From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice.
BACKGROUND
This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery.


OBJECTIVE
Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP).


METHODS
A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants.


RESULTS
The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.
Ellis
Isabelle
I
Combined Universities Centre for Rural Health, University of Western Australia, Australia. iellis@cucrh.uwa.edu.au
Howard
Peter
P
Larson
Ann
A
Robertson
Jeanette
J
D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000193:education*; D006780:Hospitals, Rural; D006801:Humans; D007318:Inservice Training; D009741:Nursing Staff, Hospital / Q000193:education*; D015397:Program Evaluation; D014904:Western Australia