NURS 6052 Wk 9 Discussion: Developing a Culture of Evidence-Based Practice
NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice
The Advancing Research and Clinical Practice through close Collaboration (ARCC) is a model that can be used by health care systems to appropriately promote and educate staff on EBP changes in a way that addresses known barriers. The ARCC model acknowledges the barriers to EBP change initiatives and deconstructs the process into manageable steps. ARCC subject matter contains EBP skills building, generating a vision to inspire change to EBP, team building and communication, mentorship to promote EBP, strategies to create EBP culture, quality improvement methods, data management and outcomes assessment, and principles of individual and organizational change (Mylnyk, 2012). Employing the ARCC template is an effective method to overcoming identified hurdles that will be met when promoting EBP initiatives in a health care organization.
Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the
ARCC model for systemwide sustainability of evidence-based practice. Nursing
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Administration Quarterly, 36(2), 127–135. https://doi- org.ezp.waldenulibrary.org/10.1097/NAQ.0b013e318249fb6a
Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Cruz, R. (2010). Correlates among
cognitive beliefs, EBP implementation, organizational culture, cohesion and job
satisfaction in evidence-based practice mentors from a community hospital
system. Nursing Outlook, 58(6), 301–308. https://doi- org.ezp.waldenulibrary.org/10.1016/j.outlook.2010.06.002
Countless research studies have shown that evidence-based practice in healthcare has proven to improve the standard of healthcare and patient care outcomes (Chien, 2019). Dissemination or distribution of information gathered from evidence-based practice depends on a carefully planned communication process, one that involves a targeted audience and the vital info that needs to be shared (NHMRC, n.d.). Selecting the right channel to communicate is crucial and should consider the stakeholders in the process (NHMRC, n.d.).
According to Curtis et al., the knowledge-to-action cycle consists of seven steps which are: (1) identifying the problem and conducting relevant research, (2) adapting the research to local context, (3) assessing barriers to using knowledge, (4) tailoring the interventions, (5) monitoring the knowledge use, (6) evaluating the outcomes and finally (7) sustaining the knowledge use (2017).
With the technological advancements of our modern-day world, we live in a world that is heavily focused and dependent on social media. This would be one of the ways that I would choose to distribute information. Social media platforms provide an excellent alternative to face-to-face discussions, which can allow people to access those on their own time and be connected (Khan et al., 2021). Social media runs on state-of-the-art technology at the speed of light and would be great for reaching a larger group of people.
Another one I think would be useful is doing workshops and seminars/webinars. Short courses offered through workshops and seminars are a good way of getting communication out, and a great hands-on way to learn and demonstrate knowledge (Prevention Research Center in St Louis, n.d.).
I think one of the worst ways that information can be disseminated is when the administration in an organization makes rules and guidelines and forces those on stakeholders without getting their feedback. I had this unfortunate experience at one of my previous jobs and it made it a very challenging work environment.
Chien L. Y. (2019). Evidence-Based Practice and Nursing Research. The journal of nursing
research : JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346Links to an external site.
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to
clinical nursing practice. Journal of clinical nursing, 26(5-6), 862–872. https://doi.org/10.1111/jocn.13586Links to an external site.
Guidelines for guidelines. NHMRC. (n.d.). Retrieved January 22, 2023, from
Khan, M. N., Ashraf, M. A., Seinen, D., Khan, K. U., & Laar, R. A. (2021, April 29). Social Media for knowledge acquisition and dissemination: The impact of the COVID-19 pandemic on Collaborative Learning Driven Social Media Adoption. Frontiers. Retrieved January 22, 2023, from https://www.frontiersin.org/articles/10.3389/fpsyg.2021.648253/full Links to an external site.
Prevention Research Center in St Louis. (n.d.). Getting the word out: New approaches for disseminating… : Journal of Public Health Management and Practice. LWW. Retrieved January 22, 2023, from https://journals.lww.com/jphmp/fulltext/2018/03000/getting_the_word_out__new_approaches_for.4.aspx
Healthcare professionals conduct numerous studies focusing on different clinical issues with varying findings. To influence practice change on a broader scale, healthcare professionals should share their findings with other practitioners and policymakers within and outside the health practice. Critical to promoting a culture of evidence-based practice (EBP), dissemination encompasses the targeted distribution of information and intervention to a broader audience to maximize the benefits of research (Ravinetto & Singh, 2020). The targeted population usually includes a specific public health or clinical practice audience.
There are multiple dissemination methods, and nurses should select the most suitable according to situations, objectives, and audience characteristics. To communicate EBP, I would be most inclined to a policy brief and organization-wide seminar. A policy brief summarizes the research information and enhances it with charts, tables, and other visualized data (Brownson et al., 2018). Seminars or workshops allow researchers to share information and interact with the audience as they clarify issues related to research findings.
Ashcraft et al. (2020) advised research disseminators to use printed materials and personal communication since they are the most common channels. Therefore, the choice of policy briefs (print materials) and workshops as dissemination channels is justified. I would be less inclined to use news media and social to disseminate EBP. News media could be valuable for reaching healthcare practitioners and policymakers but could be expensive. Social media reaches a limited audience and could not be highly effective for academic engagements.
It is possible to encounter some barriers when using policy briefs and organization-wide seminars for EBP dissemination. A potential barrier with policy briefs is information choice since they should be brief, tailored to the audience’s needs, and appealing (Brownson et al., 2018). Failure to meet these needs can hamper the readability and usability of research information. A possible barrier with organization-wide seminars or workshops is timing. The busy nature of the healthcare environment can limit healthcare practitioners’ and leaders’ availability for the seminar.
Ashcraft, L. E., Quinn, D. A., & Brownson, R. C. (2020). Strategies for effective dissemination of research to United States policymakers: a systematic review. Implementation Science, 15(1), 1-17. https://doi.org/10.1186/s13012-020-01046-3
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: new approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102-111. DOI: 10.1097/PHH.0000000000000673
Ravinetto, R., & Singh, J. A. (2022). Responsible dissemination of health and medical research: Some guidance points. BMJ Evidence-Based Medicine. http://dx.doi.org/10.1136/bmjebm-2022-111967
Developing a Culture of Evidence-Based Practice
In my evidence-based practice, I would be most inclined to use publication and presentation during the dissemination process. Publication in peer-reviewed journals allows a wide audience of professionals to access and read about the results of evidence-based practice, providing an opportunity for others to critique and build upon my work (Wieschowski et al., 2019). Additionally, presentation at professional conferences allows for face-to-face interaction with professionals from different fields, providing an opportunity for direct discussion and feedback on various issues. On the other hand, I would be least inclined to use a social media dissemination strategy, as the information shared on these platforms cannot be authenticated and may not be held to the same standards of accuracy and credibility as information shared through professional channels (Ashcraft et al., 2020). Additionally, the vast amount of information shared on social media can make it difficult for professionals to identify and authenticate evidence-based practice outcomes.
Publication and presentation as dissemination strategies for evidence-based practice are associated with different barriers, including the cost of submission to journals and the competitive nature of conference presentations (Gitlin et al., 2020). Many journals require submission fees, which can be costly for researchers with limited resources. In addition, competition for conference presentation slots can be high, making it difficult to secure a spot to present one’s work. Further, publications, such as peer-reviewed journals and textbooks, require considerable time and resources throughout their production process. Editors must review manuscripts for accuracy and quality, requiring hours of work from both parties involved. Regarding the cost, authors may need to pay a journal’s processing fee or printing costs depending on the publication outlet.
Presentations equally involve many monetary expenses over time. Presenters have to pay for travel fees, workshop registrations, venue rentals, software purchases/upgrades, supplies (computer equipment), and wages for technical support staff during conferences — any of which could drive up the cost substantially. Moreover, making changes once an EBP presentation has been submitted can be complex: speakers may need additional training materials or rehearsals in order to master new slides or alter their speaking style accordingly. All these take more money and time than initial preparation. In summary, costs associated with EBPs dissemination are understandable but expensive nonetheless; thus, healthcare providers should carefully assess their financial state prior to investing in either strategy without fail. Doing so allows them to identify which methods serve their purpose best while mitigating risk factors along the way – something that is invaluable when striving to improve the quality of patient care by using evidence-based practices.
To overcome these barriers, I might consider journals with waived submission fees for researchers with limited resources and attend conferences where the competition for presentation slots is less intense. Another way to overcome these barriers is to seek out funding opportunities. For example, I can look for grants, scholarships or other financial aid to cover the cost of submitting my work to journals and attending conferences. Besides, I can pursue mentorship and collaboration opportunities with more experienced researchers who can guide me through the submission and presentation process as well as provide advice on how to increase the chances of getting my work accepted by journals and conferences.
Ashcraft, L. E., Quinn, D. A., & Brownson, R. C. (2020). Strategies for effective dissemination of research to United States policymakers: a systematic review. Implementation Science, 15(1), 1-17. https://link.springer.com/article/10.1186/s13012-020-01046-3
Gitlin, L. N., Baier, R. R., Jutkowitz, E., Baker, Z. G., Gustavson, A. M., Sefcik, J. S., … & Gaugler, J. E. (2020). Dissemination and implementation of evidence‐based dementia care using embedded pragmatic trials. Journal of the American Geriatrics Society, 68, S28-S36. https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16622
Wieschowski, S., Riedel, N., Wollmann, K., Kahrass, H., Müller-Ohlraun, S., Schürmann, C., … & Strech, D. (2019). Result dissemination from clinical trials conducted at German university medical centers was delayed and incomplete. Journal of Clinical Epidemiology, 115, 37-45. https://www.sciencedirect.com/science/article/abs/pii/S0895435618310631
Dissemination is the targeted distribution of information and intervention materials to a specific public health or clinical practice audience. (AHRQ, 2012). It is used to spread knowledge and evidence-based practice on a wide scale within or across geographic locations, practice settings, social media, or other networks for the benefit of patients and health care providers. The two dissemination strategies I would be most inclined to use are social media and mass communication. The reason being, we live in a social media world, everyone is on some type of social media platform, and they find out information very quickly. If a specific topic is trending, it is most likely going to reach the masses of people in a matter of seconds. Social media helps facilitate to most recent and most relevant information.
Mass communication is another great way to exchanging information on a large scale to a wide range of people. It has brought information to people that otherwise could not be reached and has increased awareness among people about what is happening in other parts of the world. Websites and healthcare applications are great in delivering mass communications on topics that need to be discussed to a particular population an also keep the community up to date and in the know. (Krohn et al, 2022). I would be least likely to distribute program materials, such as flyers, guides, pamphlets and DVDs because most of the time, they end up in the trash. Having a phone or tablet to search for information is more convenient and less clutter for humans. It will take more time to find the pamphlet and scan for the information as opposed to searching online. The barriers I might encounter when using social media and mass communication are social anxiety, depression, and exposure to content that is not age appropriate. (Dalomba, 2022). People tend to believe everything on social media, it is not always a good thing, and people do not talk about what they read but tend to internalize it.
Ways to overcome these barriers are to display some type of public service announcement or disclaimer after the information. Sometimes, people need to be reminded about things they just read, and know that there is help, or someone here to further explain and answer questions.
Evidence-based practice plays an immense role in contributing to optimum care outcomes in nursing practice. Nurses utilize evidence-based interventions to ensure their patients are assured to receive highest possible safety, quality, and efficiency in the care process. Nurses should be competent in disseminating evidence-based practice data to influence the profession. Therefore, the purpose of this paper is to explore the dissemination strategies that I may use in my practice and potential barriers that may be experienced in the process.
One of the dissemination strategies that I am most inclined to use in my practice is presenting results of my project in conferences. Often, nurses participate in scientific conferences that aim at increasing the availability of current evidence on nursing practice and healthcare. Nursing conferences provide immense opportunities to interact with other nurses and reach a wider audience with the project. It also offers the opportunity to get feedback on ways of improving the evidence-based practice project and enhancing its generalizability to different populations (Lewis et al., 2021). The impact of sharing the evidence-based practice intervention and results in a conference is significant since I can be offered an opportunity to publish it and lead similar evidence-based initiatives in nursing practice.
The second dissemination strategy that I am most inclined to use in my practice is publishing an article about the project and its outcomes. Publishing an article provides opportunities to reach the global audience and inform them about the need and significance of the project. It also informs future evidence-based practice projects in nursing (Mangold & Arring, 2019). Some of the credible publishers that I may consider to achieve this objective includes PubMed, EMBASE, and CINAHL among others. Publishing will contribute to my local, regional, and global recognition as a nurse scholar.
Least Inclined Dissemination Strategies
I am least inclined to use strategies such as forcefully implementing the evidence-based practice intervention in the organization without informing or involving the other organizational stakeholders. Accordingly, the adopters of the evidence-based intervention should be actively involved in assessing, planning, implementing, monitoring, and evaluating the need and effectiveness of the intervention (Jones, 2019; Tucker & Gallagher-Ford, 2019). Implementing the initiative without their involvement increases the risk of poor outcomes due to resistance to change and their inadequate preparedness to embrace the initiative.
One of the barriers that I may experience in using the above dissemination strategies is time constraints in publishing the intervention. Accordingly, different publishers have requirements that must be met for the project to be published. For example, it may take a long period for the project to be approved and published, affecting its clinical significance and impact. The other challenge is the lack of adequate knowledge and skills among nurses who should adopt the evidence-based intervention. Dissemination of results in scientific conferences may not result in the direct adoption of the intervention in clinical practice. Strategies such as training nurses on the use of the intervention at the organizational level may be needed for its successful adoption (Dang et al., 2021). However, issues such as resource shortages and competing organizational needs may hinder the successful use of the intervention in nursing practice.
In summary, disseminating evidence-based practice project outcomes is important in nursing. I am most likely to adopt dissemination strategies such as publishing an article and presenting results in scientific conferences for my evidence-based practice project. I am least likely to forcefully translate the intervention in my workplace. I will explore anticipatory strategies to overcome barriers to disseminating the evidence-based initiative.
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition. Sigma Theta Tau.
Jones, S. (2019). Faculty and students find a niche in scholarship: Teaching strategies to disseminate scholarly evidence-based practice projects. ABNF Journal, 30(4), 109–112.
Lewis, C. C., Powell, B. J., Brewer, S. K., Nguyen, A. M., Schriger, S. H., Vejnoska, S. F., Walsh-Bailey, C., Aarons, G. A., Beidas, R. S., Lyon, A. R., Weiner, B., Williams, N., & Mittman, B. (2021). Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: Protocol for generating a research agenda. BMJ Open, 11(10), e053474. https://doi.org/10.1136/bmjopen-2021-053474
Mangold, K., & Arring, N. (2019). Advancing Professional Practice Through a Research and Evidence-based Practice Festival. Nurse Leader, 17(1), 59–64. https://doi.org/10.1016/j.mnl.2018.09.013
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A systematic and methodical approach should be used to appraise the research to implement into practice. Harris et al. (2012) suggests a framework to test and develop the dissemination of evidence-based practice (EBP) into practice. I would implement two dissemination strategies, create a diagram and a PowerPoint presentation. I would make a diagram that visualizes the research and how it positively impacts the healthcare organization, patients, and stakeholders. Harris et al. (2010) created a diagram framework that uses social marketing principles that utilize arrows to disseminate the diffusion of the EBP. I would use a PowerPoint presentation to provide bullet points defining the research intended to put into practice. I would then share the finding and highlight the impactful benefits to the healthcare organization and the patient.
Barriers may be inevitable in an attempt to disseminate the EBP. Two barriers may be a need for more support from organizational leadership and funding. To overcome the barriers, it would be essential to understand why leadership (stakeholders) are against the change, as it is likely due to a lack of understanding. However, if the rationale is driven by organization cost, it would be essential to display why the possible initial monetary displacement would have long-lasting positive impacts and save the organization capital in the long run. For example, the introduction of a stat lock to hold a foley catheter into place. While a stat lock is an additional supply cost, evidence has shown the use of a stat lock decreases the risk of the development of urinary tract infections and involuntary displacement of the catheter. Again, I would continue to adopt a visual such as the John Hopkins Evidence-based Practice Model (JHEBPM). The JHEBPM uses a problem-solving methodology to drive clinical decision-making using a three-step approach: practice question, evidence, and translation (John Hopkins University & Medicine, n.d.).
Harris, J.R., Cheadle, A., Hannon, P.A., Forehand, M., Lichiello, P., Mahoney, E., Snyder, S. &
Yarrow, J. (2012). A framework for disseminating evidence0based health promotion practices. CDC – Preventing Chronic Disease 9. http://dx.doi.org/10.5888/pcd9.110081Links to an external site.
John Hopkins University & Medicine. (n.d.). What is the john hopkins nusing evidence-based
practice model? Welch Medical Library.
The dissemination strategies I am most likely to use include at the unit level and at the practice level. At the unit level, a nurse-led initiative we have is improving our practice by improving articulation and follow-up of patient goals during participation in our rehab program. Administrative and clinical stakeholders are interested in this initiative because insurance companies have been denying payment based on our documentation being too vague to demonstrate a baseline and improvement made. One of the reasons I am inclined to use this strategy is the ease in building trust with stakeholders and collaborating with them (Gallagher-Ford et al., 2011). I also have a higher level of experience and skill set (Newhouse et al., 2007) within our unit than with other units at the department level to be able to speak to the unique needs of patients in our practice area. One potential barrier is buy-in from various stakeholders who work in different disciplines (such as occupational therapy and physical therapy). Another barrier is support from information technology as our organization has a large backlog of requests for changes to our electronic medical records systems from a variety of departments. Strategies to overcome these barriers are to take time to build relationships with occupational therapy and physical therapy team members to understand their needs and concerns. Given the lack of support from our EMR team at this time, using technology we have available within the Microsoft Teams platform and a “do-it-ourselves” mindset may help meet our needs instead.
At the nursing practice level, our organization supports a nursing research poster fair annually where nurses across the enterprise have the opportunity to share knowledge and experience with each other with posters about innovations they have adopted in their units (Newhouse et al., 2007). Our nurse administrator has expressed interest in our nurse-led initiative and wants more units in our department to see our ideas, so administrative support is a plus (Gallagher-Ford, et al., 2011). The poster fair supports innovation and is a way to disseminate our ideas and build on them further across the organization (Melnyk et al., 2011). Barriers include obtaining permission to take professional time to develop the poster given staffing shortages and professional time to have staff to participate in the poster fair. Strategies to overcome these barriers would be to work closely with our nurse manager and other members of nursing staff to buy in to the value of the poster fair and to provide coverage of patient care needs while other team members work on the posterior and attend the fair.
I would be least inclined to use the dissemination strategies of a hospital-wide policy change or even a department-wide policy change as I don’t feel I have the expertise or understanding at this point in my education to understand how other units within our department are run, financial impacts, nor what patient or staff safety issues are involved (Melnyk et al., 2011). As my education and experience progresses and I move into masters-level roles I can use what I am learning from our unit-based project to inform my participation in future projects.
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