"The expectation is that they will align with the evidence and the [electronic EBP] resource that we use."
EBP Challenges Encourage Critical Thinking
If a nurse takes issue with a standardized procedure, he or she may engage in the challenge process.
"I encourage them to look at it, I encourage them to then go back and, if they want to challenge something there's a form that they have to fill out that is very specific about what it is they have an exception with," Mason explains.
The nurse must provide citations and resources to support the challenge and Mason does an initial review of the challenge.
"If the level of evidence is below the level of evidence used to define the electronic procedure I go back to them and explain that their challenge doesn't have the same rigor of evidence that was used to develop the procedure," she says.
"And I explain, if they still want to carry this forward, the type of evidence they need to find."
This includes explaining the scale CHI uses to determine strength of evidence.
"It's a way of pulling nurses into understanding leveled evidence and how it applies to practice," she says.
Mason also includes the nurse on any communication she has with the vendor regarding the challenge.
"I always copy them if I push this forward to the editor at the vendor for review," she says.
"I copy them so that they're aware that they're being listened to and they're involved in the discussion and the decision."
While it takes time and effort, Mason says encouraging rather than dissuading nurses' challenges to EBP is a positive thing.
"It's challenging sometimes but I think very beneficial for our end users, for our clinicians," she says. "What I have found is that because they see that we're open to pushing their challenges forward if they provide the evidence to support their claim, they really are more accepting then of any kind of changes that may occur."
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.