title: The Strengths and Challenges of Implementing EBP in Healthcare Systems.
abstract: BACKGROUND
  Multihospital healthcare system leaders and individual nurses are challenged to integrate standardized evidence-based practices that support continuous performance improvement in their systems.
  
  
  OBJECTIVE
  This study was undertaken to evaluate the strength of and the opportunities for implementing evidence-based nursing practice across a diverse 9-hospital system located in the mid-Atlantic region.
  
  
  METHODS
  A cross-sectional survey of 6,800 registered nurses (RNs), with a 24% response rate, was conducted to learn about their attitudes, beliefs, and perceptions toward organizational readiness and implementation of EBP.
  
  
  RESULTS
  Although respondents' beliefs about EBP were positive, they reported their ability to implement EBP as extremely low. More than one third (36%) of the respondents worked at two of the system's Magnet designated hospitals. Magnet RNs reported more resources and held more positive beliefs about their hospital's organizational readiness for EBP. Nurses who possess advanced nursing degrees, certification, and who serve in leadership roles were favorable toward EBP. Younger RNs with fewer years in practice were more likely to have positive beliefs toward EBP and embedding it into the organizational culture.
  
  
  CONCLUSIONS
  Findings mirror previous research where nurses internationally favor EBP yet struggle with similar barriers for implementation. Strategies to link this evidence to action can be taken at local and global levels. Locally, transformational nurse leaders within each hospital can share the vision for implementing EBP and embrace Magnet principles. At the system level, transformational nurse leaders can collectively allocate resources to create a system-wide online EBP education plan with EBP competencies and tool kit to increase RN exposure to EBP and standardize practice. Globally, promoting free and accessible EBP massive open online courses (MOOC) and sharing best practices online and at international forums such as Magnet conferences will help to lead, educate, and mentor nurses with strategies to systematically increase EBP uptake.
authors.affiliation: Director, Nursing Research & Magnet, MedStar Franklin Square Medical Center, Baltimore, MD.
authors.forename: Joan I
authors.initials: JI
authors.lastname: Warren
authors.affiliation: Independent Consultant, Former Director, Nursing Research and Professional Development, MedStar Georgetown University Hospital, Washington, DC.
authors.forename: Maureen
authors.initials: M
authors.lastname: McLaughlin
authors.affiliation: Assistant Vice President of Special Projects, MedStar Health Corporate Nursing/MedStar Health Research Institute, Hyattsville, MD.
authors.forename: Joan
authors.initials: J
authors.lastname: Bardsley
authors.affiliation: Director, Nursing Education/Staff Development, Medstar Good Samaritan Hospital, Baltimore, MD.
authors.forename: Joanne
authors.initials: J
authors.lastname: Eich
authors.affiliation: Carol Ann Esche, Clinical Nurse Specialist, Evidence-Based Practice and Nursing Research, MedStar Franklin Square Medical Center, Baltimore, MD.
authors.forename: Carol Ann
authors.initials: CA
authors.lastname: Esche
authors.affiliation: Nurse Educator, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Lola
authors.initials: L
authors.lastname: Kropkowski
authors.affiliation: Critical Care Clinical Nurse Specialist, Holy Cross Hospital, Silver Spring, MD.
authors.forename: Stephen
authors.initials: S
authors.lastname: Risch
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D055318:Evidence-Based Nursing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D015279:Organizational Culture
keywords: Magnet hospitals; evidence-based practice; evidence-based practice beliefs; healthcare system; hospital system; nursing; organizational culture; organizational readiness; survey; workplace environment