Johns Hopkins Nursing Evidence-Based Practice Thrid Edition: Model and Guidelines

(^56) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
culture, peer review, shared governance, policies, and protocols. Process refers
to what is actually being done when providing care (e.g., patient care activities,
interaction between patients and providers of care), and outcomes refers to the
effects of care on the health status of the patient or the effectiveness of the in-
tervention. EBP teams need to recognize the linkage between all three categories
when assessing the results of an EBP project. According to Donabedian (1988), if
good structures are in place, it increases the likelihood of a good process, which
in turn increases the likelihood of good outcomes. As a result, understanding the
relationship between all three categories is important to the final analysis of the
end results of the EBP project, particularly if the results are less than expected.
Upon completion of the evaluation process, if the decision is made to continue
the practice change, the organization’s quality improvement process should be
undertaken when ongoing measurement, evaluation, and reporting are indicated.
Step 17: Report outcomes to stakeholders
In this step, the team reports the results to appropriate organizational leaders,
frontline clinicians, and all other stakeholders. Sharing the results, both favor-
able and unfavorable, helps disseminate new knowledge and generates additional
practice or research questions. Valuable feedback obtained from stakeholders can
overcome barriers to implementation or help develop strategies to improve unfa-
vorable results. The Dissemination Tool (see Appendix J) guides the EBP team in
identifying the audience(s), key message points, and methods to communicate the
team’s findings, recommendations, and practice changes.
Step 18: Identify next steps
EBP team members review the process and findings and consider whether any
lessons have emerged that should be shared or whether additional steps need to
be taken. These lessons or steps may include a new question that has emerged
from the process, the need to do more research on the topic, additional train-
ing that may be required, suggestions for new tools, the writing of an article on
the process or outcome, or the preparation of an oral or poster presentation at
a professional conference. The team may identify other problems that have no