Evaluation of an evidence-based practice initiative: outcomes, strengths and limitations of a retrospective, conceptually-based approach.
OBJECTIVE
Making evidence-based practice (EBP) a sustained reality is a difficult endeavor. This relates, among other factors, to lack of sufficient research upon which to base implementation efforts. Alternative sources of evidence therefore need to be considered, particularly where organizational level EBP is the goal. In this article a brief evaluation of a service-based initiative with the aim of obtaining insights regarding multiple types and levels of EBP-related outcomes is described.


METHODS
A structured, retrospective improvement evaluation was conducted. Semi-structured interviews and available documents were chosen to obtain information regarding outcomes, perceived spread of reported individual changes, and factors related to the degree of progress. Underlying the method is an evaluation model that shows a progressive set of EBP outcomes at both individual and group levels.


RESULTS
Evaluative results, although limited by several factors, provided credible and sufficient internal evidence for this organization's leadership team to build upon past efforts and refine their approach to integrating research utilization (RU) throughout the department of nursing. For example, the evaluation indicated a set of RU outcomes at the individual nurse level not previously considered and also indicated limitations and challenges to full achievement of initial project-related goals.


CONCLUSIONS
The evaluation provided suggestive internal evidence regarding potential benefits of one component of a long-term, valued EBP initiative. However, the evaluation also raised questions regarding structural aspects of this initiative; identified barriers to progress; provided information for dialogue and planning; and highlighted future needs for a proactive, systematic evaluation and a documented trail of data related to all EBP program goals. For those in settings with similar characteristics and aims that have not built in such a prospective evaluation for EBP initiatives, this evaluative project can be assessed for its applicability.
Stetler
Cheryl B
CB
Evidence-based Practice/Evaluation Consultant, Amherst, MA, USA. Cheryl.Stetler@Comcast.net
Caramanica
Laura
L
D003237:Connecticut; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000193:education* / Q000458:organization & administration; D006801:Humans; D015399:Nursing Research / Q000193:education* / Q000458:organization & administration; D009738:Nursing Service, Hospital; D015397:Program Evaluation; D012189:Retrospective Studies; D013192:Staff Development