After reading the below scenario answer the following questions: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing. 2. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources. 3. Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT.
Organizational Culture Readiness
Healthcare organization leaders strive to balance the required visualization for evidence-based practice (EBP) changes into something practical. EBP needs the translation of the research results into valuable elements, supporting the practice change, as well as championing bedside personnel in the utilization of changes to patient care. Schaffer, (2012) emphasizes that both nurse leaders and staff nurses have to be acquainted with the change process, drivers and barriers to practice change within their work environment.
Inclusion of EBP into the work environment necessitates developing a desire for knowledge culture, openness, in addition to a consistent focus on lasting learning as a professional responsibility. This author's survey of "Green Pastures" revealed a strong presence of EBP, however some barriers were identified which will be discussed along with the facilitators. Clinical inquiry integration along with strategies that will strengthen weaken areas will also be addressed. Change of any kind is often met with some form of barrier.
Barriers to Evidenced-based Practice
According to Marshal, (2014), EBP barriers incorporate characteristics of individual nurses, the healthcare environment, the state of research information, and organization Green Pasture's scored 1's in questions related to use of librarian and their impact on EBP because they do not have a library. Secondly, the organization movement towards EBP was at a "3" six months ago. While the staff of this organization is proficient with the computer, not all nurses have skills to identify research information, opting to obtain information from coworker instead of searching for journal articles to support practice. Additionally, individual barriers comprise of lack of library access, confusion regarding nursing roles and complacency. As per discussion with administrator "Wiseone," when EBP change is introduced, even before implementation, the older nurses automatically "push back, saying they "do not think it will work, and nothing is wrong with how they have been doing it." Another barrier identified is inadequate staff nurse champions. The administrator, physicians and nurse practitioners are core champions for EBP and staff nurses appear to be lagging in the back.
Facilitators of EBP
A committed project leader, facilitators, or champion is vital for an effective implementation. During the interview of "Wiseone" it was clear to see that Green Pastures was passionate about EBP and relied heavily on a team comprising of the Administrator, Physicians and Nurse Practitioners to champion their change endeavors. Green Pastures facilitate EBP implementation by offering support and resources for work while celebrating small milestones by recognizing unit staff for their accomplishments. Feedback is also very important to the Administrative team of this organization. According to "Wiseone" the information is clear on what the requirements are, centered on the role of clinician and is in a user-friendly format.