Role of Research in Evidence-Based

Role of Research in Evidence-Based Practice

Evidence-based practice holds great promise for the professional nurse in the clinical setting; additionally, learning through continuing self-education and peer-group education from evidence-based studies enables the nurse to operate at optimal efficiency in their job functions. However, given the demands of the profession it is not always easy to come together in a learning atmosphere (Krugman, 2009). However the use of evidence-based practice can be both clinically important and professional advantageous to engage in (Leasure, Stirlen, & Thompson, 2008).

The problem is identified as the clustering of cliques among nurses in the clinical setting based on their cultural background, thereby creating a potential for missed communication, lowered patient care, and interpersonal strife. The change application to address this problem is based on Lewin's model and applies transactional leadership to see it through the stages of change needed. The optimal outcome is increased cultural awareness and respect among nurses of different cultural backgrounds, as evidenced by a decrease in cultural cliques in the work environment.

Dellasega (2009) reports on the relational aggression that occurs in the nursing environment. These types of aggression occur when two or more nurses band together and engage in aggression against other nurses. The forms of aggression are not physical, they are relational. These forms of aggression include gossiping, ostracizing nurses, and deliberately withholding information (Dellasega, 2009). While all forms of aggression noted are psychologically distressing and contribute to disunity among nurses in the workplace, the last aspect of withholding information has the potential to not just hurt the nurse being aggressed upon, but also hurt the nurse's patients. This is an unacceptable situation, as lives hang in the balance.

Change Process

Stage One: Unfreeze

Problem identification: cultural cliques among nurses in the workplace.

Stage Two: Move/Action

Training/focus groups on cultural awareness among staff nurses

Ongoing ethics training classes in cultural diversity (benefits patients as well through nursing action)

CNL takes charge through implementing ethical standards of conduct:

Breaks up cliques through job rotations

Job performance evaluations include issues personal conduct toward other staff, including appropriate sanctions.

Rewards (recognition, praise) for incentives to promote cultural diversity in the workplace by nurses.

Relocate/terminate those nurses who continue to be forces of resistance to positive change.

Change action efficacy measured by ongoing anonymous nurse surveys on issues of nurse unity/disunity in the workplace, with suggestions for tweaking change.

On-going emphasis on professional standards of nursing creates unity among nurses.