Applying EBP in Nursing

Evidenced-Based Practice (EBP) Summary
Introduction
The focus on the article by Wilson, Banner, Austria and Wilson (2017) entitled “Evaluating the Implementation of an Interdisciplinary Evidence-Based Practice Educational Program in a Large Academic Medical Center” is on determining the extent to which an EBP educational program is effective at helping nurses to maintain EBP over time. The study’s aim was to develop an education plan for a healthcare provider that would “increase exposure and understanding of the evidence-based practice (EBP) process with multidisciplinary healthcare professionals” (Wilson et al., 2017, p. 162).
Key Points
The study sought to promote the EBP process by creating an educational program that would help nurses and healthcare professionals obtain and implement EBP on their own during the course of their work.
The study found that while nurses and other healthcare professionals were able to benefit from the EBP provided them at first, measurement after a one-year period had elapsed indicated that the nurses and healthcare providers were not able to maintain the EBP over this time at a high level.
Steps Taken to Implement the EBP
The steps taken to implement the EBP were, first, to assess the culture of the organization where the EBP was to be implemented. This enabled the researchers to understand strengths and weaknesses and see where possible points of resistance might be. It also enabled them to highlight “educational gaps about what EBP is” with regard to nurses’ and caregivers’ understanding of EBP (Wilson et al., 2017, p. 163).
Measurements of nurses’ and care providers’ confidence levels using EBP, knowledge of EBP and implementation practices regarding EBP were scored at baseline and again at 6 months and 12 months post-implementation using the EBP Beliefs Scale and the EBP Implementation Scale. The Likert scale was used to measure and score survey responses. Specifically EBP implementation scores were “measured by the frequency with which respondents engaged in relevant behaviors such as the appraisal of scientific evidence and sharing that evidence with patients and peers, collecting and evaluating data, and using evidence to change clinical practice were far more variable” (Wilson et al., 2017, p. 166).
Scores at baseline regarding appraising evidence from research were 28% and 35% after one year, indicating that nurses and caregivers improved their ability to appraise evidence from research one year out from the EBP education implementation. However, the score for promotion of EBP among peers fell from 52% at baseline to 35% one year post-implementation. Reading research fell from 52% at baseline to 21% one year out, indicating that the percentage of nurses and care providers who read research to facilitate EBP had fallen by more than half.
The study showed that while EBP education helps nurses to gain confidence in implementing EBP, it does not facilitate further development of EBP knowledge and skills. This indicates that nurses have to be constantly engaged with development implementations that orient them with the latest in EBP—otherwise, if left on their own, they are not likely to pursue EBP in addition to what they already possess.
Application
A practice problem that would benefit from the implementation of an EBP in my practice setting would be the issue of catheter-related infection. Catheter-related infections are a problem in my practice area and implementing a standardized approach to inserting, maintaining and removing catheters is an EBP that would help to possibly reduce the risk of catheter-related infections occurring so frequently in our department (Zingg et al., 2014; Humphrey, 2015; Page, Tremblay, Nicholas & James, 2015; Yazici & Bulut, 2018).
The information learned from the study by Wilson et al. (2017) would be applicable in my practice area with respect to this particular practice problem because it shows that nurses require training on EBP in order to be confident about implementing it. At the same time, the study showed that in order for nurses to continue to implement EBP over a long duration, there has to be continual educational intervention, so that the confidence levels do not drop, awareness of the importance of EBP is maintained at a high level, and the willingness to engage in research appraisal is developed.
In my practice area, nurses could receive standardized training on how to properly insert, maintain and remove catheter lines so as to reduce the risk of infection, according to the EBP models provided in the relevant research. This implementation could be supported with secondary education interventions every quarter throughout the year, which could also be mandatory so as to give nurses the opportunity to continuously develop their education and desire to implement EBP.
Continuous education over the course of the year would help to ensure that the information learned from the mandatory training on how to properly insert, maintain and remove a catheter would not be lost over the course of the year. It would also help to promote the idea of implementing other EBP in the department as there are numerous areas that require focus and attention in nursing in order to increase quality of care.
Conclusion
The study by Wilson et al. (2017) shows that implementing EBP requires confidence on the part of nurses and care givers and that confidence levels can be increased with the help of an educational tool that teaches nurses and care providers how to analyze research, share findings with peers and other professionals, and implement the EBP in their own practice. Their study found that confidence levels increased over the course of a year, but implementation and research on new EBP did not increase over the same time period. This information could be helpful in my practice area by showing that in order for nurses in my department to reduce the risk of catheter-related infection, they should receive mandatory training on standardized approach to catheter line maintenance as well as additional continuing education throughout the year. This would help to ensure that nurses continuously have their minds on EBP, implementing EBP, and learning new EBP so as to increase their quality of care.

References
Humphrey, J. S. (2015). Improving registered nurses' knowledge of evidence-based
practice guidelines to decrease the incidence of central line-associated bloodstream infections: an educational intervention. The Journal of the Association for Vascular Access, 20(3), 143-149.
Page, J., Tremblay, M., Nicholas, C., & James, T. A. (2015). Reducing Oncology Unit
Central Line–Associated Bloodstream Infections: Initial Results of a Simulation-Based Educational Intervention. Journal of Oncology Practice, 12(1), e83-e87.
Wilson, B. L., Banner, M., Austria, M. J., & Wilson, A. (2017). Evaluating the
Implementation of an Interdisciplinary Evidence-Based Practice Educational Program in a Large Academic Medical Center. Journal for Nurses in Professional Development, 33(4), 162-169.
Yazici, G., & Bulut, H. (2018). Efficacy of a care bundle to prevent multiple infections in
the intensive care unit: A quasi-experimental pretest-posttest design study. Applied Nursing Research: ANR, 39, 4-10.
Zingg, W., Cartier, V., Inan, C., Touveneau, S., Theriault, M., Gayet-Ageron, A., ... &
Walder, B. (2014). Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. PloS One, 9(4), e93898.