knowledge of EBP with these education modules.
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Follow the evidence
You know EBP is important; now grasp the strategies behind it.
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The journey continues
Driving interest in EBP is not always easy, but it’s worth the effort.
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An unacceptable risk
Periop nurses are striving to decrease pressure ulcers.
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Training days
Patient-centered care plus team science equals dazzling results.
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Pregame practice
Nursing students are being to appreciate the value of EBP.
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Poor self-care is a safety issue
Nurses who do not address fatigue can jeopardize patients.
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Create a dream team
A children's hospital shows how interdisciplinary care pays off.
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It's all about the team
Learn how the TeamSTEPPS strategy took shape.
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Patient care gets revamped
A cancer center reboots bedside reporting and improves care.
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