1. B Y J O R D A N K E S S L E R R N , B S N
Implementing Evidence Based
Practice at BJU

2. What is Evidence Based Practice? (EBP)
Best
Evidence
Research
Clinical Expertise
Patient
Values &
Preferences

3. Evidence based
practice has 5
simple steps,
known as the 5 A’s
 Provide an
algorithm to
guide the EBP
process
 Step-by-step
process
 Use as a guide
when there is
not up-to-date
evidence based
protocol/proced
ures for them to
use

4. Types of EBP Models
 47 different types of EBP models exist today in
literature
 Of those 47 models, they can be characterized into 4
main categories
 Knowledge Transformation Processes
 Strategic/ Organizational Change Theory to Promote Uptake and
Adoption of New Knowledge
 Knowledge Exchange
 Synthesis for Application and Inquiry
 Examples: Stetler Model, Iowa Model, PARiHS
Model, & Colorado Model

5. Here is an example of
The Colorado Patient- Centered
Interprofessional Evidence-Based
Practice Model
 Organizational
Support
 Leadership
 Mentorship
 Facilitation
All of these
components are
important to
sustaining an
evidence-based
culture

6. Quality &
Safety
Excellent
Nursing
Care
Commitment
2 Service
Culturally
Sensitive
Evidence
-based
Practice
Respect
BJU Current Model

7. Current Practices at BJU
Journal
Club
Hourly rounding
Up2DateEducation
Practices
are
evidence
informed
Presentation of
Case Studies
Curriculum Training

8. Barriers to implementing EBP
 Not enough time to read, review, research or
implement new ideas
 Overwhelming patient work load
 Nurse unaware of hospital resources, such as usage
of Up2date & journal club
 The amount of research can sometimes be too
overwhelming
Survey Conducted at BJU

9. Sample survey at BJU
Survey
Questions
What level nurse are you?
Years of nursing experience ________ years
What type of nursing degree
Have you heard of Evidence based practice (EBP)?
Have you implemented EBP for clinical decision making in the past
year?
How many times per month have you accessed the following online
database systems (Up2date) to search medical information?
What is your motivation to access online database systems?
Are you willing to participate in evidence based projects or activities in
the coming years?

10. Survey Results
20%
16%
17%
11%
11%
25%
Why do you use Up2date?
a. Improve clinical practice
b. Research
c. Patient discharge instructions
d. Unsure of patient diagnosis
e. Promotion exam
f. Self-learning
18%
19%
14%
18%
31%
Future interest
a. Journal Club
b. Evidence based practice
committee
c. Research team
d. Revising procedures to be aligned
with EBP
e. Education

11. How can BJU change its current
EBP and continue to provide
quality patient care?
Choose an
EBP
Model
Nursing
Change
Theory
SUCCESS!

12. Nursing Change Theory
 Kotter 8 Step Model, created in 1996, based on a 8 step
process
“According to John Kotter, 70 percent of all major
change efforts in organizations fail because
organizations do not take the holistic approach
required to effect that change”
 8 step model increases change
 Improves operating process and effectiveness
 Change is difficult both for the organization and for staff
 This models offers a road map for implementing change

13. Create
urgency
Formapowerful
coalition
Createavisionfor
change
Communicatethevision
Empoweraction
Createquickwins
Buildonthechange
Makeitstick!
Kotter 8 Step Model
Quality &
Safety
Excellent
Nursing Care
Commitment 2
Service
Culturally
Sensitive
Evidence-
based
Practice
Respect

14. Kotter Change Model + EBP
 Using the Kotter Change Model you can follow the
EBP steps
 Construct a patient question or clinical case
 P- Patient/population/Problem
 I-Intervention/Exposure
 C-Comparison
 O-Outcome
 Research the literature
 Look for valid applications
 Apply the evidence to your practice
 Evaluate

15. How to continue to improve EBP at BJU
TrakCare
Implementation of standardized
nursing terminology
Exit Writer
Improvement in discharge
instructions
Journal
Club
Continuation and creation of
Evidence Based Practice Committee
Promotion
Exam
Incorporate evidence based practice
questions into exam for Level III/IV
2016 Future

16. THANK YOU!

17. References
 Goode,C., Fink,R., Krugman,M., Oman, K., Traditi,L. (2011). The colorado patient-centered
interprofessional evidence-based practice model: a framework for transformation. Worldviews
on Evidence-Based Nursing. Retrieved from
https://www.researchgate.net/publication/49660700_The_Colorado_Patient-
Centered_Interprofessional_Evidence-
Based_Practice_Model_A_Framework_for_Transformation
 Gawlinksi, A. Rutledge,D. (2008). Selecting a model for evidence-based practice changes: a
practical approach. AACN Advanced Critical Care, 19(3), 291-300. Retrieved from
http://www.kau.edu.sa/Files/0004020/Subjects/EBP%20Changes%20project.pdf
 Kotter International (2016). The 8 step process to leading change. Kotter International.
Retrieved from http://www.kotterinternational.com/the-8-step-process-for-leading-change/
 Melnyk,B., Fineout-Overholt,E., Stillwell,S., Wiliamson,K. (2009). Igniting a spirit of inquiry:
an essential foundation for evidence-based practice. AJN, 109 (11), 49-52. Retrieved from
http://evidencebasednurse.weebly.com/
 Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The
Online Journal of Issues in Nursing, 18(2). Retrieved from
http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Table
ofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html
 http://qsen.org/evidence-based-practice/ (example print out)