3 The Johns Hopkins Nursing Evidence-Based Practice Model and Process Overview 55Essentially, the team must consider the who, what, when, where, how, and why
when developing an action plan for the proposed change. The Action Planning
Tool (see Appendix I) provides a guide for the EBP team to develop the action
plan.Step 14: Secure support and resources to implement action plan
The team needs to give careful consideration to the human, material, or financial
resources needed to implement the action plan. Obtaining support and working
closely with departmental and organizational leaders can help to ensure the suc-
cessful implementation of the EBP action plan.Step 15: Implement action plan
When the team implements the action plan, they need to ensure that all affected
staff and stakeholders receive verbal and written communication as well as edu-
cation about the practice change, implementation plan, and evaluation process.
EBP team members should be available to answer any questions and trouble-
shoot problems that may arise during implementation.Step 16: Evaluate outcomes
Using the outcomes identified on the Question Development Tool (see Appendix
B), the team evaluates the degree to which the outcomes were met. Although the
team desires positive outcomes, unexpected outcomes often provide opportuni-
ties for learning, and the team should examine why these occurred. This exami-
nation may indicate the need to alter the practice change or the implementation
process, followed by reevaluation.
It is also important to note that information from which inferences can be made
about the EBP project’s outcomes can fall under one of three categories: struc-
ture, process, or outcomes (Donabedian, 1988). Structure refers to the setting
in which care is provided and may include, for example, (a) material resources
such as facilities, equipment, and money; (b) human resources, such as the num-
ber and qualification of personnel; and (c) organizational characteristics such as