Do you find yourself complaining about an issue consistently at work? Those are precisely the areas you may be able to influence with evidence-based practice change. Possible areas that may need an EBP change implemented include:

Chronic interdisciplinary communication issues

High level of falls on your unit

Healthcare associated infection

High level of nurse burnout and turnover

Root cause analysis is a form of clinical inquiry designed to get to the bottom of a sentinel error. It should never be used as a punitive tactic. Techniques for Root Cause Analysis, published by Baylor University Medical Center in Dallas, Texas, is a helpful overview that covers how to accomplish a productive root cause analysis. One of the techniques posed is “Ask Why 5 Times.”

Example of the “Ask Why 5 Times” Technique

In this instance, a variety of factors played a role in the over-sedation of the patient. Occasionally the rushed pace of the OR may lead to oversights and inadequate communication. A communication handoff tool that requires covering essential details that might otherwise be missed is a possible technique to implement to avoid similar errors. Or, perhaps the overscheduling of ORs contributed to the problem. In that case, your EBP change may be related to improving operating room efficiency and scheduling techniques.

The most critical element of EBP change is the evidence. Data and scientific findings are the ammunition you need to bring a clinical issue to light. Create a brief outline to help you organize the information in a written report, including the problem, studies and data you’ve analyzed; results; possible limitations; and a proposal for the kind of program you’d like to implement.

Even if the executive leadership seems like more of a barrier than a help, continued communication throughout the process of an evidence-based practice change is essential. Without going through the proper chain of command, your efforts will likely be for naught. A well-researched and convincing review of the problem, and a sound proposal for change, will be your greatest ally in garnering nursing leadership support.

Provide educational materials, clinical reminders and tools, and feedback to staff to keep them engaged and help illustrate how a change can make a difference in their practice. Involve coworkers in data collection and program implementation.

If you want to see sustainable change, a thorough evaluation of outcomes before and after the implementation is imperative. This may include a survey, data collection or a chart review. The studies used in your literature review may be a helpful source for evaluation tools.