(^176) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
opinion for or against the change. The opinion leader is often someone that the
group members turn to for advice, opinions, or views on matters of importance,
so it is critical to identify them in the process.
Once this group is organized, its members identify barriers and facilitators to
the success of the proposed practice change, identifying strengths that can be
leveraged to overcome the barriers. They would also discuss how the change will
impact current policies and procedures, the workflow and throughput of the unit
or department, and technological supports to the group’s usual work, such as the
electronic health record (EHR) or another technology that the group depends on.
Identify Milestones and Critical Tasks
The action plan should include the identification of critical milestones and other
essential tasks to be completed for the translation. The milestones should include
a schedule of all necessary activities, with an assignment of who is responsible for
each activity and the target time frame for completion. The action plan should
also include activities associated with collection and analysis of the pre- and
post-measures for evaluation of the practice change (see Appendix B).Secure and Confirm Support and Availability of Resources
Securing support from stakeholders and decision-makers is critical to the imple-
mentation of recommendations. Availability of funds to cover expenses associat-
ed with the translation and the allocation of human, material, and technological
resources is dependent on the endorsement of stakeholders such as organization-
al leaders or committees and in collaboration with those individuals or groups
affected by the recommendations. For success, it may also be necessary to bring
in content or external experts to consult on the translation. The cost of these
resources should be estimated and budgeted and an implementation plan formu-
lated. Decision-makers may support wide implementation of the change, request
a small test of the change to validate results, revise the plan or recommendations,
or reject the implementation plan. Preparing for the presentation or meeting with
decision-makers, involving stakeholders (see Appendix C), and creating a com-
prehensive implementation plan are the key steps in building organizational