Commentary: Adult nursing
Nursing leaders must make a conscientious effort to invest in practices that support evidence-based
point to a need for improved focus and investment in resources to promote the use of EBP in practice. Commentary Although experts in clinical and academic organisations reference the importance of EBP, empirical data are lacking to quantify the value of EBP. Thus, this study makes a significant contribution to support EBP programmes by clearly articulating the positive financial benefits with improved outcomes as well as the ramifications of worse outcomes when not investing in EBP. Consistent with other authors who found EBP leads to improved patient outcomes and a significant ROI benefit, Connor et al 1 in a scoping review found implementation of EBP improved outcomes such as decreased infec- tions, decreased length of stay, readmission and decreased mortality. The Melnyk et al ’s 5 study builds on previous work by the same authors who completed a national descriptive study of 276 CNEs in 2016 where they identified low rates of EBP implementation in hospitals and found one-third of facilities did not meet quality benchmarks and had high rates of compli- cations. 6 From the surveys, CNEs believed EBP was important for promoting quality of care, but a low priority with little funding allocated to support EBP implementation. 6 In order to encourage EBP, administrators must support nurses use of evidence in their practice by investing in resources including training, time and mentors. This study is important as it demonstrates institutions with a greater investment in evidence-based resources and mentors, reap the rewards with improved patient outcomes and decreased nursing turnover. Taking into consideration the fact that the highest investment by an insti- tution in this study was still relatively low, a greater investment may result in more significant outcomes. Resources to enhance knowledge and skills of nurses to use EBP posi- tively influences the quality of care. 2 Creating a culture of clinical inquiry and striving to improve EBP knowledge and skills among nurses is essential for healthcare and nursing practice; nursing administrators play a signifi- cant role by allocating funds to support EBP. We cannot advance as a profession and continue to identify opportuni- ties to improve patient care without this financial commitment by leaders. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Competing interests None declared. Provenance and peer review Commissioned; internally peer reviewed. © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. References 1 Connor L , Dean J, McNett M, et al . Evidence-based practice improves patient outcomes and Healthcare system return on investment: findings from a Scoping review. Worldviews Evid Based Nurs 2023;20:6–15. 2 Alatawi M , Aljuhani E, Alsufiany F, et al . Barriers of implementing evidence-based practice in nursing profession: a literature review. AJNS 2020;9:35. 3 Son ğ ur C , Özer Ö, Gün Ç, et al . Patient safety culture, evidence-based practice and performance in nursing. Syst Pract Action Res 2018;31:359–74. 4 Curtis K , Fry M, Shaban RZ, et al . Translating research findings to clinical nursing practice. J Clin Nurs 2017;26:862–72. 5 Melnyk BM , Hsieh AP, Messinger J, et al . Budgetary investment in evidence-based practice by chief nurses and stronger EBP cultures are associated with less turnover and better patient outcomes. Worldviews Ev Based Nurs 2023;20:162–71. 10.1111/ wvn.12645 Available: https://sigmapubs.onlinelibrary.wiley.com/toc/17416787/20/2 6 Melnyk BM , Gallagher-Ford L, Thomas BK, et al . A study of chief nurse executives indicates low prioritization of evidence-based practice and shortcomings in hospital performance metrics across the United States. Worldviews Evid Based Nurs 2016;13:6–14.
practice (EBP) among nurses to improve patient outcomes and decrease nursing turnover 10.1136/ebnurs-2023-103771
Jan Powers Nursing, Parkview Health System, Fort Wayne, Indiana, USA
Correspondence to: Dr Jan Powers, Nursing, Parkview Health System, Westfield, Indiana, USA; Jan.powers@parkview.com
Commentary on : Melnyk BM, Hsieh AP, Messinger J, Thomas B, Connor L, Gallagher-Ford L. Budgetary investment in evidence- based practice by chief nurses and stronger EBP cultures are associated with less turnover and better patient outcomes. Worldviews Evid Based Nurs. 2023 Apr; 20 (2):162-171. doi: 10.1111 / wvn. 12645 . Epub 2023 Apr 12 . Implications for practice and research ► Providing evidence-based practice (EBP) resources including time, training and mentorship to nurses will improve patient outcomes and increase nursing engagement and decrease turnover of staff. ► Future research should be conducted on a larger scale to identify im- provements and resulting return on investment (ROI) from evidence- based implementations. Context It is well known that using evidence-based interventions in practice has positive effects on improving outcomes and safety for patients. 1–4 Nursing leaders must support a culture of EBP to impact not only patient outcomes, but also nursing outcomes by increasing decision making confidence, which enhances nursing practice. 2 This study by Melnyk et al further explores the direct association with investment of EBP to patient and nurse outcomes. 5 Methods This descriptive, correlational study by Melnyk et al used a survey design including assessments for EBP and implementation culture as well as objec- tive nationally reported data as quality indicators. This study aimed to iden- tify relationships between investment in the nursing budget for EBP and outcomes for patients and nurses. Findings Response rate for this study was 2.3% with a final sample of 115 out of 5026 invited chief nurse executives (CNEs)/Chief Nursing Officers (CNOs) in the USA completing the survey. The majority 90/115 (78.3%) of CNE/CNOs allocated less than 10% of their budget to EBP and one third had no budget allocated to EBP. The authors identified an association with an increase in the budget amount for EBP resources and fewer patient falls and trauma, less nursing turnover and stronger EBP culture. Organisations with a greater number of EBP projects also had an associated improvement in patient outcomes. These findings
1
Evid Based Nurs Month 2023 | volume 0 | number 0 |
Powered by FlippingBook