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How CNOs Can Build Support for Evidence-based Practice

By Jennifer Thew RN  
   March 22, 2016

CNOs rank evidence-based practice low on their priority lists even though its use is necessary to achieve their top goals of improving quality and safety. OSU's CNO shares specifics on how nurse execs can build EBP-friendly cultures.

When I saw the results from a recent study on nurse executives’ prioritization of evidence-based practice, I was shocked. Only 3% of the CNOs surveyed ranked evidence-based practice as a top priority. How was that possible?

EBP has become such a buzzword in the nursing profession that I assumed it would be at, or at least near, the top of every CNO’s priority list. Plus, its implementation is part of the criteria for achieving the American Nurses Credentialing Center’s much coveted Magnet Designation.

Mary Nash, RN, PhD, FAAN, FACHE, chief nurse executive at The Ohio State University Health System and assistant dean at The Ohio State University College of Nursing in Columbus, had a similar reaction to the findings. “I’ve been a nurse exec for 32 years,” she told me. “I was really surprised.”

But perhaps the results shouldn’t have been such a surprise to either of us.

As I mentioned in last week’s column, many nurses went to school before EBP was part of the curriculum and therefore, have not been steeped in its concepts and processes for their entire careers.

Not being an “EBP-native,” however, isn’t an excuse for not getting up to speed on EBP.  

“We have got to educate the chief nurses, the nursing directors, and the nurse managers [in EBP],” says the study’s author Bernadette, Melynk, RN, PhD, CPNP/PMHNP, FAAN, FANP, associate vice president for health promotion, university chief wellness officer, and dean of the College of Nursing at The Ohio State University.

“We’ve got to equip them with skills in EBP so they can build a culture and an environment that makes EBP the easy choice for people to make at the bedside.”

A Common Thread

The first step in developing a culture that embraces EBP is to set clear priorities. Nash recommends using the strategic planning process to identify about four areas on which to focus.

“We have an annual strategic planning process and a five-year strategic plan,” she says. “We look at four major areas:

  1. Quality and safety
  2. Nurse engagement
  3. Patient experience and
  4. Cost-effective care delivery

Once these areas have been defined, it’s time to bring EBP into the picture. “Rather than thinking about [EBP] as a separate component, we think about it as woven into all of our four priorities,” Nash says. “It’s a thread that’s woven across all those dimensions.”

Take the health system’s top priority of quality and safety, for example. Preventing and reducing central-line acquired bloodstream infections is a common quality and safety goal across the U.S. healthcare system. Evidence on ways to achieve this goal (Nash specifically mentions the use of disinfecting port protector caps) should be assessed and implemented.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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