Evidence-Based Practice for Nurses

to invent new options to the problem; and (8) evaluating one’s thinking to
improve it (Chubinski, 1996). Experienced nurses often use these skills au-
tomatically. Because research skills to review and evaluate the evidence and
strength of evidence are foundational to EBP, such critical thinking skills will
serve the innovator well.

Flexibility

The second innovator characteristic is flexibility to change. In any practice setting,
change is constant, so being open to and maintaining a positive attitude about
change makes it easier for oneself and one’s peers. A successful change in the
practice setting occurs when a skilled change agent, an innovator, manages the
many feelings associated with change, such as feelings of achievement, loss, pride,
and stress (Marquis & Huston, 2006). On one hand, flexibility is being willing
to try a new product or implement a new policy; your peers and patients will
benefit from trying this change. You will also benefit personally by updating your
practice. On the other hand, if nurses do not try the new product or implement
the new policy, their practices will stagnate. Flexibility to change also requires
openness to failure because sometimes new ideas do not work as planned. One
example occurred when a new graduate nurse read a research article about a
new procedure and tried to implement it in her unit. Unfortunately, this change
was rejected by most staff members on the unit. Reasons for this might have
been that implementation of the new procedure worked fine in the research
setting but did not carry through to the practice setting, this particular unit was
different from the one in the research setting, or the nurse was a novice change
agent and therefore unable to understand the process of making policy changes
on her unit. Whatever the reason for failure, it is important to keep trying to
implement new changes for the benefit of patients. Strive to evaluate why a
proposed change did not work and use unit resources to try the new procedure
in a different way. Rogers (2003) noted that the innovation–decision process
may lead to rejection for a variety of reasons. Think of the many experiments
that failed at first, such as Thomas Edison’s search for electricity.

Awareness

Awareness is a third characteristic of an innovator. This
awareness is about oneself and one’s clinical practice area
(MacIntosh, 2003). Self-awareness is about knowing
yourself; how you think, act, use your senses to make
decisions, and why you do these things. It entails your
ethical, cultural, and spiritual values. Think about the
reasons you became a nurse or why you opted to work

KEY TERMS

change agent:

Individual who

leads or champions

change

self-awareness:

Knowing yourself

FYI

An innovator is one who is willing to try

new things in practice, using evidence, to

enhance the quality of patient care and to

foster nursing knowledge. Evolving into an

EBP leader on one’s unit or practice area is

a process that occurs with effort and time.

17.1 Who Is an Innovator? 451