Discussion: Developing a Culture of Evidence-Based Practice

Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Dissemination is the targeted distribution of information and intervention materials to a specific public health or clinical practice audience. (AHRQ, 2012). It is used to spread knowledge and evidence-based practice on a wide scale within or across geographic locations, practice settings, social media, or other networks for the benefit of patients and health care providers.

The two dissemination strategies I would be most inclined to use are social media and mass communication. The reason being, we live in a social media world, everyone is on some type of social media platform, and they find out information very quickly. If a specific topic is trending, it is most likely going to reach the masses of people in a matter of seconds. Social media helps facilitate to most recent and most relevant information.

Mass communication is another great way to exchanging information on a large scale to a wide range of people. It has brought information to people that otherwise could not be reached and has increased awareness among people about what is happening in other parts of the world. Websites and healthcare applications are great in delivering mass communications on topics that need to be discussed to a particular population an also keep the community up to date and in the know. (Krohn et al, 2022).

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I would be least likely to distribute program materials, such as flyers, guides, pamphlets and DVDs because most of the time, they end up in the trash. Having a phone or tablet to search for information is more convenient and less clutter for humans. It will take more time to find the pamphlet and scan for the information as opposed to searching online.

The barriers I might encounter when using social media and mass communication are social anxiety, depression, and exposure to content that is not age appropriate. (Dalomba, 2022). People tend to believe everything on social media, it is not always a good thing, and people do not talk about what they read but tend to internalize it.

Ways to overcome these barriers are to display some type of public service announcement or disclaimer after the information. Sometimes, people need to be reminded about things they just read, and know that there is help, or someone here to further explain and answer questions.

References

Agency for Healthcare Research and Quality. (AHRQ). (2012). Communication and Dissemination Strategies To Facilitate the Use of Health-Related Evidence. https://effectivehealthcare.ahrq.gov/products/medical-evidence-communication/research-protocol

Links to an external site.

Dalomba, F. (2022). Lifespan: Pros and Cons of social media. https://www.lifespan.org/lifespan-living/social-media-good-bad-and-ugly

Links to an external site.

Krohn, Kristina M. MD1; Crichlow, Renee MD2; McKinney, Zeke J. MD3; Tessier, Katelyn M. MS4; Scheurer, Johannah M. MD5; Olson, Andrew P.J. MD6 (2022). Introducing Mass Communications Strategies to Medical Students: A Novel Short Session for Fourth-Year Students. Academic Medicine 97(7):p 999-1003 https://journals.lww.com/academicmedicine/Fulltext/2022/07000/Introducing_Mass_Communications_Strategies_to.42.aspx

Great post! I love going to conferences and hearing colleagues discussed new information or experiences they have encountered at their organization. These conferences provide education, sharpen skills, gives us the ability to interact with peers, and try new equipment which leads to improvement in health-care delivery, and patient outcomes. (Mishra, S, 2016).

Sometimes, we may think that our place of work is the only one going through an issue, when, it happens more often, but not discussed. At conferences, I learn about issues, or techniques that are being used or no longer in use and the nurses elaborate as to why. Their input is valuable, and gives us as a whole a much clearer understanding.

Publishing an article is another great dissemination strategy. Writing for a publication allows you to contribute to nursing practice and help build nursing and healthcare knowledge. Clinical articles aim to help nurses understand the clinical presentation and progression of a disease or health issue and the subsequent care for a specific patient population.

The nursing literature serves as a primary means of communicating new knowledge to nurses and should provide some discussion about the nursing perspective and nurses’ contributions to these health care initiatives. It is important not to lose our nursing perspective. (Oerman et al, 2019). Journal articles, websites, books, and other publications provide our primary means of communicating this knowledge and new information to others.

I concur with you about forcefully implementing the evidence-based practice intervention in the organization without informing or involving the other organizational stakeholders. This is a recipe for disaster, lack of support, an unwillingness to learn and implement, and dissatisfaction among leaders, nurses and other stakeholders.

References

Mishra S.(2016). Do medical conferences have a role to play? Sharpen the saw. Indian Heart J. 68(2):111-3. doi: 10.1016/j.ihj.2016.03.011. PMID: 27133315; PMCID: PMC4867024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867024/Links to an external site.

Oermann, M, Chinn, P, Carter-Templeton, H, Nicoll, L. (2019). The Importance of Nursing in Nursing Publications. https://doi.org/10.1111/j.1750-4910.2019.tb00043.xLinks to an external site.

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
- This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
Reflect on which type of dissemination strategy you might use to communicate EBP.

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By Day 3 of Week 10

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified. Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Dissemination Strategies

Evidence-based practice (EBP) is an essential competency for healthcare professionals to provide better patient outcomes (Newhouse et al., 2007). In order to promote changes that are found to have solid evidence, there are multiple dissemination strategies that can be used, including: publishing in nursing journals, sharing information through social media or website, creating pamphlets and flyers, presenting at national conferences, promoting at health fairs, and more (Rural Health Information Hub, n.d.).

One dissemination strategy I am most inclined to use is work email. Emails are a quick and easy way to send information to multiple parties at a given time. They are efficient in relaying information to the intended recipient(s) and can be opened at the convenience of the recipient.

Another strategy I would be inclined to use is creating informative flyers. I have always had a passion for art, and I enjoy creating projects that are beneficial to improving workflow and organization. Furthermore, I believe both appeal and presentation have a huge impact on the impressions of leaders.

The dissemination strategy I would be least inclined to use is speaking at national-level conferences. I have always struggled with public speaking, and this would be an amplified version of what I might consider being a typical public audience.

Barriers and Overcoming Barriers

Although most individuals in the healthcare system likely already realize the importance of promoting evidence-based practice (EBP), there are barriers as well. For instance, if using email as a dissemination technique, one might encounter a lack of response as not everyone keeps up with checking their emails daily. Another lack of response could be from an email that happened to go to the wrong email address. To overcome these issues, I would triple check email addresses for accuracy as well as encourage staff to check their emails regularly.

Another barrier could potentially be the lack of support from the manager. If the manager does not envision a successful outcome, he or she may be less likely to support the intervention. If this becomes the issue at hand, I would reach out to doctors and nurse practitioners within the workplace to gather their thoughts and opinions considering their medical knowledge. After all, being a role model, empowering others, and encouraging others to reach their full potential are all characteristics of an evidence-based leader (Melnyk & Fineout-Overholt, 2018).

Dissemination strategies aim to spread knowledge and the associated evidenced-based interventions on a wide scale within or across geographic locations, practice settings, or social or other networks of end-users such as patients and health care providers (Melnyk, Fineout-Overholt, Stillwell, Williamson, 2016).

Strategies can include large scale seminars to sharing small peer-reviewed articles with your co-workers after report. Sharing information can be done in various forms and forums. Once an evidenced-based change has been adopted or approved in your facility, the information must be transferred to the masses. One strategy is to introduce information in an all staff meeting. The new policy and procedure can be introduced and signed. Handouts, or power point presentations can be utilized to appeal to the visual and auditory learners. If the change includes hands on skill development, the watch one, do one teach one method is always helpful for those learners who may be more kinetic type learners (Walden Library). Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Foreseeable barriers include lack of staff buy in, lack of understanding, or financial issues within the budget of the facility. Ways to overcome these barriers include working in teams with education and support. Ongoing follow up to assure understanding and mastery of skills. Lastly assure that the evidenced-based change is also presented to and supported by the administrative team in order to include in the budgetary planning projects and fiscal justification. The more information and planning that can be done, the greater chance for success.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2016). Evidence-

based practice: step by step: igniting a spirit of inquiry: an essential foundation for evidence-based practice. The American Journal of Nursing, 109(11), 49–52. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NAJ.0000363354.53883.58

RE: Discussion – Week 10

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M…,

Thank you for your post. I appreciate the strategy of using staff meetings as dissemination environments. Currently the organization I work for uses huddle before shifts to introduce ideas, policy changes, and procedure updates. We are normally given the topic for which the information is based, along with a binder of information that we are to look through on our own time. The binder includes a sheet to sign that acknowledges the staff members understanding of the information. I feel this is not the most effective strategy but is the most convenient for all staff members. Our organization normally does include a module online to complete in addition to this informal education. You mentioned using power point presentations as useful for visual and auditory learners, and the module is where we would find that helpful tool.

As a kinesthetic learner, I am interested in the show one, do one, teach one method. I encountered a preceptor who utilized this method of knowledge dissemination and it was highly successful with all new nurses. I also agree with your stated barriers. I believe that they may be combated with foresight in audience. Packaging information in a way that is tailored to the audience is an effective way to combat a lack of staff interest, and hopefully lack of understanding (Derman & Jaeger, 2018). To effectively disseminate knowledge, we must identify the audience and mold the message and presentation of the message to the chosen audience (Evelina, et. al, 2020).

References

Derman, R. J., & Jaeger, F. J. (2018). Overcoming challenges to dissemination and implementation of research findings in under-resourced countries. Reproductive health, 15(Suppl 1), 86. https://doi.org/10.1186/s12978-018-0538-z

Evelina Chapman, Michelle M. Haby, Tereza Setsuko Toma, Maritsa Carla de Bortoli, Eduardo Illanes, Maria Jose Oliveros, & Jorge O. Maia Barreto. (2020). Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implementation Science, 15(1), 1–14. https://doi-org.ezp.waldenulibrary.org/10.1186/s13012-020-0974-3

Walden University Library. (n.d.). Databases A-Z:

Nursing. https://academicguides.waldenu.edu/az.php?s=19981

The Advancing Research and Clinical Practice through close Collaboration (ARCC) is a model that can be used by health care systems to appropriately promote and educate staff on EBP changes in a way that addresses known barriers. The ARCC model acknowledges the barriers to EBP change initiatives and deconstructs the process into manageable steps. ARCC subject matter contains EBP skills building, generating a vision to inspire change to EBP, team building and communication, mentorship to promote EBP, strategies to create EBP culture, quality improvement methods, data management and outcomes assessment, and principles of individual and organizational change (Mylnyk, 2012). Employing the ARCC template is an effective method to overcoming identified hurdles that will be met when promoting EBP initiatives in a health care organization.

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the

ARCC model for systemwide sustainability of evidence-based practice. Nursing

Administration Quarterly, 36(2), 127–135. https://doi-org.ezp.waldenulibrary.org/10.1097/NAQ.0b013e318249fb6a

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Cruz, R. (2010). Correlates among

cognitive beliefs, EBP implementation, organizational culture, cohesion and job

satisfaction in evidence-based practice mentors from a community hospital

system. Nursing Outlook, 58(6), 301–308. https://doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2010.06.002

Healthcare professionals conduct numerous studies focusing on different clinical issues with varying findings. To influence practice change on a broader scale, healthcare professionals should share their findings with other practitioners and policymakers within and outside the health practice. Critical to promoting a culture of evidence-based practice (EBP), dissemination encompasses the targeted distribution of information and intervention to a broader audience to maximize the benefits of research (Ravinetto & Singh, 2020). The targeted population usually includes a specific public health or clinical practice audience.

There are multiple dissemination methods, and nurses should select the most suitable according to situations, objectives, and audience characteristics. To communicate EBP, I would be most inclined to a policy brief and organization-wide seminar. A policy brief summarizes the research information and enhances it with charts, tables, and other visualized data (Brownson et al., 2018). Seminars or workshops allow researchers to share information and interact with the audience as they clarify issues related to research findings. Ashcraft et al. (2020) advised research disseminators to use printed materials and personal communication since they are the most common channels. Therefore, the choice of policy briefs (print materials) and workshops as dissemination channels is justified. I would be less inclined to use news media and social to disseminate EBP. News media could be valuable for reaching healthcare practitioners and policymakers but could be expensive. Social media reaches a limited audience and could not be highly effective for academic engagements.

It is possible to encounter some barriers when using policy briefs and organization-wide seminars for EBP dissemination. A potential barrier with policy briefs is information choice since they should be brief, tailored to the audience’s needs, and appealing (Brownson et al., 2018). Failure to meet these needs can hamper the readability and usability of research information. A possible barrier with organization-wide seminars or workshops is timing. The busy nature of the healthcare environment can limit healthcare practitioners’ and leaders’ availability for the seminar.

References

Ashcraft, L. E., Quinn, D. A., & Brownson, R. C. (2020). Strategies for effective dissemination of research to United States policymakers: a systematic review. Implementation Science, 15(1), 1-17. https://doi.org/10.1186/s13012-020-01046-3

Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: new approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102-111. DOI: 10.1097/PHH.0000000000000673

Ravinetto, R., & Singh, J. A. (2022). Responsible dissemination of health and medical research: Some guidance points. BMJ Evidence-Based Medicine. http://dx.doi.org/10.1136/bmjebm-2022-111967

In the contemporary healthcare society, evidence-based practice has emerged to be very important in ensuring quality and optimal care. According to Gallagher (2011), EBP is associated with nurses’ effective and efficient performance since it offers the knowledge to solve several clinical issues. Ideally, the dissemination of evidence enables healthcare practitioners to share and advocate for the use of EBP in healthcare. Nurses and clinicians can share and advocate for the development and integration of EBP in medical practice due to the sharing of evidence.

Dissemination Strategies

To disseminate EBP, my initial technique would be to use electronic poster presentations. Electronic poster presentations can be established on screens in various locations across healthcare institutions to reach a larger audience. Using an electronic poster presentation saves time and money while being “green” (Melnyk & Fineout-Overholt, 2018). For instance, in my healthcare organization, we use electronic poster boards, which are more efficient and time-saving since nurses can examine the content more regularly and in a more pleasant setting, such as our breakroom. Roundtable presentations are the second method of disseminating information. For instance, new EBP changes are communicated to inpatient units within the hospital during briefings before the start of each workday. Roundtable discussions allow for a more in-depth conversation with complete participation from the clinical team and possibilities for professional development (Harper et al., 2019).

Least Inclined Dissemination Strategy

The utilization of online modules would be the least inclined dissemination technique. Online modules are only useful if the user completes the module and engages completely in the EBP. Several of the educational modules offered to physicians, for instance, question if you have reviewed the message and provide a yes or no button. Most physicians do not even read the instruction and check the box indicating that they have completed the module when, in fact, they haven’t.

Two Barriers and How to Overcome

When using electronic poster presentations, I might have one barrier: there are no possibilities for learners to ask questions, and they lose the ability to be explicitly specified. A limited amount of area for education is available in an electronic poster presentation, which is similar to a PowerPoint presentation (Melnyk & Fineout-Overholt, 2018). The second hurdle to the diffusion strategy to roundtable presentations is that the number of clinical staff attending EBP presentations is limited. The EBP material cannot be pushed due to low attendance during roundtable presentations. One way to deal with these issues would be to advocate for implementing the EBP to aid in educating, promoting, and lobbying for change (Walden University, 2018). Some other strategies will include allowing enough time for clinical personnel to attend roundtables, complete online modules, and create easy-to-read electronic poster presentations with all relevant material.

References

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change. AJN, American Journal of Nursing, 111(3), 54–60. https://doi.org/10.1097/10.1097/01.naj.0000395243.14347.7eLinks to an external site.

Harper, M. G., Warren, J. I., Bradley, D., Bindon, S. L., & Maloney, P. (2019). Nursing Professional Development’s Spirit of Inquiry Focus Areas. Journal for Nurses in Professional Development, 35(3), 118–124. https://doi.org/10.1097/nnd.0000000000000515Links to an external site.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Walden University (Producer). (2018). Evidence-based Decision Making [Video file]. Baltimore, MD: Author.

To make sure that the most recent and efficient interventions are incorporated into clinical care, it is essential to spread evidence-based practice (EBP) in the healthcare industry. Using a combination of strategies has been more effective than using a single strategy (Silva et al., 2021). Peer networking/collaboration and educational seminars are two strategies to spread EBP. The use of EBP among peers would be facilitated by the nursing staff and would be encouraged by the peer-to-peer strategy. This can be accomplished by designating a staff nurse for each shift to serve as “champions” who can mentor and instruct their fellow employees. The champions can contribute to the creation of emails and educational material that will encourage participation among their coworkers (Gallagher-Ford et al., 2011). Urge them to get in touch with the champions if they have any questions or concerns regarding the EBP being promoted in these emails and posters. Letting the staff know that their input is valued and will be considered will help keep them on board during the EBP rollout.

Identifying the key stakeholders is a crucial step to take before launching the new EBP. Once the stakeholders are identified, bringing them together for a private meeting to introduce the EBP can aid in gaining their support. Explain the project’s aim, objective, and expected results during this meeting to help gain their support (Gallagher-Ford et al., 2011). It is necessary to have leadership onboard to be successful when implementing a new EBP project. Especially since they are responsible for managing the staff and financing of the establishment (Newhouse et al., 2007).

Challenges would include uncertainty among the nursing staff. Uncertainty can create criticism among the nursing staff and resistance to a new implementation. This uncertainty may be created from the staffs lack of knowledge and skills in EBP. Another barrier for the implementation of EBP is not having the support of administration (Melnyk, 2012).

References

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change. AJN, American Journal of Nursing, 111 (3), 54-60. doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e.

Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36 (2), 127-135. doi: 10.1097/NAQ.0b013e318249fb6a.

Newhouse, R. P. , Dearholt, S. , Poe, S. , Pugh, L. C. & White, K. M. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: The Journal of Nursing Administration, 37 (12), 552-557. doi: 10.1097/01.NNA.0000302384.91366.8f.

Silva, M. T., Galvao, T. F., Chapman, E., da Silva, E. N., & Barreto, J. O. M. (2021). Dissemination interventions to improve healthcare workers’ adherence with infection prevention and control guidelines: a systematic review and meta-analysis. Implementation science : IS, 16(1), 92. https://doi.org/10.1186/s13012-021-01164-6

Discussion: Developing a Culture of Evidence-Based Practice NURS 6052