Establishment of Nurse Manager Leadership Competencies to Support Clinicians in Evidence-Based Practice.

OBJECTIVE: This 2-part study was conducted to validate nurse manager (NM) leadership competencies that support clinicians in using evidence-based practice (EBP). BACKGROUND: Numerous studies validate the critical need for NM support among clinicians seeking to engage in EBP. METHODS: In phase 1, a Delphi study was conducted to establish the validity of a set of NM leadership competencies that support EBP. In phase 2, descriptive analyses, tests of significance, and reliability coefficients were used to assess reliability. RESULTS: An expert panel achieved consensus on a set of 22 NM leadership competencies that constitute effective support for EBP. Further quantitative analyses demonstrated excellent levels of internal consistency and overall consistent outcomes across time. CONCLUSION: A valid set of 22 NM leadership competencies with evidence of reliability that successfully support clinicians to engage in EBP in clinical settings was established.

Outcomes From the First Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare Invitational Expert Forum.

BACKGROUND: Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. AIMS: In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing. METHODS: Interprofessional leaders from national organizations and federal agencies across the United States were invited to participate in the Forum. A pre-Forum survey was disseminated to participants to assess their perceptions of the state of EBP and actions necessary to speed the translation of research into real-world clinical settings. RESULTS: Findings from a pre-Forum survey (n = 47) indicated ongoing low implementation of EBP in U.S. healthcare settings. These findings were shared with leaders from 45 organizations and agencies who attended the Forum. Breakout groups on practice, education, implementation science, and policy discussed the findings and responded to a set of standardized questions. High-priority action tactics were identified, including the need for: (a) enhanced reimbursement for EBP, (b) more interprofessional education and skills building in EBP, and (c) leaders to prioritize EBP and fuel it with resources. LINKING EVIDENCE TO ACTION: The delivery of and reimbursement for evidence-based care must become a high national priority. Academic faculty across all healthcare disciplines need to teach EBP, healthcare systems must invest in EBP resources, and payers must attach reimbursement to care that is evidence-based. An action collaborative of the participating organizations has been formed to accelerate EBP across the United States to achieve the quadruple aim in health care.

Evidence-Based Practice and U.S. Healthcare Outcomes: Findings From a National Survey With Nursing Professional Development Practitioners.

Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners' EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities.

A Study of Chief Nurse Executives Indicates Low Prioritization of Evidence-Based Practice and Shortcomings in Hospital Performance Metrics Across the United States.

BACKGROUND: Although findings from studies indicate that evidence-based practice (EBP) results in high-quality care, improved patient outcomes, and lower costs, it is not consistently implemented by healthcare systems across the United States and globe. AIMS: The purpose of this study was to describe: (a) the EBP beliefs and level of EBP implementation by chief nurse executives (CNEs), (b) CNEs' perception of their hospitals' EBP organizational culture, (c) CNEs' top priorities, (d) amount of budget invested in EBP, and (e) hospital performance metrics. METHODS: A descriptive survey was conducted. Two-hundred-seventy-six CNEs across the United States participated in the survey. Valid and reliable measures included the EBP Beliefs scale, the EBP Implementation scale, and the Organizational Culture and Readiness scale for EBP. The Centers for Medicare and Medicaid Services Core Measures and the National Database of Nursing Quality Indicators (NDNQI) were also collected. RESULTS: Data from this survey revealed that implementation of EBP in the practices of CNEs and their hospitals is relatively low. More than one-third of the hospitals are not meeting NDNQI performance metrics and almost one-third of the hospitals are above national core measures benchmarks, such as falls and pressure ulcers. LINKING EVIDENCE TO ACTION: Although CNEs believe that EBP results in high-quality care, it is ranked as a low priority with little budget allocation. These findings provide a plausible explanation for shortcomings in key hospital performance metrics. To achieve higher healthcare quality and safety along with decreased costs, CNEs and hospital administrators need to invest in providing resources and an evidence-based culture so that clinicians can routinely implement EBP as the foundation of care.