Now that the evidence has been gathered, you are ready to apply the findings and evaluate whether the intervention should be accepted, rejected or modified for clinical practice, keeping in mind your own clinical expertise and the patient preferences and values (the Evidence Triad)
Applying the recommended practice change may require staff education about its importance
- Solicit staff input so that they will more readily “buy into” the recommended practice change. Identify others who may have a stake in the practice change. Remember that getting assistance from those who will be affected by the practice may be helpful to acceptance of the new practice.
- Determine who should be involved in the approval process for the practice change. Is administrative approval needed? Should it be sent to Nursing Practice Council? What education will be needed to assure that the practice change can be carried out effectively?
- If costs are likely to increase as a result of the practice change, how will this situation be handled? Knowing in advance the barriers that may exist in applying the practice change can be helpful in working through these obstacles.
Conduct a trial implementation by focusing on one area where the practice change can be carried out easily.
- For example, at Penn State Hershey Medical Center, nursing care delivery is based on the Collaborative Care Transition Model (CCTM). A review of the available evidence showed that this approach to nursing practice produced better care coordination, improved nurse satisfaction, and enhanced patient outcomes to a greater extent that traditional nursing care delivery methods. However, the CCTM was not implemented throughout the entire Medical Center at first. In order to determine the feasibility of this practice change, one area (the Children’s Hospital) was selected for initial implementation. The successes and challenges of implementation in the Children’s Hospital provided a solid foundation for moving the CCTM to other areas of the Medical Center.
Evaluation assists in determining whether the practice change should be accepted, rejected or modified for the specific setting.
- Data can include comparison of outcomes that occurred after implementation of the practice change with information available prior to making the change.
- Comparisons can be made with other areas that have not made the practice change. External benchmarks can also be used for comparison.
Monitoring the process and the outcomes of the new practice is part of evaluation.
- Observe the effects of the practice change for a minimum of two quarters post implementation.
- Assess staff’s knowledge and determine ongoing needs regarding the new practice.
Remember that implementing Evidence Based Practice is an ongoing process.
Your participation in this tutorial shows that you have made an important commitment. Share this knowledge and the skills with your colleagues.
Congratulate and reward each other for persisting in the crucial work of making EBP a part of every day nursing practice.