title: The EPCOR model: a model for promoting the successful implementation of evidence-based nursing in hospital-based settings.
abstract: BACKGROUND
  An effective organizational infrastructure is essential to successfully implement and sustain an evidence-based nursing (EBN) practice. Although EBN has been promoted in Taiwan for more than 10 years, variations in the organizational policies and strategies necessary to support EBN among healthcare organizations have prevented effective implementation. Barriers to the implementation of EBN located at the organizational level have also been reported. The need for a model that focuses on the organizational infrastructure to promote EBN in Taiwan has therefore become increasingly apparent.
  
  
  OBJECTIVE
  This study aims to develop a model that contains the key contextual elements of organizational infrastructure necessary to effectively promote EBN, especially in hospital settings.
  
  
  METHODS
  A steering committee drafted the components and related strategies of the proposed model. Delphi technique was used to obtain consensus on the proposed model among a group of experts with expertise in EBN. Thirty experts participated in all three rounds of the Delphi survey. To confirm the appropriateness of the proposed model for clinical settings, the model was further reviewed by a focus group composed of experts with experience in implementing EBN or evidence-based medicine in hospitals. The strategies were then further modified based on the suggestions of this focus group, and only those strategies that best fit hospital settings were retained.
  
  
  RESULTS
  Five key contextual elements and related strategic processes were identified, including equipment, policy, training courses, outcome indicators, and reward plans. The resultant model was named EPCOR, an acronym composed of the names of each identified element.
  
  
  CONCLUSIONS
  EPCOR is a comprehensive model of organizational infrastructure and strategic procedures for implementing EBN in hospital-based settings in Taiwan. Organizations may use the EPCOR model to initiate and implement EBN practices and then to evaluate their effectiveness.
authors.affiliation: 1PhD, RN, Associate Professor, Department of Nursing, Cardinal Tien Junior College of Healthcare and Management 2MSN, RN, Vice President, Wang-Fang Hospital 3PhD, RN, Associate Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences, and Nursing Consultant, Department of Nursing, Shuang Ho Hospital, Taipei Medical University.
authors.forename: Mei-Yeh
authors.initials: MY
authors.lastname: Wang
authors.forename: Ching-Chiu
authors.initials: CC
authors.lastname: Kao
authors.forename: Chiou-Fen
authors.initials: CF
authors.lastname: Lin
mesh_terms: D003697:Delphi Technique; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D017144:Focus Groups; D006801:Humans; D016294:Models, Nursing; D017146:Models, Organizational; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009937:Organizational Objectives; D011795:Surveys and Questionnaires; D013624:Taiwan