Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

摘要

Purpose: This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an EBP culture among nurses in a military healthcare setting. Background: The need to identify gaps in practice, apply principles of evidence-based practice (EBP), and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. Description: The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: The Organizational Readiness for System-wide Integration of Evidence-based Practice (ORSIEP); EBP Beliefs (EBPB); and EBP Implementation (EBPI) scales. The study took place in three military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Outcome: 360 (38%) nurses completed baseline; and 325 (31%) completed follow-up surveys. Scores improved on all three measures following implementation of the program; however, the differences were statistically significant only for the ORSIEP scale (70.96 vs. 77.63, t = -3.95, p <.01). In the paired individual pre/post-test sub-sample (N=56), scores improved significantly on all three instruments. Conclusions: Despite typically high turnover rates of military personnel and restructuring of three facilities during the study period, the readiness for, beliefs about, and implementation of EBP improved. This study suggests that a commitment to an EBP culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition. Implication for Military Nursing: Further studies among military nurses, using t