Reply 1
 Before implementing evidence-based practice, it is important to know what the community is like where the practice change will occur. A community needs assessment for availability of resources may well support the evidence-based practice change at the hospital level. For example, my capstone change proposal is on why there is such a delay in hospital discharges. If there is no availability in long term care facilities or a lack of home health care services within the community, this could play a role in the delays in discharge. Anecdotally, case management where I work, experiences longer wait times for insurance companies to approve planned discharge placements.
At the local level, it is through transformational leadership, collaboration and shared vision with the hospital and community stakeholders that evidence-based practice can be successfully instituted (Warren, et al., 2016). The culture of the local hospital or organization must be considered since the change in practice will need to be implemented by a supportive staff. Transformational leadership plays a key role in implementing new practice. The work environment where the evidence-based practice proposal is to occur must be considered beforehand. Afterall, if it is not supported at the local level, it is doubtful that it would be successful (Warren, et al., 2016).
In a systematic review study, the conclusion was that most nurses are simply not familiar with evidence-based practice, let alone how to implement it (Valizadeh, et al., 2020). According to Valizadeh, et al., (2020), healthcare managers, policy makers, and nursing professors must guide nurses to implement evidence-based practice, make new protocols and break through the Its always been done this way mentality.
References
Warren, J.I., McLaughlin, M., Bardsley, J., Eich, J., Esche, C.A., Kropkowski, L., & Risch, S. (2016). The strengths and challenges of implementing EBP in healthcare systems. Worldviews Evid Based Nursing,13(1).15-24. doi: 10.1111/wvn.12149. PMID: 26873372.
Valizadeh, L., Zamanzadeh, V., Babaei, N., & Avazeh, M. (2020). Challenges and strategies for implementing evidence-based practice in nursing: a systematic review. Research in Medical Education, 12(3). 55-67. URL: http://rme.gums.ac.ir/article-1-977-en.html
Reply 2
 
3 postsRe: Topic 4 DQ 1

Understanding the health care system at the local level important to consider when planning an EBP implementation because it gives you an indication of what you can expect as far as demographics and availability of resources. According to my course mentor, when any evidence-based implementation has taken place at her facility, such as the change from paper charting to electronic medical records (EMR) was an arduous endeavor that required much planning and implementation. To promote use of research evidence in clinical and administrative health care decision making, multifaceted implementation strategies are needed (Moloney, Taylor & Ralph, 2016). Implementation strategies also need to address both the individual practitioner and organizational perspective. In addition to a shared vision, effective leadership is needed for change to be successful.
The key to transformational change or any change is to have leadership that is able to understand it, support it, explain it, and move the organization to commit to it (Cowell, Gillespie, Cheung & Brown, 2018). Although full schedules, distracting events, fear of change, and apathy are obstacles to change, the real enemy of change is complacency and having the will to change is vital Even groups that seek change may be complacent and not committed to follow through.
References:
Cowell, F., Gillespie, S., Cheung, G., & Brown, D. (2018). How to implement changes to reduce incidence and facilitate early management. Journal of Hand Therapy, 31, 201“205. https://doi.org/10.1016/j.jht.2018.01.013
Moloney, C., Taylor, M., & Ralph, N. (2016). Flooded with evidence: using a spillway model to improve research implementation in nursing practice. Australian Journal of Advanced Nursing, 34(1), 23“31.