Melnyk_Evidence-Based Practice in Nursing & Healthcare, 5e

359 Chapter 9 / Key Strategies for Implementing Evidence in Real-World Clinical Settings

EBP, Research, Innovation, and QI Alignment Model

Organizational Leadership/Questions

Performance Metrics Questions

Clinical Questions

EBP Process

Innovation

Implement Evidence-Based Change

Conduct Research: Generate Evidence

Suf cient Evidence to support a change

Insuf cient Evidence to support a change

Monitor and Sustain Evidence-based Change through QI Process

Copyright © 2014 Lynn Gallagher-Ford Ph.D. RN, NE-BC, DPFNAP, FAAN 2014

Figure 9.2: The EBP, research, innovation, and QI alignment model.

2020; Yamada et al., 2015). In order to achieve the desired results, toolkits must be evidence-based; include options for individualization; and be expert-led with a phased implementation to include identifying key stakeholders, providing training opportunities, and establishing regular meeting intervals. Effective toolkits include: educational resources; implementation checklists; tracking resources; organizational (pre) assessment; structured communication plans; and barrier identi cation strategies (Shrout & Gallagher-Ford, 2021). Toolkits with all of these critical components have been shown to positively improve patient and organizational outcomes. It is imperative to recognize that toolkits are a passive strategy, requiring the competence of an EBP mentor and leadership support to actualize implementation. Most of the literature about the development and use of toolkits to implement EBP are focused on implementing a single practice change to address a single outcome (i.e., fall prevention, patient satisfac tion). While single practice change toolkits are effective, the development is laborious and unnecessarily repetitive, requiring clinician expertise in the practice change and toolkit development. Recognizing that healthcare organizations are consistently underresourced, the time and money to support single-change toolkit development for implementation is unreasonable. In order to address this challenge, multiple EBP centers have published and shared implementation toolkits. Most recently, the Helene Fuld National Trust Institute for Evidence-Based Practice in Nursing and Healthcare team published the Fuld ARCC EBP Initiative Implementation and

Copyright © 2022 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.