title: Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship programme.
abstract: OBJECTIVE
  This paper is a report of the effectiveness of a structured multifaceted mentorship programme designed to implement evidence-based practice in a clinical research intensive environment.
  
  
  BACKGROUND
  Barriers to implementing evidence-based practice are well-documented in the literature. Evidence-based practice is associated with higher quality care and better patient outcomes than care that is steeped in tradition. However, the integration of evidence-based practice implementation into daily clinical practice remains inconsistent, and the chasm between research and bedside practice remains substantial.
  
  
  METHODS
  This quasi-experimental mixed methods study included three focused discussions with nursing leadership and shared governance staff as well as pre- (N = 159) and post-intervention (N = 99) questionnaires administered between June 2006 and February 2007. Online questionnaires included measures of organizational readiness, evidence-based practice beliefs, evidence-based practice implementation, job satisfaction, group cohesion and intent to leave nursing and the current job. Results.  Participants in the evidence-based practice mentorship programme had a larger increase in perceived organizational culture and readiness for evidence-based practice and in evidence-based practice belief scores than those who did not participate. Qualitative findings suggested that leadership support of a culture for evidence-based practice and the dedication of resources for sustainability of the initiative needed to be a priority for engaging staff at all levels.
  
  
  CONCLUSIONS
  These findings corroborate other studies showing that nurses' beliefs about evidence-based practice are significantly correlated with evidence-based practice implementation and that having a mentor leads to stronger beliefs and greater implementation by nurses as well as greater group cohesion, which is a potent predictor of nursing turnover rates.
authors.affiliation: Nursing Research and Translational Science National Institutes of Health, Clinical Center, Bethesda, Maryland, USA. gwallen@cc.nih.gov
authors.forename: Gwenyth R
authors.initials: GR
authors.lastname: Wallen
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
authors.forename: Bernadette
authors.initials: B
authors.lastname: Melnyk
authors.forename: Ellen
authors.initials: E
authors.lastname: Fineout-Overholt
authors.forename: Claiborne
authors.initials: C
authors.lastname: Miller-Davis
authors.forename: Janice
authors.initials: J
authors.lastname: Yates
authors.forename: Clare
authors.initials: C
authors.lastname: Hastings
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D007857:Leadership; D008297:Male; D008611:Mentors; D008875:Middle Aged; D017146:Models, Organizational; D015279:Organizational Culture; D009936:Organizational Innovation; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011795:Surveys and Questionnaires
references.citation: Health Syst Manage. 1981;15:1-160
references.pmid: 10304293
references.citation: J N Y State Nurses Assoc. 2004 Fall-2005 Winter;35(2):28-32
references.pmid: 15884483
references.citation: J Nurs Adm. 1987 Jun;17(6):8-16
references.pmid: 3647116
references.citation: Semin Neurol. 2006 Feb;26(1):131-9
references.pmid: 16479452
references.citation: Worldviews Evid Based Nurs. 2008;5(4):208-16
references.pmid: 19076922
references.citation: Cancer Nurs. 2002 Oct;25(5):404-15
references.pmid: 12394568
references.citation: J Am Acad Nurse Pract. 2006 Feb;18(2):56-61
references.pmid: 16460411
references.citation: J Nurs Adm. 2002 May;32(5):283-91
references.pmid: 12021569
references.citation: J Nurs Adm. 2001 Apr;31(4):210-6
references.pmid: 11324334
references.citation: Nurs Outlook. 2001 Nov-Dec;49(6):272-9
references.pmid: 11753294
references.citation: Reflect Nurs Leadersh. 2002;28(2):22-5, 45
references.pmid: 12073802
references.citation: Home Healthc Nurse. 1998 Jun;16(6):411-5
references.pmid: 9708155
references.citation: Pediatr Nurs. 1999 Jan-Feb;25(1):102-3, 101
references.pmid: 10335257
references.citation: Image J Nurs Sch. 1999;31(4):317-22
references.pmid: 10628096
references.citation: J Nurs Scholarsh. 2005;37(2):173-7
references.pmid: 15960062
references.citation: Worldviews Evid Based Nurs. 2005;2(3):113-21
references.pmid: 17040532
references.citation: J Adv Nurs. 1998 Nov;28(5):1146-57
references.pmid: 9840888
references.citation: J Prof Nurs. 2005 Nov-Dec;21(6):335-44
references.pmid: 16311228
references.citation: Nurs Econ. 2000 Jul-Aug;18(4):202-7
references.pmid: 11061158
references.citation: Am J Kidney Dis. 1997 Apr;29(4):533-40
references.pmid: 9100041
references.citation: Am J Nurs. 2005 Sep;105(9):40-51; quiz 52
references.pmid: 16138038
references.citation: BMJ. 1996 Jan 13;312(7023):71-2
references.pmid: 8555924
references.citation: J Prof Nurs. 2008 Jan-Feb;24(1):7-13
references.pmid: 18206837
references.citation: Nurs Inq. 2002 Sep;9(3):156-61
references.pmid: 12199879
references.citation: J Abnorm Soc Psychol. 1961 May;62:713-5
references.pmid: 13875334
references.citation: J Nurs Care Qual. 2002 Oct;17(1):63-70
references.pmid: 12369749
references.citation: Nurs Manage. 2006 Feb;37(2):16-8
references.pmid: 16452884
references.citation: Int J Qual Health Care. 2000 Dec;12(6):459-64
references.pmid: 11202599
references.citation: J Nurses Staff Dev. 2006 Jan-Feb;22(1):15-20; quiz 21-2
references.pmid: 16465092
references.citation: Worldviews Evid Based Nurs. 2004;1(3):185-93
references.pmid: 17163896
references.citation: J Interprof Care. 2002 Nov;16(4):335-47
references.pmid: 12487842
references.citation: Child Adolesc Psychiatr Clin N Am. 2005 Apr;14(2):255-71, viii
references.pmid: 15694785
references.citation: J Clin Psychol. 2007 Jul;63(7):695-705
references.pmid: 17551940
references.citation: Worldviews Evid Based Nurs. 2007;4(3):123-5
references.pmid: 17850493
references.citation: Nurs Res. 1993 Jan-Feb;42(1):29-35
references.pmid: 8424064