Integrating Evidence-Based Practice

Integrating Evidence-Based Practice

Describe the eight steps to integrating evidence-based practice into the clinical environment. What barriers might you face in implementing a new practice to address on research topic burn-out Describe strategies that could be used to increase success including overcoming barriers.

Part 2:

Describe six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes. Integrating Evidence-Based Practice

Sources one outside and the book. APA format 7th edition.

Template example how it should look like.

Integrating Evidence-Based Practice

This is where you will write out your introduction. Briefly identify the eight steps of integrating evidence-based practice into the clinical environment (Melnyk, 2015) These are (a) Establish Formal Implementation Teams (b) Build Excitement (c) Disseminate Project (d) Develop Clinical Tools (e) Pilot Test the Evidence-Based Practice Change (f) preserve Energy Sources (g) Timeline for Success (h) Celebrate success. Inform the reader that you will then be describing how to follow these steps to implement your specific project, based on your topic, into your own practice setting. Inform the reader you will also be discussing barriers to be implementing your project and how to overcome those barriers. Finally, inform the reader that you will also be describing six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes after implementing the project in your setting. Integrating Evidence-Based Practice

Establish Formal Implementation Teams

You’ve developed your PICOT question, found and critiqued evidence to support it (modules one through four), now you want to implement this new practice in your clinical setting. In this section, you will describe who needs to be on your team to help you implement the project. Who do you need on your team and why? What will they do? Describe the people from your actual work setting. Refer to page 212 in Melnyk (2015) will list them down what is on this page these are; (a) Integrate experts in change theory at the systems level such as advanced practice Registered nurses. (b) Include expert staff members to ensure clinical applicability, feasibility, and adoption into practice. (c)Exhibit passion for the practice change. (d) Enlist local opinion leaders who can attest to the need for practice change. (e) Bring in outside speakers who have the potential to connect and inspire key stakeholders. (f) create discomfort with the status quo.

Build Excitement

In this section, describe how you will get people on board to support the proposed change. How will you get people motivated to help you? Refer to page 212 in Melnyk (2015) just for FYI: This is what on this chapter (Team members who exhibit passion can ignite a fire in their colleagues. Recognized national experts lend stature and credibility to the relevance of the practice in local settings and add synergy for the change. It is essential to engage the staff by demonstrating the link between EBP changes and desired patient outcomes (Feifer et al., 2004). Building a “burning platform” (i.e, a passionate, compelling case to drive change) to drive change at this time can be strengthened with baseline practice-based data (e.g quality and performance improvement data). Creating a level of discomfort with the status quo by sharing evidence of better outcomes at other healthcare settings can create a readiness for change. Fostering enthusiasms by unit/service-based staff and leaders can lead to a shared ownership in the success of an EBP initiative.))


Disseminate Evidence

For this step, describe how you will “get the word out” to people who will be affected by, or participating in, this change. Will education be provided? Where, when, and by who? How will you explain and/or share the evidence to people and why the change is needed? Refer to page 212 in Melnyk (2015). Just for FYI: On this chapter will list them down the strategies (a) Utilize multifaceted strategies like education be planned to overcome knowledge deficits, skills deficits and skepticism. (b) promote experience sharing to emphasize the need for change and positive outcomes of change including external and internal evidence (eg quality improvement data), actual patient experiences, and stories from authentic voices (i.e., practitioners using recommended practice) (c) provide time to assimilate new practices. Strengthening beliefs about the value of EBP, an important strategy for increasing EBP implementation, and changing attitudes can be more challenging than imparting knowledge. A shared understanding of the problem and identified gaps in outcomes can be a foundation to valuing the change in practice. Evidence summaries should be shared with practitioners, along with persons who would be involved in consensus building. Perceived barriers need to be removed, and processes may need to be streamlined to create time and support for the new practice.

Develop Clinical Tools

What kinds of tools will you need to implement your new practice? Will nurses need to fill out some sort of checklist? Refer to pages 212-213 in Melnyk (2015). Just for FYI: On this chapter this what you refer (a) Anticipate tools and processes that the staff will need to transform practice. (b) Revise patient care documentation records (c) Ensure easy access to clinical resources (d)Integrate alerts and reminders into workflow processes at the point of care. (e)Repeatedly expose the staff to evidence-based information. Clinical tools to enhance appropriateness and consistency of care may include guidelines, EBP summaries, order sets, decision support embedded with electronic medical records Integrating Evidence-Based Practice

Pilot Test the Evidence-Based Practice Change

Before you can completely implement a new practice change, you need to see how the new process will work. It needs to be tested on a smaller scale first. Describe how this will be done. Refer to pages 213-214 in Melnyk (2015). What is on this page just for FYI: (a) Choose pilot sites with consideration to unit leadership strength, patient population diversity, acuity, and geographic location (b) Address the root causes of problems (c) Decide to adopt, adapt, or abandon at the end of the pilot. Pilot testing in selected number of patient care areas before moving to widespread implementation can be useful in identifying issues of clinical applicability and feasibility that will have an impact on the future efforts at successful EBP implementation.

Preserve Energy Sources

Don’t stress people out! Remember, a lot of people don’t like change. When a new process or change comes about, many people may start to freak out. What is your plan to avoid or decrease this stress? Remember, give examples specific to your setting. Refer to page 214 in Melnyk (2015). What is on this chapter strategies just for FYI (a) Engage support personnel (b) Implement smaller, more manageable projects (c) Anticipate setbacks and have patience and persistence.

Timeline for Success

This step in pretty self-explanatory, but you can also refer to page 215 in Melnyk (2015). Basically, how is this change going to roll out? How long will it take to establish your team, educate staff, develop tools, etc.? This include planning practice changes for an EBP project includes evaluating current practice, identifying gaps in “what is” and “what is desired” establishing incremental steps of the project, and setting timelines.

Celebrate Success

The best part! What do you plan to do if your project / practice change is successful? One major way is to acknowledge those who helped. Not just those who were on the formal team, but people who were involved in the actual implementation. People who had to enact the new process. How will you do this? Give them a gift card? Recognize them in a unit or hospital newsletter? Refer to page 215 in Melnyk (2015). On this page just FYI: (a) Acknowledge the staff instrumental in process (b) Ensure recognition by supervisors and administrations (c) Recognize the staff in presentations. Integrating Evidence-Based Practice

Barriers to Implementing a New Practice Change

This is where you will describe possible barriers to implementing your identified practice change. Is there a lack of leadership support? Does the new process create more work? Are certain people resistant to change?

Strategies to Overcome Barriers

Describe one or more ways in which to overcome the above identified barriers.

Sources of Internal Evidence to Demonstrate Improvement

This is where you will introduce the six sources of internal evidence that can be used to show if outcomes have improved after implementing your practice change. Then you will give an example of each that is specific to your setting. If you can’t think of specific examples for each, at least describe each source. The six sources of internal evidence are addressed on pages 227-228 of Melnyk (2015 Integrating Evidence-Based Practice

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