|EVIDENCE-BASED NURSING: Boost your staff's understanding and utilization of EBP
|Phyllis Tipton MSN, PhD
Debra K. Ucci RN, FNP, ACNP, DNP
Volume 39 Number 9
Pages 12 - 14
Evidence-based practice (EBP) is increasingly a topic of interest within the nursing profession. Basing practice on the best available evidence has become highly valued by nurse leaders and it's expected that nursing professionals are able to translate research-based findings into clinical practice. EBP can be generally defined as using knowledge gleaned from the best data available to make decisions regarding the planning and implementation of patient care interventions.1 The Joanna Briggs Institute defines EBP as the melding of individual clinical judgment and expertise with the best available evidence to generate the kind of practice that's most likely to lead to positive outcome for patients.2
Healthcare organizations are beginning to develop methods that involve nurses at all levels to facilitate the process of moving research from literature to practice at the bedside. Although this can positively affect nurses' job satisfaction, evidence exists that nurses don't routinely apply research findings to their clinical practice.3,4 Only 20% of nurses surveyed by Sigma Theta Tau, International Honor Society of Nursing (2006) indicated that EBP was a significant component of their basic nursing education, which suggests a large number of practicing nurses have a very limited understanding of EBP.5 The challenge, therefore, is getting nurses to embrace the concept of EBP.
Continuing education (CE) opportunities, journal clubs, research committees, and adding research to the clinical performance ladder (CPL) can help encourage nurses' assimilation of EBP. This article will briefly summarize these four methods of overcoming this obstacle to practice.
Offering CE opportunities is one method to help nurses gain a better understanding of EBP. For example, consider offering a series of programs: an initial offering presented by faculty from a local college or university that provides an overview of the research process, explains key concepts (such as reliability, validity, types of research design, sampling techniques, and data collection methods), and concludes with a critique of a relevant research article, followed by a second offering presented by a librarian that provides information on how to use databases. The use of statistical methods can be very intimidating and may cause nurses to feel uncomfortable with research findings. A class reviewing the more common statistical methods and simple resources to use for critiquing research may also be beneficial. Finally, you may want to consider offering classes on how to become more involved in the research process in actual clinical settings, including grant writing, developing a research question or hypothesis, defining the research problem, data collection methods, and reporting of findings. Unless nurses have taken a research course, they may not be familiar with these research basics.
Monthly journal clubs
Monthly journal clubs are an excellent method of involving staff with EBP because they provide staff members the opportunity to choose articles of interest to them. The club can be structured in a variety of ways, but it usually works best to have a set time and place away from direct patient care. This will minimize distractions and provide time to concentrate and share ideas with other professionals in the group. Having a selected discussion leader, making the article available several weeks before each meeting, and encouraging participants to keep in mind how an article can be related to clinical practice are some of the suggestions for a successful journal club.6 If time is at a premium, having an online journal club in which a summary of the article is posted, specific questions are identified, and responses elicited may be successful. Or staff members can simply post their thoughts on the article. Unit meetings are another opportunity to present and discuss research findings. Regardless of the method used, it's always helpful to provide positive reinforcement for staff participation, such as a monthly drawing for a gift for journal club attendees or public acknowledgment of journal club involvement in newsletters, unit meetings, institution bulletin boards, or the intranet.
A research committee is a third way to involve staff in EBP. For example, the committee can be used to teach members about the research process, work effectively with the institutional review board, develop and oversee research projects, and communicate findings of these projects both within the institution and to a wider audience. It's suggested that each unit/department has representation on the committee.7 Membership may include department managers, educators, advanced practice nurses, or any staff members with an interest in promoting EBP in their area.
Adding research to the CPL
A final method is adding EBP activities to the CPL. A CPL can be used to recognize and reward skill in nursing practice or as a system for developing new expertise.8 The EBP activities may be categorized depending on the degree of involvement. For example, nurses may receive CPL points for attending a certain number of journal club meetings in a given year. Additional points can be earned if nurses initiate or lead a journal club. Nurses can earn points on the CPL by attending EBP CE offerings or becoming members of the nursing research committee. Other CPL activities may include participating in a research project under the direction of the principal investigator. The nurse may be involved in developing the research question, conducting the literature review, coordinating and assisting with data collection, and data analysis. Communicating research findings is a vital part of the research process. Points may be awarded for sharing study results within the institution, publication in a national nursing journal, or presenting results at a professional conference. Nurses may also be awarded points on the CPL if they demonstrate how they've taken findings from published research studies and used them to change current practice, policies, or procedures.
EBP strives to promote best practices so nurses are able to work more efficiently and effectively and provide care at the highest level possible. Using information from what others in the nursing field have learned can lead to a higher level of satisfaction with care for both nurses and patients. Using techniques such as CE opportunities, journal clubs, research committees, and adding EBP to the CPL are methods that encourage nurses at all levels to incorporate EBP in their daily routine.
1. Myers G, Meccariello M. From pet rock to rock-solid: implementing unit-based research. Nurs Manage. 2006;37(1):24–29. [Context Link]
2. The Joanna Briggs Institute. Evidence based nursing. Available at: http://www.joannabriggs.edu.au/about/eb_nursing.php . Accessed July 7, 2008. [Context Link]
3. Pravikoff DS. The evidence-based practice dilemma. Available at: http://www.cinahl.com/library/cinahlnews/cnews2004v23–1.pdf . Accessed July 7, 2008. [Context Link]
4. Stevens KR, Staley JM. The Quality Chasm reports, evidence-based practice, and nursing's response to improve healthcare. Nurs Outlook. 2006;54(2):94–101. [Context Link]
5. Sigma Theta Tau International Honor Society of Nursing. 2006 EBP study: summary of findings. Available at: http://www.nursingknowledge.org/go/study . Accessed July 7, 2008. [Context Link]
6. Luby M, Riley JK, Towne G. Nursing research journal clubs: bridging the gap between practice and research. Medsurg Nurs. 2006;15(2):100–102. [Context Link]
7. Beyerman K. Keys to nursing research within a community hospital. Nurs Manage. 2005; 36(8):35–40. [Context Link]
8. Bjørk IT, et al. Evaluation of clinical ladder participation in Norway. J Nurs Scholarsh. 2007;39(1):88–94. [Context Link]