title: Improving the adoption of evidence-based practice among nurses in Army outpatient medical treatment facilities.
abstract: This quality improvement project implemented and evaluated an evidence-based practice (EBP) program at two Army outpatient health care facilities. The EBP program consisted of five implementation strategies that aimed to inculcate EBP into organizational culture as well as nursing practice and culture. A conceptual model of the "Diffusion of Innovations" theory was adapted to explain the application of the program. The Institutional Review Boards at Walter Reed National Military Medical Center and Duke University School of Medicine reviewed and exempted this quality improvement project. A pretest-posttest design was used with four instruments at each facility. The EBP program was successful in enhancing organizational culture and readiness for EBP (p < 0.01) and nursing staff's belief about the value of EBP and their ability to implement it (p < 0.05). Another indicator that the EBP program achieved its goals was the significant difference (p = 0.002) in the movement of the outpatient health care facilities toward an EBP culture. These results suggest that this EBP program may be an effective method for empowering outpatient nursing staff with the knowledge and tools necessary to use evidence-based nursing practice.
authors.affiliation: Department of Clinical Operations, San Antonio Military Health System, 7800 I-10 West, San Antonio, TX 78234, USA.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Yackel
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Short
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lewis
authors.forename: Sara T
authors.initials: ST
authors.lastname: Breckenridge-Sproat
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Turner
mesh_terms: D022126:Access to Information; D000553:Ambulatory Care / Q000592:standards; D001291:Attitude of Health Personnel; D004506:Education, Nursing; D055318:Evidence-Based Nursing / Q000592:standards*; D006801:Humans; D007857:Leadership; D008888:Military Nursing / Q000592:standards*; D015279:Organizational Culture; D057184:Practice Patterns, Nurses' / Q000592:standards*; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D014481:United States