Professional Documents
Culture Documents
– 2sd – sd + sd
Rogers, E.M. (1995). Diffusion of Innovations (4th Ed.). New York, NY: The Free Press.
Stay a cycle ahead.
Scale down the scope of tests.
Pick willing volunteers.
Pick changes that don’t require a
lengthy approval process.
Don’t reinvent the wheel.
Pick easy changes to try.
Avoid technical slowdowns.
Reflect on the results of every change.
Be prepared to end a test of change.
Nurses are just like any other hospital worker
Nurses must operate
from a body of knowledge
Practice must be
evidenced-based
Nurses must collect
reliable data
Nurses must base
decisions on sound data
Transformational leaders
Staff involvement
Nurse Champions
Unilateral Assignments
Vision and Mission
Time and Resources
Internal Expertise
Identified leaders for EBP
• Knowledge
• Practice/Process
• Patient
Sackett et al, 2004
P (Population) In adult patients undergoing joint
replacement surgery,
Population:
Intervention:
Comparison:
Outcome:
In critically ill patients, are low-pressure
mattresses/beds w/positioning more effective than
usual foam mattress/bed w/positioning in
preventing pressure ulcers, (defined as all stages,
discoloration of skin, partial or full thickness skin
loss)?
Once a policy or clinical practice
issue is selected, relevant
research and related literature
needs to be retrieved:
Conducting the Literature Review
• Cochrane Collaboration
• Professional Organizations
• Benchmark Institutions
• Traditional methods of finding published
literature (e.g., card catalogs, health indexes)
• Other sources include:
Bibliographies of integrative reviews
Abstracts published as part of conference proceedings
Master's theses and doctoral dissertations
Others having completed an EBP project on the same topic.
Systematic Reviews & Meta
Analysis
Randomized Controlled Trials
Experimental Studies
Quasi-experimental Studies
Non-experimental Studies
Descriptive Studies
Comparative Studies
Case Reports
Expert Opinion & Textbooks
• Once the research and other levels
of evidence have been obtained and
critiqued, the evidence-based
intervention (innovation) needs to be
developed
• The intervention needs to be written
into some unit or department-based
practice document such as a
practice guideline, procedure,
competency, policy, patient
education, documentation forms,
computer charting screens, menus
• How will it solve the identified problem
• The solution is described so it is clear to
readers exactly what will change
• Ways the proposed solution consistent with
the research base of support
• The population involved
• Those who will implement the project
Elements of an Implementation Plan
Are undaunted by insults and rebuff, and above all persist for
the good of the patient
Nobody can do everything, but
everybody can and must do something!
Thank You!!!