An Evidence-Based Practice Assessment and Quality Improvement Initiative in Idaho's Critical Access Hospitals
Date of Final Presentation
Dr. Teresa Serratt
Dr. Pamela Gehrke
Coordinator/ Chair of DNP Program
Dr. Pam Strohfus
Abstract/ Executive Summary
Background: Health care providers and systems have been challenged to discard tradition-based care and outdated practices in lieu of evidence-based practice (EBP). Yet, little is known about the state of EBP, barriers and facilitators to EBP, and organizational readiness for EBP in Idaho’s Critical Access Hospitals (CAH). To affect positive change, it was necessary to understand whether providers in Idaho’s CAHs were using evidence as a foundation for practice—and, if not, what challenges existed in implementing EBP. Mitigating barriers and providing EBP education by way of webinar-based online technology has been proven to be practical and feasible. Providing EBP education, employing EBP tools and techniques, and implementing an evidence-based QI initiative will bridge the gap between knowledge and practice to improve health outcomes
Project Design: The aim of this project was to determine whether providers in Idaho’s CAH were using evidence as a foundation for practice. Nurse Executives (NE) from CAHs in the Northern region of Idaho answered questions about the state of evidence-based practice. One CAH volunteered to participate in an EBP continuing education program and complete a quality improvement initiative. Pre- and post-education intervention surveys were administered to measure the outcomes of this EBP continuing education program.
Results: The results of the NE needs assessment indicated NEs were familiar with EBP and were willing to participate in this project. Nurse executives reported they and their staffs wanted to learn more about EBP, they were interested in participating in an online modular EBP continuing education program, and they were willing to allocate a moderate amount of education dollars to fund this program. Additionally, they were engaged in EBP activities and interested in implementing EBP to address a specific quality issue in his or her organization. However, not all NEs were able to allocate education funds for clinicians to complete the 13-hour program or implement an interdisciplinary quality improvement initiative. The resulting hybrid modular EBP continuing education program was effective in improving mean scores for EBP competency, EBP beliefs, and EBP knowledge. After five months, mean scores demonstrated additional improvements in EBP competency, EBP beliefs, and EBP implementation.
Recommendations and Conclusions: Evidence-based practice improves patient care and quality outcomes. However, barriers exist and removing them can be a challenge for small and rural hospitals. The findings from this EBP assessment and quality improvement initiative demonstrate using an EBP nurse mentor to implement a hybrid modular EBP continuing education program is practical, feasible, and effective. With ongoing support from an EBP nurse mentor, interdisciplinary teams can employ EBP tools, processes, and resources to implement evidence-based quality improvement initiatives to improve patient outcomes. It is recommended this project be replicated in other CAHs in Idaho in partnership with Ohio State University’s Center for Transdisciplinary Evidence-Based Practice.
Rauch, Deena R., "An Evidence-Based Practice Assessment and Quality Improvement Initiative in Idaho's Critical Access Hospitals" (2018). Doctor of Nursing Practice Projects. 16.