title: Three-Year Pre-Post Analysis of EBP Integration in a Magnet-Designated Community Hospital.
abstract: BACKGROUND
  Adoption of evidence-based practices (EBP) by registered nurses (RNs) and nurse leaders continues to be a challenge. Although multiple strategies and substantial resources are being invested to advance nursing practice based on evidence, little is known about the long-term impact of these interventions.
  
  
  OBJECTIVE
  This study was undertaken to assess nurse leaders' and clinical RNs' beliefs to use EBP, perceptions about organizational readiness for EBP, and frequency of implementing EBP following implementation of multifaceted interventions to achieve and maintain Magnet designation.
  
  
  METHODS
  This retrospective descriptive study compared data from two previously administered online surveys (2008 and 2012) at a mid-Atlantic Magnet-designated community hospital.
  
  
  RESULTS
  Clinical RNs' self-reported attitudes toward EBP were more positive (2008: M = 53.85, standard error of the mean [SEM] = 0.65; 2012: M = 57.07,SEM = 0.58), as well as their perceptions of organizational readiness (2008: M = 50.72, SEM = 1.20; 2012: M = 81.09, SEM = 0.98), between the two survey years. Contrarily, although nurse leader scores were significantly higher for beliefs (2008: M = 61.15, SEM = 1.23; 2012: M = 60.60., SEM = 0.96), readiness (2008: M = 61.28, SEM = 2.16; 2012: M = 85.18, SEM = 1.64), and implementation (2008: M = 21.35, SEM = 1.72; 2012: M = 19.08, SEM = 1.43) little change was observed in the nurse leader scores between the two survey years compared with clinical RNs.
  
  
  CONCLUSIONS
  Results from this study suggest that the multifaceted interventions have had a positive impact on clinical RNs' beliefs and readiness for EBP, but not for nurse leaders. Albeit low, self-reported implementation of EBP by RNs and nurse leaders has been sustained, but has not improved.
  
  
  CONCLUSIONS
  Leaders must see their role as not only facilitators of EBP but also as active participants practicing EBP. Actively engaging leaders in EBP by serving on interprofessional EBP teams and role modeling these behaviors to staff is critical to EBP implementation. Realistic expectations of RNs for EBP implementation and clear and accessible resources may enhance RNs' willingness to implement. Going forward, it may be necessary to differentiate the expectations of RNs in EBP implementation by clarifying expectations in the process of identification and analysis of evidence from use of EBP in clinical practice.
authors: Director of Nursing Research and Magnet, MedStar Franklin Square Medical Center, Baltimore, MD.
authors: Joan Insalaco
authors: JI
authors: Warren
authors: Associate Professor, Chair, Department of Partnerships, Professional Education, & Practice, University of Maryland School of Nursing, Baltimore, MD.
authors: Kathryn Lothschuetz
authors: KL
authors: Montgomery
authors: Associate Dean of Research, and Professor, Organizational Systems & Adult Health, University of Maryland School of Nursing, Baltimore, MD.
authors: Erika
authors: E
authors: Friedmann
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D055317:Evidence-Based Practice; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology; D015279:Organizational Culture; D015397:Program Evaluation / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: community hospital; evidence-based practice; leadership; magnet hospitals; research; survey