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Posted: July 30th, 2023
References
Cullen, L., Hanrahan, K., Farrington, M., Anderson, R., Dimmer, E., Miner, R., Suchan, T., & Rod, E. (2020). Evidence-Based Practice Change Champion Program improves quality care. Journal of Nursing Administration, 50(3), 128–134. https://doi.org/10.1097/nna.0000000000000856
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Melnyk, B. M., & Fineout-Overhold, E. (2022). Evidence-Based Practice in nursing & healthcare: A Guide to Best Practice. Lippincott Williams & Wilkins.
Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2016). A test of the ARCC© model improves the implementation of Evidence-Based Practice, healthcare culture, and patient outcomes. Worldviews on Evidence-based Nursing, 14(1), 5–9. https://doi.org/10.1111/wvn.12188
Advancing Evidence-Based Practice in Healthcare: Dissemination Strategies and Barriers
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Evidence-Based Practice (EBP) is a crucial healthcare approach that integrates research data, clinical expertise, and patient preferences to enhance patient outcomes. Successful implementation of EBP requires the identification of the problem, stakeholders, change agents, and the practice change to be implemented. Disseminating pertinent information using appropriate models is essential to ensure successful EBP adoption. This paper discusses two dissemination models, the Iowa Model and the Advancing Research and Clinical Practice through Close Collaboration (ARCC), to promote quality care and improve patient outcomes. Additionally, the paper explores existing barriers to EBP implementation and sustainability.
Dissemination Models for Evidence-Based Practice:
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The Iowa Model of Evidence-Based Practice:
The Iowa Model is widely used in healthcare settings, especially by Magnet organizations, due to its systematic approach to EBP implementation. It emphasizes collaboration among healthcare professionals from various disciplines and encourages a team-based approach to EBP. The model's flexibility allows adaptation to fit the needs of patients and staff workflow, ensuring successful implementation.
To disseminate pertinent information about identified best practices, a five-minute PowerPoint video with a brief quiz can be utilized at workstations, accommodating busy healthcare professionals' schedules. The Iowa Model also emphasizes ongoing evaluation, enabling continuous quality improvement and adjustments throughout the implementation process.
Advancing Research and Clinical Practice through Close Collaboration (ARCC) Model:
The ARCC Model takes a holistic approach to EBP implementation, involving healthcare professionals from diverse backgrounds and disciplines. The model's initial step involves using the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice (OCRSIEP) to assess existing support for EBP within the organization. EBP mentors are then developed to guide and establish EBP implementation, fostering a culture of EBP and enhancing patient and system outcomes.
Dissemination of evidence-based interventions is facilitated by these mentors, who work alongside staff to encourage a change in EBP culture and improve EBP belief. The model's emphasis on continuous assessment and interdisciplinary engagement leads to greater nurse satisfaction, reduced turnover, and higher implementation and sustainability success rates.
Barriers to Evidence-Based Practice Implementation:
Despite the effectiveness of the aforementioned dissemination models, barriers to EBP implementation persist and must be addressed to ensure successful adoption. Some common barriers include:
Lack of EBP knowledge and skills: Healthcare professionals may not be adequately trained in EBP methods, hindering their ability to access and critically appraise research evidence.
Inadequate administrative support: Without support from leadership and management, EBP initiatives may not receive the necessary resources and commitment for successful implementation.
Resistance to change: Some healthcare organizations may have a culture resistant to adopting best practices, preferring to maintain existing practices, impeding EBP integration.
Complexity of implementation models: Models like i-PARIHS may be challenging for staff to comprehend, leading to difficulty in understanding the rationale for best practice implementation.
Resource constraints: Some EBP implementation models may require significant resources, time, and personnel, making them difficult to implement in resource-limited settings.
Insufficient staff buy-in: Successful EBP implementation often requires acceptance from the bottom up, with frontline staff actively participating in the transformation process.
Conclusion:
Evidence-Based Practice is essential for improving patient outcomes in healthcare settings. To successfully integrate EBP, organizations must employ effective dissemination strategies. The Iowa Model and the ARCC Model are two viable approaches, each with its strengths and benefits. However, barriers to implementation must be addressed to ensure sustained adoption of evidence-based interventions. By identifying and overcoming these barriers, healthcare organizations can make significant strides in promoting a culture of EBP and delivering high-quality care to patients.
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