Original Article

Use of Evidence-based Practice Models and

Research Findings in Magnet-Designated
Hospitals Across the United States: National
Survey Results
Karen Gabel Speroni, PhD, RN, BSN, MHSA ● Maureen Kirkpatrick McLaughlin,

PhD, RN-BC, NEA-BC ● Mary Ann Friesen, PhD, RN, CPHQ

Key words ABSTRACT

evidence-based Background: All nurses have responsibilities to enculturate evidence-based practice (EBP) and
practice models, translate and implement research findings into nursing care, practices, and procedures.
evidence- Aims: To report EBP-related findings from the national Hospital-Based Nursing Research
based practice, Characteristics, Care Delivery Outcomes, and Economic Impact Survey questionnaire.
nursing practice,
Methods: In this cross-sectional survey research study of 181 nursing research leaders, 127
implementation,
responded to these questions: “Has your hospital adopted or does it use a model of evidence-
nurse leaders,
based practice?” “If yes, what is the name of the model and how is it used?” “Does your hospi-
nursing research,
tal implement (translate) findings from nursing research into clinical practice?” “Describe how
Magnet hospitals
your hospital implements these findings and whose responsibility it is.” “What factors do you
believe facilitate the implementation of findings from nursing research into clinical practice at
your hospital?” Qualitative content analyses were used.
Results: Over 90% of nursing research leaders specified that their hospital used an EBP model
and implements findings into practice. The most frequently reported models were the Iowa
Model of Evidence-Based Practice, Johns Hopkins Nursing Evidence-Based Practice Model,
and Advancing Research and Clinical Practice Through Close Collaboration Model. EBP mod-
els were used most frequently for education and training, nurse residency programs, and EBP
and research fellowships. Findings were implemented through policy and procedure commit-
tee processes, shared governance structures, and EBP processes. Those responsible for imple-
menting findings were project leads, nursing professional practice councils, and clinical nurse
specialists and advanced practice nurses. Implementation facilitators were nursing leadership,
dissemination of findings, and engaged and educated nurses.
Linking Evidence to Action: These new findings report >90% EBP model use and implemen-
tation. All nurses, especially our leaders, have responsibilities to evaluate EBP and how nursing
research findings are implemented (translated) into practice. Ideally, engaged and educated
nurses who enculturate, support, and sustain EBP will facilitate advancing nursing practice to
improve patient and work environment–related outcomes.

BACKGROUND AND SIGNIFICANCE most important features for organizations implementing

Nurses and interprofessional teams must apply evidence EBP (Li et al., 2018). An important feature related to EBP
to achieve, improve, and sustain optimal patient and work implementation is application of nurses’ critical think-
environment–related outcomes. Translation and imple- ing skills, which is required to understand interferences
mentation of nursing research into practice is slow and a with successful implementation of research evidence into
challenge worldwide (Li, Jeffs, Barwick, & Stevens, 2018; practice (Camargo et al., 2017; Canada, 2016; Rapport et
Shayan, Kiwanuka, & Nakaye, 2019; Warren et al., 2016; al., 2017). Also important is understanding basic precepts,
Wilson et al., 2016). Implementation is frequently under- models, theories, and frameworks for implementation sci-
developed and is a difficult step in the evidence-based ence (Bauer, Damschroder, Hagedorn, Smith, & Kilbourne,
practice (EBP) process (Cullen & Adams, 2012). There is 2015; Nilsen, 2015; Rapport et al., 2017; Tucker, 2019) and
no consensus among implementation scientists of the “why it [EBP] is not being integrated into care decisions,

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 Original Article
practices, and procedures consistently” (McNett, Tucker, Malaysia, Nepal, South Africa, and Turkey) identified in-
& Melnyk, 2019, p. 174). Conducting research and imple- stitutional-related, interdisciplinary, and nurse-related
menting EBP is required for hospitals seeking American barriers, indicating that EBP implementation requires a
Nurses Credentialing Center Magnet recognition (Pintz, commitment at the individual, interdisciplinary, and orga-
Zhou, McLaughlin, Kelly, & Guzzetta, 2018). nizational levels (Shayan et al., 2019). Melnyk et al. (2018)
report “only 14% of research findings lead to widespread
changes in care and policy” (p. 6). Findings from the
LITERATURE Harper et al. (2017) study reported that none of 253 nursing
Literature gaps include the need for evaluating how EBP professional development practitioners rated their compe-
models are used, how nursing research findings are trans- tence in the EBP process as high, and they lacked compe-
lated into clinical practice, who is responsible, and im- tence in many of the basic steps of the EBP process. In a
plementation facilitators. Between 1970 and 2015, 16 study from Taiwan of over 6,000 healthcare professionals
models from four countries (Australia, Canada, the United (medical, nursing, pharmacological, and allied healthcare
Kingdom, and the United States) were identified from a professionals), Weng et al. (2013) indicated differing lev-
narrative review of the literature of how nurses use re- els of EBP implementation among healthcare professionals,
search in the hospital setting (Camargo et al., 2017). Many and nurses (N = 4,206) were less aware of EBP, with sig-
EBP models are similar in following problem-solving steps nificantly lower positive EBP attitudes and beliefs. Nurses
of the EBP process but may differ in terminology describ- educated before or just after the turn of the century may
ing those steps. While an EBP model may be adopted by a not be knowledgeable about EBP processes (Harper et al.,
hospital, there may be varying degrees of its use and under- 2017; Melnyk et al., 2018). Nursing faculty need to integrate
standing by nurses. Due to diverse needs and nursing envi- EBP throughout academic curricula to produce high-cali-
ronments, one model may not fit all (Gawlinski & Rutledge, ber EBP clinicians (Fitzpatrick, 2019; Melnyk et al., 2018)
2008). EBP models can be enhanced with an EBP imple- and may incorporate EBP competencies for nurses (Melnyk,
mentation guide that provides implementation strategies to Gallagher-Ford, Long, & Fineout-Overholt, 2014). Further,
“create awareness & interest, build knowledge & commit- the development of, or revisions to, an EBP curriculum for
ment, promote action & adoption and pursue integration & nursing and other health professionals may benefit from
sustained use” (Cullen & Adams, 2012, p. 223). Recently, the Core Competencies in Evidence-Based Practice for
Tucker and Melnyk (2019) created “12 steps to success” (p. Health Professionals identified by Albarqouni et al. (2018).
8) to help leaders implement EBP in their organizations. Keeping EBP culture sustainable and promoting translation
Sandström, Borglin, Nilsson, and Willman (2011) con- of new knowledge into practice requires nurturing (Albert,
ducted a literature review to identify leadership influences 2016). Friesen, Brady, Milligan, and Christenson (2017)
on the EBP implementation process and concluded that purport that nurses at all levels need mentoring and coach-
leadership is vital, recognizing the importance of the cul- ing to foster EBP sustainment.
ture and organization of the leader. Yet EBP implementa- This report is a continuation of previous research con-
tion is “relatively low” among chief nurse executives, and ducted by members of the Washington Regional Nursing
only 3.0% (8 of 271) rated EBP as a high priority (Melnyk et Research Consortium (WRNRC). The first study, the National
al., 2016). According to Li et al. (2018), leadership may be a Survey of Hospital Nursing Research Requirements and
moderator that enhances or impedes EBP implementation. Outcomes (HNRRO), provided data about research require-
Their systematic, 36-study, integrative review focused on ments and outcomes from 160 nurses (out of 798) respon-
determinants of EBP from 11 countries (Canada, England, sible for nursing research at U.S. Magnet and non-Magnet
Iran, the Netherlands, Norway, Saudi Arabia, Sweden, hospitals (McLaughlin, Speroni, Kelly, Guzzetta, & Desale,
Turkey, Uganda, the United Kingdom, and the United 2013). Findings from this study produced the prototype
States). Six interrelated, synergistic organizational features for the U.S. Hospital-Based Nursing Research Program and
were identified that were most frequently reported to in- included a dedicated nursing research mentor, the nurse
fluence implementation outcomes: (1) culture; (2) leader- as the principal investigator, policies and procedures, re-
ship; (3) networks and communication; (4) resources; (5) search education and training, and research program schol-
evaluation, monitoring, and feedback; and (6) champions. arly outcomes (McLaughlin et al., 2013). In addition, the
Sub features were collaboration, teamwork, communica- researchers suggested that chief nursing officers (CNOs)
tion, financial resources, time, staffing and workload, and providing structures and processes might help with the
education and training. Organizational culture and leaders dissemination of scholarly work and promote nurse-led re-
within that culture play key roles to provide structures and search studies (McLaughlin et al., 2013).
processes that facilitate EBP as a top priority. Following the quantitative reporting from the HNRRO
A systematic review (N = 16 studies and 8,409 partici- study, researchers Kelly, Turner, Speroni, McLaughlin, and
pants) of EBP barriers among nurses in eight low- and mid- Guzzetta (2013) used content analysis to analyze responses
dle-income countries (Bahamas, Columbia, Iran, Jordan, from two open-ended questions that were part of the

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Evidence-based Practice Model Use: Translating and Implementing Findings Into Practice

HNRRO study. Those questions asked survey participants full implementation of these characteristics into practice”
to identify what they believed were facilitators and hin- (Pintz et al., 2018, p. 247). Next, qualitative findings from
drances related to research studies and research productiv- EBP-related questions on the HNRC study will be reported
ity at their U.S. hospitals. A research mentor was reported below.
as the top facilitator for nursing research by participants
from Magnet and non-Magnet hospitals, and the lack of a
research mentor was reported as the biggest hindrance by PURPOSE AND AIMS
non-Magnet hospitals, compared to lack of time by Magnet The purpose of this report is to address the qualitative find-
hospitals (Kelly et al., 2013). This qualitative data was ings from the HNRC questionnaire related to EBP model
added to the original prototype (McLaughlin et al., 2013) use and implementation (translation) of research findings
to become the expanded prototype for the Hospital-Based into nursing practice (Pintz et al., 2018). The aims of this
Nursing Research Program (Kelly et al., 2013), which is qualitative work are to describe (1) what EBP models are
organized into three foundational categories: the hospital used and how they are implemented in Magnet-designated
infrastructure, the hospital culture, and building a nursing hospitals throughout the United States, (2) how hospitals
research program, all of which contribute to the effects on translate research evidence into clinical practice, (3) who
care delivery and on patient and family outcomes (Kelly et is responsible for leading EBP efforts, and (4) what factors
al., 2013). facilitate the use of research in practice.
The work continued by members of the WRNRC
with the national Hospital-Based Nursing Research
Characteristics (HNRC), a follow-up cross-sectional, de- METHODS AND JUSTIFICATION
scriptive-correlational study that included quantitative and As part of the qualitative section of the HNRC question-
qualitative questions (many from the HNRRO study) dis- naire, nursing research leaders responded to one or more
tributed via an online survey to determine how nursing of the following questions: “Has your hospital adopted or
research leaders at Magnet-designated hospitals align the does it use a model of evidence-based practice?” “If yes,
three categories of the hospital infrastructure, the hospital what is the name of the model and how is it used?” “Does
culture, and building a nursing research program (Pintz et your hospital implement (translate) findings from nursing
al., 2018). Participants responding to the survey were 181 research into clinical practice?” “Describe how your hospi-
nursing research leaders from Magnet-designated hospitals tal implements these findings and whose responsibility it
across the United States. These participants may also have is.” “What factors do you believe facilitate the implementa-
been members of the Association for Nursing Professional tion of findings from nursing research into clinical practice
Development (ANPD) or the American Organization for at your hospital?”
Nurse Executives (AONE), which were included in survey
recruitment methods in efforts to increase the response Ethical Issues and Approval
rate. The ANPD has approximately 5,000 members and de- This study was deemed exempt by the Institutional Review
fines and promotes the specialty practice of nursing profes- Board. Participants provided electronic informed consent
sional development in multiple settings to advance quality prior to initiating the survey.
health outcomes. The AONE (now known as the American
Organization for Nursing Leadership) is comprised of al- Analyses
most 10,000 members and is considered to be “the voice Qualitative content analysis was used for open-ended
of nursing leadership” (American Organization for Nursing questions (Elo & Kyngas, 2007; Graneheim & Lundman,
Leadership, n.d.) para. 1. Demographics reported by Pintz 2004; Hsieh & Shannon, 2005; Weber, 1990). The re-
et al. (2018, p. 250) included “respondents who met the search team delineated the process for analysis to include
inclusion criteria (i.e., were working at a Magnet hospi- the following: (1) define the recording units (coding;
tal and were conducting nursing research) and completed Miller, 1990); (2) independently code using an iterative
the questionnaire, which included 67 (37% of total; 19% process; (3) after the coding was completed, research-
response rate) from the Magnet hospitals, 26 (14%) from ers reviewed codes, tested codes to resolve ambiguities,
AONE, and 88 (49%) from ANPD. Response rates were un- and revised to clarify meanings and assure consistency;
known for the AONE and ANPD groups because we did not and (4) categories were aggregated from the codes in a
know which members belonged to Magnet hospitals and deliberate, systematic manner. All three researchers then
which members were conducting nursing research at their reviewed all the narrative codes and categories to resolve
hospitals.” discrepancies and reach final consensus. Strategies used
Quantitative findings from the HNRC study indicated to ensure trustworthiness of the data were based on
that “Magnet hospitals provide most of the needed re- the evaluative criteria by Lincoln and Guba (1985) and
search infrastructure and have a culture that supports Melnyk and Fineout-Overholt (2019) and included peer
nursing research,” yet there “continues to be barriers to debriefing (credibility), coding accuracy and intercoders’

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reliability to ensure findings are repeatable (dependabil- Qualitative analysis was conducted for Question 4. For
ity), reflexivity during regular investigator meetings to part one, how hospitals implement (translate) findings
corroborate results (confirmability), and purposive sam- from nursing research into clinical practice, 11 categories
pling for research leaders (transferability). were generated. The most frequent categories were hos-
pitals implementing (translating) findings through policy
and procedure committee processes at the unit level, de-
RESULTS partment and organization or system level, through shared
A total of 127 (70.2%) of the 181 nursing research leaders governance or leadership council structures and processes,
who completed the survey responded to at least one of the and through EBP processes.
five following questions; participants were not required to
respond to every question. Responsibility for Implementing (Translating)
Findings Into Practice
Adoption and Use of EBP Models For part two of Question 4, whose responsibility is it to
Participants (n = 125 of 181, 69.1%) responded to Question implement (translate) findings from nursing research into
1: “Has your hospital adopted or does it use a model of ev- clinical practice, 18 categories were generated. The most fre-
idence-based practice?” Most reported yes (n = 115 of 125, quent categories were primary lead for the project, nursing
92.0%). For those reporting yes, they were asked to respond professional practice councils or shared governance coun-
to Question 2, which was a two-part question: “What is the cil, clinical nurse specialists (CNS) and advanced practice
name of the model and how is it used?” nurses (APNs), nursing practice councils, and unit leaders.
Qualitative analysis was conducted for Question 2. For Table 2 provides the rank order of categories and sample
part one, the EBP model name, eight categories were gen- responses for Question 4. Four participants reported a lack
erated. The name of the EBP model used was reported by of consistency in how nursing research findings are imple-
105 of 115 (91.3%) participants. The three most frequently mented (translated) into practice and responsibility.
reported models were the Iowa Model of Evidence-Based
Practice to Promote Quality Care (Iowa; n = 63 of 105, Factors Facilitating Implementation of Findings of
60.0%); the Johns Hopkins Nursing Evidence-Based Practice Nursing Research Into Clinical Practice
Model (JHNEBP; n = 20 of 105, 19.0%); and the Advancing Participants (n = 88 of 127, 69.3%) responded to Question
Research and Clinical Practice Through Close Collaboration 5: “What factors do you believe facilitate the implementa-
Model (ARCC; n = 7 of 105, 6.7%). tion of findings from nursing research into clinical prac-
For part two, how the EBP model was used, 67 of 115 tice at your hospital? Please describe.” Of the 27 categories
(58.3%) participants provided a description, generating identified, the most frequent were nursing leadership,
eight categories. The most frequent uses of the EBP model sharing and disseminating findings, and engaged nurses
were for education and training, in nurse residency pro- and educating nurses. Categories in rank order and sample
grams, and for EBP or research fellowships. responses are provided in Table 3.
Table 1 provides the rank order of categories as well as
sample responses for Question 2. Additionally, seven par-
ticipants commented that they are reevaluating their cur- STUDY LIMITATIONS
rent EBP model. Participant responses included: “We are Inherent with survey research and self-selection to par-
currently using the Iowa model. However, this is a task- ticipate, the nursing research leader responses may not be
force (assigned by professional practice council) to evaluate representative of all Magnet-designated hospitals. Some EBP
and determine different models. The taskforce will present models reported by participants at the time of this study may
their recommendations back to PPC.” And: “We have the have since been modified. Additionally, this study aimed at
Johns Hopkins model in place. However, our nursing re- exploring EBP model use and implementation (translation)
search council will be assessing this model soon for effec- of research findings into nursing practice. However, it did
tiveness within the organization.” not ask the participants why a particular EBP model was
used or about the benefits of using that model.
Implementation (Translation) of Findings from
Nursing Research Into Clinical Practice
Participants (n = 127 of 181, 70.2%) responded to Question DISCUSSION
3: “Does your hospital implement (translate) findings from There is no “magic bullet” for successful EBP enculturation.
nursing research into clinical practice?” Most reported yes Facilitators to implement findings of nursing research into
(n = 116 of 127, 91.3%). Those reporting yes were asked clinical practice include nursing leaders ensuring nurses at
to respond to Question 4, a two-part question: “Describe all levels are engaged in EBP and are being educated about
how your hospital implements these findings and whose EBP. Nurses who lead shared governance or leadership
responsibility it is.” councils or interprofessional teams need to fortify nursing

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Evidence-based Practice Model Use: Translating and Implementing Findings Into Practice

Table 1. Question 2: “What is the Name of the [EBP] Model and How is it Used?”

Ranking of categories (highest to lowest)

Name of EBP model (part one):
• Iowa Model of Evidence-based Practice to Promote Quality Care
• Johns Hopkins Nursing Evidence-based Practice Model
• Advancing Research and Clinical Practice Through Close Collaboration
• Site-developed models
• Model for Change to Evidence-based Practice
• Other*: ACE Star Model of Knowledge Transformation; McMaster Model of EBP; Transdisciplinary Model of EBP
*Category frequency <5
How EBP model is used (part two):
• Education and training
• Nurse residency programs
• EBP or research fellowships
• Other*: orientation; research and EBP leaders; inquiry processes (EBP and quality improvement projects); templates
and documents that support EBP processes; mentoring by clinical nurse specialist
*Category frequency <5
Sample responses (parts one and two)
Iowa Model
“Iowa Model—used to guide EBP studies; taught to hospital nurses as an algorithm to direct the project”
“Used for all EBP project implementation. Used in nurse residency program. On our nursing intranet page. Nursing
research council uses it”
“This model is used in the structure of our EBP & Research Fellowship Program”
JHNEBP Model
“Class offered to learn the model. Also have utilized their online modules”
“Johns Hopkins EBP Model is used for teams doing lit searches, evaluating the evidence, and developing and imple-
menting a plan to use the evidence, if warranted. This model is used when existing evidence summaries (e.g., AHRQ or
AACN toolkits) do not exist to address clinical questions. New nurse residents also use the model in teams during their
first year of residency to evaluate the literature on a topic. These projects make recommendations, but plans are not
developed and usually there is no implementation”
“We have used the Iowa EBP Model for more than 10 years. This model informed our overall Nursing Fellowship in EBP.
We have just recently, in the last three months, adopted the Johns Hopkins Model, in part because of the extensive set
of handouts/worksheets/templates that really support the early steps in the process. Our organization has a standard-
ized approach to improvement so we are leveraging these resources to support the ’translation’ into practice”
ARCC Model
“ARCC. We use the model to help sustain a culture of EBP, including nurse mentors and alignment of systems and pro-
cesses to support nursing research and EBP”
“Melnyk’s model. Used as a guideline only. Presented in orientation and occasionally in ’how to’ research classes”
“We have just begun to evaluate Levels of Evidence using the Melnyk/Fineout-Overholt Model”

practice that is evidence-based and ensure that EBP compe- (Gallagher-Ford, 2014; Li et al., 2018). Pintz et al. (2018)
tencies (Melnyk et al., 2014) are part of all nurses’ practice concluded that some CNOs and nursing leaders support EBP
set. Camargo et al. summarized this concept, stating, “the and research enculturation even though research and EBP
use of research in the practice of hospital nurses requires were rarely included in nursing orientation, job descrip-
knowledge and skills beyond the daily work” (2017, p. 1). tions, clinical ladders, or performance appraisals.
Further, nurses can become more familiar with implemen- Although there were no theoretical frameworks de-
tation science (National Institutes of Health, n.d.). scribed in the quantitative report by Pintz et al. (2018), the
While most (92.0%) participants specified that their analyses from the EBP-related qualitative data reported here
hospital used an EBP model, there was less consensus on make a connection with two theoretical frameworks: first,
how the model was used, how it was implemented (trans- the Donabedian Framework and its association with struc-
lated) into practice, and whose responsibility it was. ture, processes, and outcomes (Ayanian & Markel, 2016;
The literature supports the importance of imple- Donabedian, 1966). The hospital infrastructure (structure)
mentation and sustainment of EBP in healthcare settings and hospital culture (leadership support), along with the

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Table 2. Question 4: “Describe How Your Hospital Implements These Findings and Whose Responsibility
It Is”

Ranking of categories (highest to lowest)

How hospital implements findings from nursing research into clinical practice (part one):
• Policy and procedure committee processes at the unit level, department and organization, or system level
• Shared governance/leadership council structures and processes at the unit level, department and organization, or
system level
• EBP processes
• Research fellowship, nurse scientist program, EBP fellowship, and clinical scholar program
• Dissemination
• Nurses working with leaders for implementation
• Other*: policy and procedure; project lead presents to group responsible for implementing; change acceleration pro-
cess/change management strategy; additional research; quality improvement done after changes made
*Category frequency <5
Whose responsibility it is (part two):
• Primary lead for the project
• Nursing professional practice councils/shared governance councils
• CNS/APN
• Unit leader
• Nursing research director, scientist, or department
• Nursing educators
• Nursing research council
• Policy and procedure committee organizational level
• Staff nurses
• Other*: unit-based councils; magnet program director; quality improvement specialists facilitating change manage-
ment processes; EBP manager; department-wide council; all nurses are responsible for EBP; all leaders are responsi-
ble for EBP; physicians; study team
*Category frequency <5
Sample responses (parts one and two)
“This typically is done through our policy and procedure work. If a new practice needs to be implemented (based on new
evidence), the policy/procedure is updated, after which it goes through a Policy and Procedure Committee and then to
the Nursing Practice”
“Ideas are submitted to Nursing Coordinating Council. From there, they are assigned to a Central Shared Governance
Council or appropriate committee. The responsible council investigates the issue, especially checking current EBP and
research related to the issue, and makes recommendations based on the findings. If approved as a nursing project, the
appropriate council would submit an abstract to make the change with the inclusion of an evaluation measurement. The
responsible party and the evaluation of effectiveness process depend on the scope of the project and the implementa-
tion into practice”
“This is dependent on the project’s PI and their role in the organization. It is often the PI who will meet with key stake-
holders, present evidence, and gather support. The PI is often involved in changing policy/procedure and development
of the education plan. The PI will work with nursing management in the area of change as well as the nursing research
department to effect change”
“The Director of Nursing Research and the nurse PI on the project work with the clinical nurse specialists on the units to
determine applicability to practice. Specifically, unit policy/procedures are reviewed and updated as needed based on
research findings, and often unit-based PI projects are implemented to trial a new intervention or procedure based on
findings from the research study”

multiple characteristics (processes) that build a nursing is applicable as the idea of EBP becomes more encultur-
research program (e.g., dedicated research mentors and ated and diffuses in more nursing departments whereby
leaders, education and training, policies and procedures, CNOs and other nurses in leadership positions advocate to
resources, etc.) as noted in the HNRRO study (Kelly et establish EBP as an expectation for nursing practice in job
al., 2013; McLaughlin et al., 2013) and the HNRC study descriptions, performance appraisals, and clinical ladders
(Pintz et al., 2018), are necessary in order to achieve EBP so that it becomes standard practice. Strategies to engage
and research-related outcomes. It is important for nurses nurse leaders who are late or non-adaptors of EBP are to
at all levels within the organization to ensure that EBP show and tell them how EBP saves money, complies with
exists in their practice. The second framework is Rogers’ regulations, avoids litigation, and satisfies patients (Tucker
Diffusion of Innovation Theory (Rogers, 2003). This theory & Gallagher-Ford, 2019).

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Table 3. Question 5: “What Factors Do You Believe Facilitate the Implementation of Findings from Nursing
Research Into Clinical Practice At Your Hospital?”

Ranking of categories (highest to lowest)

• Nursing leadership
• Sharing and disseminating findings
• Engaged nurses; educating nurses
• Shared governance
• Strong CNO
• PhD-prepared nurses
• Nursing research and EBP council
• Mentors
• Communication and collaboration
• Funding
• Culture of inquiry
• Time
• CNS/APN library support
• Institutional support
• Being a Magnet facility
• Other*: clinical ladder program; accountability; statistical support; journal clubs; being an academic/university
center; clinical and content experts; grant writing support; adequate staffing; research strategic plan; recognition for
dissemination*Category frequency <5
Sample responses
Nursing leadership
“Nurse leader (frontline, director, and CNO levels) helps to facilitate changes, along with peer-to-peer support”
“The support from leadership is highly important; the managers and directors are playing an important role—how they
support initiatives and hold staff accountable”
“Supportive leadership (CNO, directors, managers) who support staff participation and encourage a spirit of inquiry”
Sharing and disseminating findings
“When staff are shown data showing that practice change has improved outcomes, they become more vested in continu-
ing the new process”
“Collaboration between key stakeholders and communicating why and how the change will affect patient outcomes is
critical in being able to facilitate the implementing of findings from nursing research”
“I’ve learned that, if you want to change a staff nurse’s life forever, get them involved in a research project and take it all
the way to publication”
Engaged nurses/educating nurses
“Engaged nurses who are not only supported but encouraged to perform research”
“Broad interprofessional stakeholder engagement”
“Growing to a culture of expected practice”
“Education, transparency, leadership support, and significance of the findings to practice.”
“Education of staff”
“Ongoing education, easy access to resources including: library, research mentors, access to research committee which
offers support, education, practice in designing questions and projects”

IMPLICATIONS FOR NURSING LEADERSHIP IMPLICATIONS FOR EDUCATION

Nurse leaders must ensure that structures and processes are Determining EBP readiness is critical, as is conducting
in place to achieve EBP outcomes in all areas where nursing ongoing evaluation of EBP-related educational needs as-
is practiced. This includes nurse leaders in administrative sessments. Warren et al. (2016) recommend establish-
positions (CNOs), clinical nurse leaders, CNSs and APNs, ing a hospital-wide EBP education plan that includes
those leading EBP or research councils, nursing profes- EBP competencies for practicing nurses and APNs. EBP-
sional practice councils and shared governance councils, competent nursing professional development practition-
nurses who are responsible for policy and procedure re- ers can take the lead in educating nurses, from “bedside
view, and all levels of nurses who seek nursing excellence. to boardroom,” on how to apply basic precepts, models,

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theories, and frameworks of implementation science to CONCLUSIONS
promote the uptake and sustainability of EBP. For exam- These new findings report >90% EBP model use and im-
ple, the ANPD just launched its inaugural, asynchronous, plementation of nursing research findings into clinical
yearlong EBP Academy for its nursing professional de- practice. All nurses, especially our leaders, have respon-
velopment practitioner members. The academy consists sibilities to evaluate EBP and how nursing research find-
of approximately 25 15-min modules created with ex- ings are implemented (translated) into practice. Engaged
periential learning activities for the practice setting and and educated nurses in EBP who enculturate, support,
EBP mentors who will work with the academy partici- and sustain EBP will ideally facilitate advancing nurs-
pants and provide guidance as needed for EBP projects ing practice to improve patient and work environment-
(ANPD, 2019). Other professional nursing organizations related outcomes. WVN
(regional, state, national, and international) can also fol-
low this path to promote and embrace EBP by providing
their members with EBP education through a variety of Author information
methods such as in continuing education programs, cer- Karen Gabel Speroni, Independent Nursing Research
tification requirements, specialty role-related competen- Consultant, Consultation LLC, Leesburg, VA, USA; Maureen
cies, and innovative educational conferences. Notably, Kirkpatrick McLaughlin, Independent Nursing Research
EBP curricula included in nurse residency programs help Consultant, Manassas, VA, USA; Mary Ann Friesen,
enculturate organizational EBP by requiring the develop- Nursing Research and Evidence-Based Practice Coordinator,
ment of a plan to execute an EBP project as part of the Professional Practice, Inova Health System, Falls Church, VA,
residency. USA
Acknowledgments: Christine Pintz, PhD, RN, FNP-
BC, FAANP, Study Principal Investigator; Cathie E.
IMPLICATIONS FOR FUTURE RESEARCH Guzetta, PhD, RN, FAAN, George Washington University
Factors influencing implementing nursing research find- School of Nursing; Katherine Patterson Kelly, PhD, RN,
ings into clinical practice are those that support, promote, Nurse Scientist, Children’s National Health System;
and sustain EBP. Future research is warranted to determine and members of the Washington Regional Nursing
the effect of EBP enculturation, including model use and Research Consortium, Washington, DC. This research
processes for implementing (translating) nursing research was supported by a nursing research grant from the
findings on care decisions, practices, and procedures that Council for the Advancement of Nursing Science and the
improve patient and work environment-related outcomes. American Nurses Foundation.
Address correspondence to Karen Gabel Speroni; karen.
speroni@outlook.com
LINKING EVIDENCE TO ACTION
Accepted 16 November 2019
• These new findings identify that most (>90%) leaders © 2020 Sigma Theta Tau International
report their hospital’s EBP model use. The most fre-
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