Purpose:

To identify the hidden challenges of conducting an evidence-based practice (EBP) project within a hospital organization.

Significance:

Unexpected system and practice barriers in an EBP project could ultimately impede a change in practice.

Design/Background/Rationale:

Unit-based CNSs designed and implemented an EBP project using the Iowa Model for Evidence-Based Practice to Promote Quality Care. During the process of implementing this model, the CNSs were faced with unexpected organizational challenges.

Methods/Description:

CNSs met to design and implement a project to verify NG tube placement, which included an extensive literature review, grading the evidence, and trialing a specific procedure on 2 separate units. Using pH measurement as a method of verification became an unexpected challenge in order to meet laboratory regulations, as well as the practice concerns of the nurses.

Findings/Outcomes:

Networking with authors from the literature, developing a problem-solving approach to meet individual department regulations, and written and verbal communication with staff nurses were winning strategies.

Conclusions:

CNS leadership was instrumental in the successful completion of this EBP project.