Discuss leadership qualities essential for sustaining as EBP IS A NURSING CLASS – MASTER CLASSEBPSAMPLEWEEK5.docx2020NSG5111EBPModelsWeek4PPT.ppt

  

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Describe how the unique role of evidence-based leadership (EBL) can facilitate an organization’s change to the new paradigm of evidence-based practice (EBP).
Discuss leadership qualities essential for sustaining as EBP

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IS A NURSING CLASS – MASTER CLASS

EBPSAMPLEWEEK5.docx

2020NSG5111EBPModelsWeek4PPT.ppt

Week 5 Initial Discussion Post
The Unique Role of Evidence-based Leadership (EBL)
            Healthcare organizations are challenged with ensuring that consistent use of evidence-based practices (EBP) is implemented in the clinical setting.  Therefore, these challenges will require nurse leaders to promote a culture of inquiry amongst the nursing team.  To further complicate the challenge of using the best evidence for providing quality patient care, Gallagher et al. (2019) note that it takes 8-30 years to get evidence into practice resulting in patients not receiving the best possible care.  To mitigate these challenges, leaders must act as change agents and provide the resources needed to promote and support EBP implementation (Valimaki et al., 2021).  Additionally, healthcare leaders need to better understand and lead the charge by ensuring the minimization of barriers and allocation of resources so that caregivers feel supported with bringing EBP to the patients served (Gallagher et al., 2019).  Furthermore, leaders acting as visionaries are crucial to front-line staff members’ success, sustainability, and engagement in EBP initiatives.  A few items to aid in the success of EBP are ensuring staff education, revised job descriptions, changes in clinical ladder requirements, and having EBP mentors within the organization (Gallagher et al.)
Leadership Qualities
            Evidence-based practice (EBP) improves safety, quality, and patient care outcomes. It is defined as “a lifelong problem-solving approach to the delivery of healthcare that integrates the best evidence from well-designed studies” (Caramanica et al., 2022, p. 27).  Leaders must be influential in supporting and guiding their team through focused problem-solving to incorporate the best evidence into the patient care setting.  Leaders must also possess the knowledge and skill-set needed to act as a mentor in the push for driving EBP in the work environment.  The two levels of evidence-based leadership commitment are self-actualization of EBP and being the visionary for ensuring EBP is engrained into practice.  The second evidence-based leadership commitment is to facilitate a culture of EBP as the basis for clinical decision-making.  According to Gallagher et al. (2019), a leadership style that is important to mention is transformational leaders that form a partnership with and gain the trust of frontline caregivers to gain the ability to effect change and EBP inclusion into the culture.  Caramanica et al. (2022) note that leadership support and engagement are integral to successfully sustaining EBP to guide practice and improve patient outcomes. 
References
Caramanica, L., Gallagher-Ford, L., Idelman, L., Mindrila, D., Richter, S., & Thomas, B. K. (2022). Establishment of nurse manager leadership competencies to support clinicians in evidence-based practice. The Journal of Nursing Administration, 52(1), 27-34. https://doi.org/10.1097/NNA.0000000000001099 (Links to an external site.)
Gallagher-Ford, L., Buck, J. S., & Melnyk, B. M. (2019). Leadership strategies for creating and sustaining evidence-based practice organizations. In B. M. Melnyk & E. Fineout-Overholt (Eds), Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice (4th ed., pp. 328-347). Wolters Kluwer.
Valimaki, M. A., Lantta, T., Hipp, K., Varpula, J., Liu, G., Tang, Y., Chen, W., Hu, S., & Li, X. (2021). Measured and perceived impacts of evidence-based leadership in nursing: A mixed-methods systematic review protocol. BMJ Open, 11(10), e055356. https://doi.org/10.1136/bmjopen-2021-055356
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EVIDENCE-BASED PRACTICE (EBP) MODELS AND ORGANIZATIONS
NSG 5111
Evidence and Practice
Nova Southeastern University
Ron and Kathy Assaf College of Nursing

EBP MODELS

Purpose

Assists in implementing research findings into nursing practice
Breaks down complex challenges of translating research into nursing practice
Promotes return on investment of time and resources
Provides a belief system to guide practice

EVIDENTIARY DYNAMICS

EBP is dynamic and not linear
Fluid, mobile and portable
Continuous and unending movements
Interacting elements that constantly change
Provide a basis for good practice, creativity and innovation

Characteristics:

ORGANIZATIONS AND CULTURES OF CARING

Culture of innovation
Innovation not driven from the top down
Narrow locus of control
Open to ideas, questioning, and diving deeper into issues
Operating in a constantly changing environment
Associational thinking and planning to seek out uncommon and unrelated partners, issues, and processes that result in new knowledge and different perspectives

MODELS TO CHANGE PRACTICE

Identify a problem
Identify stakeholders
Identify a practice change
Identify potential barriers
Provide strategies to disseminate the change
Evaluate the practice change
Identify strategies to sustain a change

Commonalities of Models:

STEVENS STAR MODEL OF KNOWLEDGE TRANSFORMATION

Five steps:

Discover new knowledge
Summarize the evidence after a rigorous review
Translate evidence for nursing practice
Integrate changes into practice
Evaluate practice and its contribution to quality improvement

JOHNS HOPKINS NURSING EVIDENCE-BASED PRACTICE MODEL

3 major steps: Practice evidence translation

Identify practice question using a team approach
Collect the evidence
Translate evidence into practice

STETLER MODEL

Practitioner model
Critical thinking focus
Utilization of research findings

Five phases:
Preparation
Validation
Comparative/evaluative decision making
Refinement
Evaluation

IOWA MODEL

Represented as an algorithm
Defined decision points and feedback loops
Incorporates input from entire organization
Nursing is involved in each step
Advocates a pilot step before full implementation of practice change

ADVANCING RESEARCH AND CLINICAL PRACTICE THROUGH CLOSE COLLABORATION (ARCC)

Five steps:

Assessment of organizational culture and readiness for implementation
Identification of barriers and strengths of the EBP organization process
Identification of EBP mentors
Implementation of evidence in to organizational practice
Evaluation of outcomes from practice change

ITEMS TO CONSIDER WHEN CHOOSING A MODEL FOR YOUR ORGANIZATION

Fit with quality improvement programs
Ease of implementation by educators
Likelihood of success
Cost and time expenditures
Patient population
Inter- and Intra- disciplinary focus
Practicality and sustainability
Engagement of stakeholders

REFERENCES
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia: WoltersKluwer/Lippincott Williams & Wilkins.

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