Why is understanding the health care system at the local level important to consider when planning an EBP implementation?

Assignment: Planning an EBP implementation

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Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course mentor that you will take into consideration for your own change project.

Nurses in leadership positions have responsibility for
provision of evidence-based healthcare that meets
the expectations of patients, families, regulators and
others.1-3 Research shows that use of evidence is
inconsistent. Basic practices from hand hygiene to
early ambulation are difficult to implement. Nursing leaders are expanding use of evidence-based care
delivery to improve patient and organizational outcomes by developing the infrastructure, defining the
processes, strategically planning for implementation,
and reporting results.
One of the 1st steps when defining the process is to select an evidence-based practice (EBP)
model.4,5 Several models have been developed to guide organizational and project leaders through
the steps of the EBP process.6-10 Most of these process models include similar steps such as identifying
a problem, critiquing the evidence, implementing
evidence-based recommendations, evaluating the
change, and disseminating results. Despite extensive use of EBP process models, it is understood that
additional guidance may be needed at each step. Recent attention is now focusing on the indistinct step
of implementation.11-14
Failure to provide guidance for use of effective
implementation strategies promotes the use of ineffective strategies, or worse, no strategy at all. This
results in ‘‘reduced patient care quality and raises
costs for all, the worst of both worlds.’’15(p380) It has
been demonstrated that change happens over time;
the literature provides little direction for nurses regarding when to use specific strategies. Insights from
implementation science and successful EBP work indicate that application of implementation strategies
varies over the course of the EBP process. Assisting
nurses at the point of care in leading EBP projects16
has led to creation of a 4-phase approach for planning implementation.16
This article provides clinicians and nursing leaders with an application-oriented approach to organize, plan, and select strategies for implementation of
EBP changes. This guide is meant to supplement EBP
process models, not replace them. It is designed to be
simple and intuitive