Evidence-Based Practice for Nurses

hand, if nurses are in organizations that operate from a

philosophy of “we have done it this way for years,” one

can expect change to be painful. On the other hand, it

can be equally disturbing if one is in an organization that

seems to change with the seasons. So, what is the solution?

Prepare, prepare, prepare, or as Fullan noted, it is about

strategizing. Think of EBP as a process. By using some of

the models described in this chapter, nurses can strategize

about how to embed evidence into practices, processes, and policies. You can

learn more about the change process by reading the works of Beer, Eisenstat,

and Spector (1990), Hammel (2002), and Kotter (1996).

Engaging Others in Change

One place to start engaging others in transitioning to EBP is to conduct an

assessment of the practice environment. In conducting the assessment, nurses

may find it helpful to include as many of their colleagues as possible.

Box 16-1 provides an example of a tool for assessing the practice environ-

ment. Although this tool is by no means an exhaustive list of questions, it

provides the reader with an understanding of the types of questions to be

FYI

Just as nurses need to understand the bar-

riers to research utilization, they need to

understand how change can affect EBP.

One place to start when engaging others in

transitioning to EBP is to conduct an assess-

ment of the practice environment.

Date of Assessment:___________________________

Practice Environment Being Assessed:___________________________

Answer as many of the following questions as possible. The more complete the answers, the

better the quality of the assessment.

1. What types of patients do you take care of on your unit?


2. What is the average daily census on the unit?


3. What care delivery model do the nurses on the unit use to care for patients?


4. What is the staffing mix on the unit? How many RNs, LPNs, aides?


5. How are practice errors reported?


6. Who is responsible for reporting practice errors?


7. What are the top three practice errors reported on your unit?


8. When errors are identified, what is done to correct the error?


9. Where is the policy and procedure manual on your unit?


10. How easy is it for you to access the policy and procedure manual?


11. How often are policies and procedures updated in your organization?


12. Who is responsible for updating policies and procedures?


13. How much input do staff nurses have related to creating or revising policy and procedure?


14. What are the quality initiatives in place on the unit at present?


15. How well is the unit doing related to the quality initiatives?


16. How are the results of quality initiatives communicated to staff?

BOX 16-1 Assessment of Practice Environment

436 CHAPTER 16 Transitioning Evidence to Practice