Clinical Inquiry and Problem Identification.

This is the second article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making. It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to http://links.lww.com/AJN/A133). This follow-up series will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey.

National evaluation of DNP students' use of the PICOT method for formulating clinical questions.

BACKGROUND: The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence-based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence-based practice process, DNP graduates' competence in the PICOT method needs to be better understood. AIMS: This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects. METHODS: Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education-accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus. RESULTS: Although the PICOT method was project author-identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty-three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0-5). LINKING EVIDENCE TO ACTION: Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non-evidence-based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP-prepared nurses shore up this foundational skill.

Cultivating an Evidence-Based Decision-Making Mindset.

This is the first article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making. It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to http://links.lww.com/AJN/A133). This follow-up series will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey.

National evaluation of DNP projects based on 2015 AACN white paper and 2019 DNP project roadmap.

The AACN expectation to prepare DNP graduates with EBP and QI competencies using the project was clarified with the 2015 White Paper and these expectations have not changed with the new Essentials. Evidence suggests DNP projects continue to be a mix of research and QI. Using the DNP Project Roadmap, we reviewed 214 projects from 120 schools from publicly available sources for the presence of EBP and QI project elements. Of the 27 Roadmap elements evaluated, only two had a significant (p ≤ .05) positive change after the release of the White Paper 1) a question to frame the problem/issue (pre-48.4 %, n = 45, post-64.5 %, n = 78) and 2) an evidence search (pre-26.9 %, n = 25, post-39.7 %, n = 48). Nineteen of the 27 elements had positive change; however, were still not present in >50% of the project papers. These findings can be used to engage in a national conversation on DNP curricular expectations of projects that demonstrate student competency in EBP and QI.

How nursing stakeholders in the Republic of Ireland define evidence-based practice and why it matters.

BACKGROUND: Evidence-based practice (EBP) has garnered increasing exposure in professional healthcare discourse over three decades. While the term is used frequently, its interpretation varies widely. An accurate, shared understanding of what EBP means is essential to the achievement of EBP implementation in clinical practice. As part of a national study in the Republic of Ireland, nurses, midwives, educators, and students shared their personal understanding of what EBP was to them. AIM: To establish nurses', midwives', educators', and students' knowledge and understanding of the concept of EBP in the Republic of Ireland. METHODS: In a national study exploring EBP beliefs, implementation, and organizational readiness for EBP among nurses, midwives, educators, and students, an open-ended question invited participants to explain what EBP is, in their own words. Content analysis was used to interpret participants' responses. RESULTS: Five themes emerged from the data from the single open-ended question: (1) varying definitions of EBP, (2) best practice, (3) nurses' and midwives' role in EBP, (4) knowledge, and (5) barriers and facilitators of EBP. The dominant finding centered on the substantial conflation of EBP with research utilization and other concepts such as quality improvement. LINKING EVIDENCE TO ACTION: Poor knowledge and understanding of EBP is a fundamental challenge to EBP implementation. Conflation of EBP with research utilization and other healthcare concepts is not uncommon among nurses and midwives globally and has persisted for some time. This has the potential to hinder the advancement of EBP in nursing and midwifery and, therefore, measures to enhance EBP knowledge and promote EBP implementation are key. Professional regulating bodies, educators, and clinical and educational organizations all have a role to play. The findings from this aspect of this national study offer a realistic, context-specific starting point for tailored educational interventions for clinicians, educators, and students and identify professional and organizational strategies that promote EBP as the expectation and "the way things are done here."

Evidence-Based Practice Beliefs, Implementation, and Organizational Culture and Readiness for EBP Among Nurses, Midwives, Educators, and Students in the Republic of Ireland.

BACKGROUND: Evidence-based practice (EBP) is an approach to health care that combines best available evidence, healthcare professionals' expertise, and patient preferences, yielding benefits for patients, healthcare professionals, and organizations. However, globally, EBP implementation remains inconsistent among nurses. Exploring this in an Irish context will establish a national baseline from which progress can be made on system-wide integration of EBP in nurse and midwife (i.e., clinician) practice, nursing/midwifery education, and the Irish healthcare system. AIM: To establish clinician, educator, and student's EBP beliefs, knowledge, and implementation, and the organizational culture of the clinical and educational settings within the Republic of Ireland. METHODS: Using a descriptive study design, a national survey with demographic questions, uniquely focused EBP scales, and an open-ended question were administered to clinicians, nursing/midwifery educators, and students. Ethical review was obtained. Descriptive and inferential statistics were used to analyze the quantitative data. RESULTS: Clinicians, educators, and students reported positive beliefs about EBP (M = 59.98, SD 8.68; M = 87.72, SD = 10.91; M = 55.18, SD = 10.29, respectively). Beliefs regarding their ability to implement EBP were lower overall. EBP implementation was low across all groups (clinicians: M = 12.85, SD = 14; educators: M = 31.09, SD = 16.54; students: M = 16.59, SD = 12.11). Clinicians, educators, and students reported varying perceptions of organizational support and readiness for EBP (M = 74.07, SD = 19.65; M = 86.43, SD = 15.01; M = 93.21, SD = 16.21, respectively). Across all measures, higher scores indicated higher beliefs, implementation, and organizational culture and readiness for EBP. LINKING EVIDENCE TO ACTION: Clinicians have a unique opportunity to facilitate system-wide integration of EBP. Furthermore, given the variable EBP knowledge, beliefs, and implementation, opportunities to enhance these attributes abound, particularly when supported by their organizations. This study established a contemporary baseline in Ireland from which to engage the identified strengths, challenges, and opportunities required to craft an organizational culture and environment that supports and advances an EBP approach to nursing and midwifery practice and education.

Translation, cross-cultural adaptation and preliminary validation of instruments for Portuguese nursing educators regarding evidence based practice / Traducción, adaptación cultural y validación preliminar de instrumentos para educadores de enfermería portugueses sobre práctica basada en la evidencia / Tradução, adaptação transcultural e validação preliminar de instrumentos para docentes de enfermagem portugueses sobre prática baseada na evidência

Abstract The objective of this study is to translate and culturally adapt to European Portuguese "EBP Beliefs Scale for Educators" (EBPB-E), "EBP Implementation Scale for Educators" (EBPI-E) and "Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey" for Educators (OCRSIEP-E); and to provide preliminary validation data. The study was carried out in two phases: translation and transcultural adaptation; and preliminary validation in nursing educators of nine nursing schools in Portugal. Pre-final versions of the instruments were considered easy to understand. But, the participants suggested including the possibility of "I don't know" response and increasing the recall period in the EBPI-E. 68 educators participated in phase II. The α for EBPB-E, EBPI-E and OCRSIEP-E was 0.88, 0.95 and 0.94 and the corrected element-total correlations between the items and the total score ranged from 0.20 to 0.75, 0.59 to 0.84 and -0.06 to 0.78, respectively. Preliminary findings showed a strong internal consistency. It is concluded that other validation studies with more robust samples are needed to prove the reliability and validity of the instruments.

Resumen El objetivo de este estudio es traducir y adaptar culturalmente al portugués europeo "EBP Beliefs Scale for Educators" (EBPB-E), "EBP Implementation Scale for Educators" (EBPI-E) y "Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey" para docentes (OCRSIEP-E); y presentar datos preliminares de validación. El estudio se realizó en dos fases: traducción y adaptación transcultural; y validación preliminar en docentes de enfermería de nueve escuelas de enfermería de Portugal. Las versiones prefínales de los instrumentos se consideraron de fácil comprensión. Pero, los participantes sugirieron incluir la posibilidad de respuesta "no sé" y aumentar el período de recuerdo en el EBPI-E. 68 educadores participaron en la fase II. El α para EBPB-E, EBPI-E y OCRSIEP-E fue 0,88, 0,95 y 0,94 y las correlaciones elemento-total corregidas entre los ítems y la puntuación total variaron de 0,20 a 0,75, 0,59 a 0,84 y -0,06 a 0,78, respectivamente. Los hallazgos preliminares mostraron una fuerte consistencia interna. Se concluye que se necesitan otros estudios de validación con muestras más robustas para probar la confiabilidad y la validez de los instrumentos.

Resumo O objetivo deste estudo é traduzir e adaptar culturalmente o português europeu "Escala de Crenças EBP para Educadores" (EBPB-E), "Escala de Implementação EBP para Educadores" (EBPI-E) e "Cultura Organizacional e Prontidão para Integração em toda a Escola de Pesquisa Prática Baseada em Evidências" para profesores (OCRSIEP-E); e fornecer dados preliminares de validação. O estudo foi realizado em duas fases: tradução e adaptação transcultural; e validação preliminar em professores de enfermagem de nove escolas de enfermagem em Portugal. As versões prefinais dos instrumentos foram consideradas fáceis de entender. Porém, os participantes sugeriram incluir a possibilidade de resposta "não sei" e aumentar o período de recall no EBPI-E. 68 educadores participaram da fase II. O α para EBPB-E, EBPI-E e OCRSIEP-E foi de 0,88, 0,95 e 0,94 e as correlações elementototal corrigidas entre os itens e a pontuação total variaram de 0,20 a 0,75, 0,59 a 0,84 e -0,06 a 0,78, respetivamente. Os resultados preliminares mostraram uma forte consistência interna. Conclui-se que outros estudos de validação com amostras mais robustas são necessários para comprovar a confiabilidade e validade dos instrumentos.

Tradução e adaptação de instrumentos sobre prática baseada na evidência para estudantes de enfermagem portugueses / Translation and cross-cultural adaptation of evidence-based practice instruments for Portuguese nursing students / Traducción y adaptación de instrumentos relativos a la práctica basada en la evidencia para estudiantes de enfermería portugueses

Enquadramento: A implementação da prática baseada na evidência (EBP) em contextos clínicos é recomendada pelo seu impacto positivo na saúde, contudo, permanece abaixo do desejável. A formação de estudantes de licenciatura em enfermagem em EBP é fundamental, pelo que é crucial haver medidas válidas e confiáveis desta aprendizagem. Objetivo: Traduzir e adaptar transculturalmente para português europeu as escalas EBP Beliefs Scale (EBPB), EBP Implementation Scale for Students (EBPI-S) e Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey for students (OCRSIEP-ES). Metodologia: Tradução e adaptação transcultural segundo recomendações internacionais. Validação preliminar em estudantes portugueses de licenciatura em enfermagem, provenientes de nove instituições. Resultados: Às versões prefinais dos instrumentos os participantes sugeriram incluir a possibilidade de resposta “não tenho conhecimento suficiente que me permita responder” e aumentar o período de recordação no instrumento EBPI-S. Na fase II participaram 167 estudantes. O a para o EBPB, EBPI-S e OCRSIEP-ES foi 0,854, 0,943 e 0,970, respetivamente. Conclusão: Os resultados preliminares revelaram uma forte consistência interna. É necessário realizar mais estudos de validação com amostras robustas para testar a confiabilidade e validade dos instrumentos.

Background: The implementation of evidence-based practice (EBP) in clinical contexts is recommended due to its positive impact on health, but it remains under the desirable. The training of undergraduate nursing students in the use of EBP is crucial, and, for that, there must be valid and reliable measures of EBP learning. Objective: To translate and to cross-cultural adapt into European Portuguese of the EBP Beliefs Scale (EBPB), EBP Implementation Scale for Students (EBPI-S), and Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey for Students (OCRSIEP-ES). Methodology: Translation and cross-cultural adaptation according to international recommendations. Preliminary validation in Portuguese undergraduate nursing students from nine institutions. Results: In the pre-final versions of the instruments, the participants suggested including the optional answer “I do not have sufficient knowledge to be able to answer” and increasing the recall period in the EBPI-S instrument. Phase 2 included 167 participants. The a for EBPB, EBPI-S, and OCRSIEP-ES was 0.854, 0.943, and 0.970, respectively. Conclusion: Preliminary results showed good internal consistency. Further validation studies with robust samples are required to test the reliability and validity of the instruments.

Marco contextual: Se recomienda implementar la práctica basada en la evidencia (EBP) en contextos clínicos, debido a su impacto positivo en la salud, aunque sigue estando por debajo de lo deseable. La formación de los estudiantes de enfermería de grado en el uso de la EBP es crítica. Por ello, tener medidas válidas y fiables de este aprendizaje supone un aspecto clave. Objetivo: Traducir y adaptar al portugués europeo: la EBP Beliefs Scale (EBPB), la EBP Implementation Scale for Students (EBPI-S) y la Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey for students (OCRSIEP-ES). Metodología: Traducción y adaptación intercultural de acuerdo con las recomendaciones internacionales. Validación preliminar en estudiantes de enfermería portugueses de grado de nueve instituciones. Resultados: En las versiones prefinales de los instrumentos, los participantes sugirieron incluir la respuesta “no sé” y aumentar el periodo de recuerdo en el instrumento EBPI-S. En la fase II participaron 167 estudiantes. El a para EBPB, EBPI-S y OCRSIEP-ES fue de 0,854, 0,943 y 0,970, respectivamente. Conclusión: Los resultados preliminares mostraron una fuerte consistencia interna. Se requieren más estudios de validación con muestras sólidas para probar la fiabilidad y la validez de los instrumentos.

A Test of the ARCC© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes.

BACKGROUND: Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings. AIM: The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians' EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States. DESIGN: A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full implementation of the ARCC Model. SETTING AND SAMPLE: The study was conducted at a 341-bed acute care hospital in the western region of the United States. The sample consisted of 58 interprofessional healthcare professionals. METHODS: The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Healthcare professionals' EBP beliefs, EBP implementation, and organizational culture were measured with valid and reliable instruments. Patient outcomes were collected in aggregate from the hospital's medical records. RESULTS: Findings indicated significant increases in clinicians' EBP beliefs and EBP implementation along with positive movement toward an organizational EBP culture. Study findings also indicated substantial improvements in several patient outcomes. LINKING EVIDENCE TO ACTION: Implementation of the ARCC Model in healthcare systems can enhance clinicians' beliefs and implementation of evidence-based care, improve patient outcomes, and move organizational culture toward EBP.

Psychometric Properties of the Slovak and Czech Versions of the Evidence-Based Practice Beliefs and Implementation Scales.

BACKGROUND: The Evidence-Based Practice Beliefs (EBP-B) and Evidence-Based Practice Implementation (EBP-I) scales are psychometrically sound instruments that were used, within an educational setting, to systematically study students' beliefs about and their implementation of evidence-based practice (EBP). Czech and Slovak versions of these instruments were developed and evaluated using a sample population of nursing students. PURPOSE: The purpose of the study was to test the psychometric properties of the Czech and Slovak versions of the EBP-B and EBP-I scales. METHODS: Psychometric properties were evaluated using a sample of undergraduate and graduate (nearly graduated) nursing students (n = 223) completing EBP courses. To test psychometric properties of the questionnaire, its reliability and validity were explored. Cronbach´s alpha was computed to evaluate internal structure and internal consistency. RESULTS: The Slovak versions of both the EBP-B and the EBP-I scale have good internal consistency (Cronbach's alpha: .82 and .94, respectively). Similarly, the Czech versions of the EBP-B and the EBP-I scales both have good internal consistency (Cronbach's alpha: .85 and .89, respectively). LINKING EVIDENCE TO ACTION: The results of psychometric analysis of the Czech and Slovak versions of the EBP-B and the EBP-I scales are consistent with the results of the original study and indicate that the Czech and Slovak versions have the potential to be valid, reliable, and sensitive instruments for measuring an individual's beliefs about the value of EBP and their ability to implement it. Both instruments can be used to assess changes in nurses´ beliefs about EBP over time as well as the effectiveness of strategies aimed at promoting the use of evidence in practice.

The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs.

BACKGROUND: Although it is widely known that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs, it is still not the standard of care delivered by practicing clinicians across the globe. Adoption of specific EBP competencies for nurses and advanced practice nurses (APNs) who practice in real-world healthcare settings can assist institutions in achieving high-value, low-cost evidence-based health care. AIM: The aim of this study was to develop a set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings that can be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP. METHODS: Seven national EBP leaders developed an initial set of competencies for practicing registered nurses and APNs through a consensus building process. Next, a Delphi survey was conducted with 80 EBP mentors across the United States to determine consensus and clarity around the competencies. FINDINGS: Two rounds of the Delphi survey resulted in total consensus by the EBP mentors, resulting in a final set of 13 competencies for practicing registered nurses and 11 additional competencies for APNs. LINKING EVIDENCE TO ACTION: Incorporation of these competencies into healthcare system expectations, orientations, job descriptions, performance appraisals, and clinical ladder promotion processes could drive higher quality, reliability, and consistency of healthcare as well as reduce costs. Research is now needed to develop valid and reliable tools for assessing these competencies as well as linking them to clinician and patient outcomes.

The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators.

This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.

Preparing clinical preceptors to support nursing students in evidence-based practice.

Staff nurse preceptors contribute importantly to student learning and to academic program outcomes; however, academic-clinical partnerships can offer focused learning opportunities for preceptors as well. This study addressed different interest levels in evidence-based practice across clinical settings by testing the effectiveness of a workshop designed to increase preceptor knowledge and endorsement of evidence-based practice. Nurse preceptor participants (N = 160) recruited from seven hospitals during 2009 to 2011 had an average age of 43.9 (SD = 11.5) and an average of 17.0 (SD = 11.2) years of nursing experience. Participants' scores on the Evidence-Based Practice Beliefs Scale improved significantly from pretest to posttest (M(pre) = 59.0, SD(pre) = 8.4, M(post) = 66.4, SD(post) = 6.8, p < .001), which was confirmed by subgroup analyses. At follow-up (1 to 25 months), 52% of the nurse preceptors reported increased use of evidence-based practice. This study indicates that a short collaborative, content-focused workshop can promote preceptor endorsement of evidence-based practice.

Evidence-based practice, step by step: sustaining evidence-based practice through organizational policies and an innovative model.

The team adopts the Advancing Research and Clinical Practice Through Close Collaboration model.This is the 12th and last article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When it's delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved. The complete EBP series is available as a collection on our Web site; go to www.ajnonline.com and click on Collections.

Evidence-based practice, step by step: evaluating and disseminating the impact of an evidence-based intervention: show and tell.

This is the 11th article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series has been to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. The final article in the series will be published in the September issue.

Evidence-based practice, step by step: rolling out the rapid response team

This is the 10th article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved. The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every other month to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Chat with the Authors" calls every few months to provide a direct line to the experts to help you resolve questions. See details opposite

Evidence-based practice, step by step: implementing an evidence-based practice change.

This is the ninth article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every other month to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Chat with the Authors" calls every few months to provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will be published with May's Evidence-Based Practice, Step by Step.

Fostering evidence-based practice to improve nurse and cost outcomes in a community health setting: a pilot test of the advancing research and clinical practice through close collaboration model.

Although evidence-based practice (EBP) improves health care quality, decreases costs, and empowers nurses, there is a paucity of intervention studies designed to test models of how to enhance nurses' use of EBP. Therefore, the specific aim of this study was to determine the preliminary effects of implementing the Advancing Research and Clinical practice through close Collaboration (ARCC) model on nurses' EBP beliefs, EBP implementation behaviors, group cohesion, productivity, job satisfaction, and attrition/turnover rates. A 2-group randomized controlled pilot trial was used with 46 nurses from the Visiting Nurse Service of New York. The ARCC group versus an attention control group had stronger EBP beliefs, higher EBP implementation behaviors, more group cohesion, and less attrition/turnover. Implementation of the ARCC model in health care systems may be a promising strategy for enhancing EBP and improving nurse and cost outcomes.