title: "Stars" aligned for evidence-based practice: a Triservice initiative in the Pacific.
abstract: BACKGROUND
  Establishing system-wide evidence-based nursing practice requires the support of senior leadership as well as adherence to a model that is sensitive to the challenges of practice change.
  
  
  OBJECTIVE
  The purpose of this study was to establish a level of skill and knowledge among Army, Navy, and Air Force nurses to develop, to implement, and to evaluate best evidence-based practices (EBPs) for improved patient care.
  
  
  METHODS
  Using the Iowa Model to guide their work, nurses from the Air Force, the Army, and the Navy joined efforts to establish EBP as a standard of nursing practice at four different military healthcare facilities in Hawaii: one tertiary medical center and three clinics on the island of Oahu. With the support of senior leadership at all four sites, four nurse researchers and a project director facilitated the work of advance practice nurses and staff nurses.
  
  
  RESULTS
  Twelve different EBP projects were developed, implemented, and evaluated over 18 months by more than 50 nursing personnel across the three branches of service on Oahu. The result was a positive contribution to patient care throughout the healthcare system, affecting all areas of military nursing practice. Supporting goal was the improvement in the attitudes of nurses about research and their skills in applying evidence to their practice by way of a year-long internship program. Also influenced was the development of a foundation for evidence-based clinical and administrative military nursing decision making in the Pacific.
  
  
  CONCLUSIONS
  A successful EBP program requires (a) consistent long-term vision and support from senior leadership; (b) resources such as trained personnel, finances, and time; and (c) structured approach to create an environment that facilitates the process. However, the success of an EBP program relies heavily on each nurse's commitment to change designed to improve nursing care for patients.
authors.affiliation: School of Nursing and Dental Hygiene, Honolulu, Hawaii, USA. debramar@hawaii.edu
authors.forename: Debra D
authors.initials: DD
authors.lastname: Mark
authors.forename: Renee W
authors.initials: RW
authors.lastname: Latimer
authors.forename: Mary D
authors.initials: MD
authors.lastname: Hardy
mesh_terms: D055318:Evidence-Based Nursing / Q000193:education / Q000458:organization & administration*; D006254:Hawaii; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D008888:Military Nursing / Q000193:education / Q000458:organization & administration*; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care