Implementing Evidence-Based Practices in Hospitals: A Narrative Review of Implementer Roles and Project Attributes

TL;DR

This paper reviews who implements evidence-based nursing practices in hospitals and what project features are common, aiming to improve how these practices are adopted.

Contribution

The study identifies key implementer roles and project attributes in hospital EBP implementation, offering insights for optimizing the process.

Findings

Most EBP projects in hospitals occur at the unit level and involve multi-level teams.

The Joanna Briggs Institute model is frequently used to guide these projects.

Process measures are commonly evaluated in these EBP projects.

Abstract

Evidence-based nursing leads to improved care quality and patient outcomes; however, challenges with implementation prevent that from being achieved. In hospitals, nurses are well positioned across multiple organizational levels to influence the adoption of evidence-based practices (EBP). A better understanding of the roles of those who are serving as implementers of EBP changes in the hospital is needed.

This narrative review sought to answer: In hospitals, who (i.e., what roles) are the implementers of nursing-related EBP changes and what are the attributes of those EBP projects? This review aimed to describe (1) the roles and the organizational level of those implementing EBP changes in the hospital for nurses and (2) the attributes of the projects including, its location, the model used to guide the project, and the evaluation measures.

An iterative, two-phased literature review was conducted. Categorical data were analyzed to achieve the aims.

Across 158 articles, numerous roles, mostly nursing roles, spanning multiple organizational levels were described. The majority of articles described teams representing multiple levels (n = 132; 84%), implementers positioned in unit-level roles (n = 37; 23%), and projects occurring at the unit-level (n = 127, 80%), using the Joanna Briggs Institute model (n = 97, 61%) and an evaluation of process measures (n = 77; 49%).

This review identified the implementers of nursing-related practice changes and the attributes of the projects, which provides a rich description of some contextual elements that shape how EBP changes occur in hospitals. This new foundational knowledge can stimulate a systematic approach for improvement and optimization of the implementation process, both in practice and through research. This review highlights the need for tailored and role-specific skills, education, and competencies to equip implementers to lead collaborative and effective teams across hospital systems and maximize the impact of implementation.

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