Interview with a Nursing Quality Expert

Criteria

Fill in the answers in this column.

Indicate 2 scholarly resources or texts used prior to the interview to familiarize yourself with the individual’s organization, role, or any of the questions you plan to ask that will make you a more knowledgeable interviewer.

Resource #1:

Hauck, S., Winsett, R, P., & Kuric, J. (2013). Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. Journal of advanced nursing, 69(3), 664-674.

This article highlights the strategies that nurse leaders can use to influence nurses’ perception on the importance of evidence-based practice in nursing practice. It focuses on education on evidence-based practice and establishment of internal methods of disseminating information as primary in ensuring successful implementation of evidence-based practice in the acute care hospital. This article helped in preparing by understanding the relationship between the concepts of evidence-based practice and leadership. It guided the interview on the particular questions to ask such as what the Quality Care Coordinator had done in education and information dissemination to ensure comprehensive implementation of evidence-based practice.

Resource # 2:

Melnyk, B, M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417.

This article provides the perception of nurses on evidence-based practice. It asserts that barriers such as resistance from nurses, nurse leaders, and managers compromise the implementation of evidence-based practice, EBP. It enhanced the understanding of the challenges of EBP implementation. The contents assisted in formulating questions such as “What are the difficulties in implementing EBP?” and “How do you manage resistance from staff during EBP implementation?”

Both the two articles helped in determining the outline of the interview and formulating the questions to ask the nurse expert concerning evidence-based practice.

Required Questions

(Ask the interviewee about EVERY topic in this section)

Scope of responsibility: Major responsibilities, direct reports, and operational budget

First, evidence-based practice implementation requires the collaboration of researchers, educators, administrators, clinicians, and nursing care coordinators to ensure patient-care is framed according to the patient needs using the best evidences available. RG also asserted that she was intensively involved in ensuring the collaboration of all healthcare professionals such as laboratory technicians, physicians, nursing staff, administrators, and even external suppliers of various hospital commodities. Her additional roles regarding evidence-based practice included:

Ø  Creating an enabling environment for evidence-based practice among nurses by organizing for their access to sources of information such as online libraries and healthcare databases. RG was also involved in policymaking for resource allocation for professional development of the nursing staff. The responsibility involved identifying the need for educational development among the nurses to enable use of evidence-based nursing.

Ø  The role of ensuring the newly recruited nurses engage in a formal mentorship program assist in enabling the new recruits understand the importance and basis behind evidence-based practice. The core responsibility in the mentoring program is to identify the mentors in various departments and charge them with the responsibility of coaching new nurses or recommended nurses on the management of evidence-based information. The mentoring program involves all the departments of the hospital and proper planning helps RG to ensure no unit is left while coordinating the program.

Ø  The responsibility of advocating for the patients ensures that all patients receive quality care by emphasizing the importance of evidence-based practice. According to RG, the main focus during such advocacy programs is encouraging all the staff members to incorporate research findings in their practice to enable greater patient satisfaction. Patients report adequate satisfaction when healthcare provision is tailored according to their needs based on the best evidence available.

Ø  RG reported that in her case her coordination involved all the stakeholders of health such as all the healthcare professionals, administrators of the hospital, patients and their families, community, and the State Department of Health and Human Services. She had to ensure the cooperation of all these stakeholders at various levels to ensure practice of evidence-based nursing. She obtained information on the current developments in evidence-based practice and the policies and regulations on EBP from the State Department of Health and Human Services. She also educated patients and the community on evidence-based practice. Therefore, her role was critical in ensuring that all the stakeholders understand EBP.

Ø  The Care Coordinator also reports to the State Department of Health and Human Services on the state of application of EBP in their organization after which she could obtain proposals on how to further improve EBP implementation.

Ø  The reports are also extended to the administration of the hospital to ensure the level of use of EBP is evaluated to determine the existing gaps.

Ø  She receives direct reports from all the nurses on the issues affecting evidence-based nursing in the organization. However, she was unwilling to disclose the total operational budget she is responsible for in the hospital.

RG identified organizational culture, staff perceptions, availability of resources, and leadership as the primary factors influencing the use of EBP in their hospital. She reports that she had been actively involved in empowering employees to use EBP by planning for professional development and providing access to various healthcare informational databases. They had promoted positive staff perceptions by organizing for seminars for training employees using experts in Health Information Systems and quality care provision. RG ensures resources such as computer devices for accessing information are available in every department and in appropriate working condition. Lastly, leaders in the organization, including RG, have employed transformational leadership skills that enable changes in the organization.

RG reported resistance among nurses and other healthcare professionals in implementing the use of evidence-based practice. The main strategy for reducing the resistance includes ensuring the involvement of all the nurses and healthcare team members in every decision on how to use EBP. It is important to involve the staff in making decisions on EBP because the staff members can only take responsibility on issues that they have influence on their implementation. The influence of nurses and other healthcare providers is ensured by calling for regular brief staff meetings during which everyone is given equal opportunity to give their opinions on the use of EBP in the organization.

Organizational mission, vision, values, and beliefs

The beliefs, mission, vision, and value statement has provided RG and the rest of the staff the framework guiding all their operations. Their organizational mission, vision, values, and beliefs have been critical in supporting implementation of EBP due to the enabling culture exhibited in the organization. The mission statement we strive to change people’s lives through quality excellent patient care focuses on excellence in care provision and therefore, every healthcare provider works towards excellence in healthcare provision. Consequently, EBP is supported in the organization is a basic strategy for ensuring excellence in patient care. Their organizational vision is a global leader in healthcare recognized for innovation and clinical excellence, preferred for greater patient satisfaction, and distinguished by highly-qualified staff. This vision reminds the employees on the importance of innovation and patient satisfaction in excelling in healthcare provision. The focus on innovation promotes research that is essential for evidence-based practice. Lastly, their values and beliefs include dignity for patients and compassion in care delivery.

Strategic planning related to ONE core competency (name the core competency)

Role of BSN-prepared nurse to support the strategic plan

BSN-prepared nurses play a key role in linking best evidence to action during patient care. Their full support is important is important because the nursing staff uses their guidance in EBP implementation. They are able to influence policymaking as well as the rest of nursing staff either in favor of or against use of EBP in the organization. Therefore, RG’s organization ensures that they are involved in all the phases of the strategic plan. The senior nurses determine the appropriate sources of information to use and train other nurses on how to apply research to nursing practice. Role modeling has been of significance in supporting use of EBP. BSN-prepared nurses acts as the custodians of EBP and other nurses depends on their attitudes and skills for EBP implementation.

Practice Impact Question

(Reflect on the interview afterwards to ask yourself this question and provide it below.)

How does completing this interview impact your practice as a BSN-prepared nurse? Give specific examples.

The interview has enabled me to learn about the implementation of evidence-based practice at length. I have understood the roles and responsibilities of advanced nurses in EBP implementation. Nurse leaders must create enabling environment and plan for effective change implementation in a clinical setting. The responsibility of nurses in care coordination is overwhelming. RG had to coordinate care between healthcare professionals, hospital administrators, patients and their families, and the community. It is the responsibility of BSN-prepared nurses to ensure safe practices are implemented appropriately. As such, acting as a role model in healthcare organization is important to influence nursing staff to adapt to the reforms in healthcare. Therefore, my nursing practice will change to incorporate effective communication skills that can enable care coordination and advocacy for patients to receive quality and safe care. As a BSN-prepared nurse, I look forward to advocating for change in my clinical setting for the benefit of the patients. Strategic planning is important for effective implementation of projects. Therefore, I will ensure that I participate in strategic planning by identifying and reporting the needs of the department under my surveillance.