EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM
Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
- Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
- Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
- Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:
- Patient experience
- Population health
- Work life of healthcare providers
BY DAY 7 OF WEEK 1
Submit your anaylsis.
EVIDENCE-BASED PROJECT, PART 1: IDENTIFYING RESEARCH METHODOLOGIES
Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
- Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
- Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
- Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
- Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
- The full citation of each peer-reviewed article in APA format.
- A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
- A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
- A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
- A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.
DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE
As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.
In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.
- Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
- This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
- Reflect on which type of dissemination strategy you might use to communicate EBP.
BY DAY 3 OF WEEK 9
Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.
BY DAY 6 OF WEEK 9
Respond to at least two of your colleagues on two different days by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.
Evidence-based practice healthcare interventions are essential in meeting the needs and expected outcomes for the intended target population. There are always opportunities to increase healthcare access, reduce cost, and improve the overall health of Americans (U.S Government Information, 2008). Within the mental health population there are numerous healthcare interventions to help stabilize and improve the mental wellbeing of individuals. I was appointed by the Nurse Executive at my hospital to formulate a position to better service the hospital’s mental health population.
Creating a position in a hospital has allowed me to use various dissemination strategies. Dissemination is defined as intent to distribute information and intervention materials to a specific targeted audience (McCormack et al., 2013). When I see an area that could be improved in the mental health population I create hard evidence of the problem, use evidence-based research to support the solution to the problem, and then formulate how I will deliver the evidence to my intended audience. Two dissemination strategies that I would be most inclined to use within my healthcare organization is to present my proposal of information during an organizational level meeting or a hospital level meeting (Ross et al., 2020). An example of an organizational level meeting would be the Behavioral Health forum and a hospital level meeting would be the Best Practice Council, both of which I’m an active member. From my experience in the past with presenting proposals to my organization to facilitate change, the most important aspect is where and when is your target audience available. This is strategically planned to increase the reach of the evidence and increase leadership’s motivation to use and apply the evidence.
Barriers that may present itself when relying on an intended organization or hospital level meeting is some of your intended audience may not be present like you had thought, or the meeting might be pushed back to the following month. I’ve had both barriers happen. If I was expecting a specific person to be at the meeting I was presenting at and they ended up not being present, I would then reach out to them directly to discuss the information. If the meeting was pushed back to the following month, I have been known to discuss my information with the chair and co-chair so I can possibly be given advice on how to move forward in the next month while waiting for the meeting.
Two dissemination strategies that I would be least inclined to use is to share information through organization’s social media page or create informational flyers, guides, or pamphlets to distribute (National Health and Medical Research Council, 2019). I would not use a strategy where I could not be face-to-face with my audience. I enjoy communicating with my audience when advocating for a specific topic to gain their prospective and insight.
McCormack, L., Sheridan, S., Lewis, M., Boudewyns, V., Melvin, C. L., Kistler, C., & Lohr, K. N. (2013). Communication and dissemination
strategies to facilitate the use of health-related evidence. https://effectivehealthcare.ahrq.gov/products/medical-evidence-
National Health and Medical Research Council. (2019) Guidelines for Guidelines: Dissemination and
Ross-Hellauer, T., Tennant, J. P., Banelytė, V., Gorogh, E., Luzi, D., Kraker, P., & Vignoli, M. (2020). Ten simple rules for innovative dissemination of
research. PLoS computational biology, 16(4), e1007704.
United States Government Information. (2008). https://www.govinfo.gov/content/pkg/ERP-2008/pdf/ERP-2008-chapter4.pdf
Module 5 Discussion reply 1.
Great read! You and I are pretty alike when it comes to dissemination of information, I am too a supervisor at my organization so I do get opportunities to do so. I agree with you, I’d much rather speak to people in person than post things around the facility or use social media. I found a great article that talks about how common dissemination of information from COVID-19 start was online and used in the media. I do think that I saw a lot of my information on there as well, which does kind of contradict what I wrote about. I think the topic must be big enough where people want to know more information about it before they pay attention to those types of posts though. There are so many limitations to social media such as insufficient source information, not the entire audience views, not able to answer questions directly, and others not being able to distinguish between valid and invalid information (Chan et al., 2020).
Another article that I read does talk about some barriers with using in person communication as a way of dissemination. Some of these barriers include the amount of time and resources that need to be in place, time to hold meetings, recruit the staff to attend, provide follow-up after these meetings (Chapman et al., 2020). Which I can see where the barriers are true, but if you have the resources, time and staff that are dedicated to their jobs, it can be easy to hold meetings and do follow-up with them. Like I said, I think its more personable to do in person meetings, this way I am available for questions if needed.
Chan, A., Nickson, C., Rudolph, J., Lee, A., & Joynt, G. (2020). Social media for rapid knowledge
dissemination: early experience from the COVID‐19 pandemic. Anaesthesia, 75(12), 1579–1582.
Chapman, E., Haby, M,. Toma, T. (2020). Knowledge translation strategies for dissemination with a focus
on healthcare recipients: an overview of systematic reviews. Implementation Science, 15(14).
I agree with you Leslie that some barriers with using in person communication as a way of dissemination. However, I believe that the issue needs to be significant enough that people are interested in learning more about it before such kinds of blogs will get seen. Some users may not be able to tell the difference between true and false material posted on social media, there may be a lack of complete background information or the ability to respond directly to inquiries.
I do agree with you that one method of spreading information that will garner a considerable amount of attention is through the use of social media. Making a personal blog is probably yet another option worth considering.
great post Cassie,
I agree with you about using staff meetings/in-service training as a method of dissemination as this helps individuals to be more engaged and voice out any concerns that may arise. I strongly believe the use of infographics and PowerPoint presentations can be a great tool to incorporate in any dissemination. This allows individuals to grasp and visualize what is being presented. Infographics are elements that serve as a visual presentation of data (Henandez-Sanchez et al., 2020).
Infographics have been seen as an effective, and convenient way to present information and deliver nursing education (Jackson et al., 2018)
Hernandez-Sanchez, S., Moreno- Perez, V., Garcia- Campos, J., Marco-Lledo, J., Navarrete-Munoz (2020). twelve tips to make a successful medical infographic. Medical Teacher, 1- 19. doi/10.1080/0142159x. 2020
Jackson, L., Jowsey, T., & Honey, M. L. (2018) In-service Education: Evolving internationally to meet Nurses’ lifelong Learning Needs. The journal of continuing education in nursing, 50(7), 313-318. doi/10.3928/00220124-20190612.
Thanks for a great read.
I do agree that Social Media is one way of disseminating info that will gain a significant amount of attention. Another way I suppose would be to Create a personal blog. YouTube is great for podcast once it’s created. According to (Tripathy […], 2017), In recent years, academics have shown a growing interest in non traditional methods of evaluating their scholarly ‘impact’ known as ‘altmetrics’, which is another way in which researchers are able to gave the impact and reach of their research instead of the once traditional way.
Tripathy, J., Bhatnagar, A., […] and Harries, A. (2017), Ten tips to improve the visibility and dissemination of research for policy makers and practitioners. Publish Health action. 7(1): 10-14. DOI: 10.5588/pha.16.0090 https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5526489/
Hi Cassie, Great Post! Similarly to you, I have been able to implement strategies within our Behavioral Health Department. While I am not an executive I have been valued as a leader. Below you will see some of the strategies implemented by myself and the leadership team within the department.
(Newhouse et al., 2007, p. 556) Two dissemination strategies that I would utilize are unit-level presentations and posters. (Melnyk, 2018). In the Behavioral Health Department, we utilize unit-level presentations in the form of start of shift huddle. We have four daily huddles; this is where appropriate data is shared to improve clinical practice. Staff are gathered in a centralized location on the unit during huddle which allows information to be disseminated quickly. Leadership shares our department metrics, policies and procedures, and important updates critical to the day’s work. Staff are then given the chance to voice concerns, pose questions, and share any other data considered fundamental for practice. (Melnyk, 2018). The biggest barrier to this strategy is that information is given verbally and missing the huddle or distractions during huddle means that someone may miss important information with this communication method. Ways to improve this type of strategy are to move the huddle to a private or less crowded area of the unit so there are less distractions or to follow up critical information with a written recap that can be reviewed later. (Melnyk, 2018).
Another strategy to disseminate information would be using posters. Behavorial Health units can be hectic and fluid, therefore adapting to many changes at once is often necessary. (Melnyk, 2018). Medical staff work closely with one another to provide patient care. With poster presentations, the disseminated information only presents the most vital information related to a topic. It is visual and easy to read so the information can be learned and absorbed quickly. (Melnyk, 2018). Although this is informal, it does allow continued interaction among colleagues. Recently, during the huddle, a poster was presented with our new restraint process. The poster included the steps of how to physically restrain and provided statistical information on restraints, core measure standards, and proposed outcomes. The Behavorial Health team was able to change quickly by beginning to use the new methods as it gave a visual presentation on where we were, what we needed to do, and what needed improvement. Barriers to this type of dissemination strategy is there that the poster could miss critical information, be too busy to read. (Melnyk, 2018). The content could be either too sparse for real value or contain too much information or be placed in an area where no one sees it. There is also no way to confirm that all nurses learned the information or that the information was understood. Strategies to help with this can be to make sure that the presenter uses PowerPoint slides or clear graphics, sequencing the information to ensure that the poster is concise and easy to read in a visible area. (Melnyk, 2018). Additionally, the presenter should offer specific times to be available for questions and include ways for follow-up to be provided, such as through email.
Melnyk, B. M. (2018). 20: Disseminating Evidence Through Presentations, Publications, Health Policy Briefs, and the media. In E. Fineout-Overholt (Ed.), Evidence-based practice in nursing and healthcare (4th ed ed., pp. 547–602). Wolters Kluwer Dissemination Strategies Discussion Essay.
Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L., & White, K. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: Journal of Nursing Administration, 37(12), 552–557. https://doi.org/doi: 10.1097/01.NNA.0000302384.91366.8f
Cheron, your essay was quite enjoyable to read. I wholeheartedly concur that using posters is one method that might be utilized to distribute information. Because of Behavioral Health facilities’ chaotic and unpredictable nature, it is frequently essential to adjust to multiple changes simultaneously. People with a history of receiving psychiatric treatment in an institution are more likely to experience increased levels of social stress and stigma, as do their family members and friends. People who have spent extensive time in mental health care institutions experience hostility and intolerance from their various social networks. This is because of the stigma associated with mental illness (Dorai et al., 2023).
In addition, it’s beneficial that you pointed out that this strategy’s most significant drawback is the information conveyed verbally. If someone is absent from the huddle or distracted while the huddle is going on, they are likely to miss out on crucial details. Moving the huddle to a more private or less crowded unit area can make this strategy more effective. Hence, there are fewer distractions, or you can follow up on critical information with a written recap that can be reviewed later. Both of these options are ways to improve the situation.
You brought up another key aspect when you said that information presented in poster presentations only includes the most critical details about a subject. This is a very crucial point. Poster presentations draw in an audience with comparable interests, allow the researcher to connect with the audience and clarify the research method and conclusions, permit creative expression in presenting, and assist in creating collegial relationships with others who share similar interests.
There is a consensus that disseminating and explaining scientific findings is an integral component of the research experience; however, only a tiny fraction of science programs offer a formal undergraduate curriculum for developing oral science communication skills (Leone & French., 2022). The potential for the poster to overlook important information because they are too busy reading presents a challenge for this type of information-sharing technique. In addition, I recognize that you make a very valid point when you say, “Strategies to help with this can be to ensure that the presenter uses PowerPoint slides or clear graphics, sequencing the information to ensure that the poster is concise and easy to read in a visible area.” You are correct in making this statement.
Dorai, V. L., Kannekanti, P., Bhattacharjee, D., & Das, B. (2023). Challenges Implicit During Discharge of Persons with Mental Illness in Tertiary Care Settings: A Case Series. Journal of Psychosocial Rehabilitation and Mental Health, 1-10.
Leone, E. A., & French, D. P. (2022). A mixed-methods study of a poster presentation activity, students’ science identity, and science communication self-efficacy under remote teaching conditions. Journal of Microbiology & Biology Education, 23(1), e00262-21.
I absolutely loved your post! I’m extremely interested to hear about your daily huddles. Being that our charge nurses do huddles before shift, and then things get crazy during the shift, this leaves the managers to have little direct conversations with their team. Having a manager directed huddle during the shift is an amazing idea. I’m going to start researching the evidence-based information on this strategy!
I agree with you that having a poster during a visual presentation could be a barrier in presenting your information in a clear manner. I also think it depends on the atmosphere in which you are presenting your information. A poster presentation is viewed as less intimidating, informal, and used in a relaxed atmosphere (Sherbinski and Stroup, 1992). A well-designed poster presentation should always follow the five Cs; compliant, catchy, concise, clear, and clutter free (Moyo, 2019). Keeping the poster simple and clear on the information being disseminated will help keep the audience engaged and allow them to easily comprehend the material given.
Moyo, M. (2019). The 5 Cs for developing an effective poster presentation. Journal of Radiology Nursing, 38(3), 210-212. https://doi.org/10.1016/j.jradnu.2019.05.015
Sherbinski, L. A., & Stroup, D. R. (1992). Developing a poster for disseminating research findings. AANA journal, 60(6), 567–572.
Hello, Cassie! Excellent discussion post! I’d like to offer some additional suggestions for overcoming the barriers to the strategies suggested in your post. The obstacles you mentioned are valid, especially if a meeting is postponed; responding to an organization or hospital is difficult. That is an excellent way to make up for lost time by being productive until the next meeting. Having early support from your administration is critical to success. You will encounter obstacles, but you will also learn strategies to help you overcome them. We can create an EBP environment that benefits our patients and ourselves (Ginex, 2023). When dissemination is lacking, research may be viewed as a waste of resources and a futile endeavor incapable of influencing positive health outcomes (Derman & Jaeger, 2018).
Derman, R. J., & Jaeger, F. J. (2018, June 22). Overcoming challenges to dissemination and implementation of research findings in under-resourced countries. Reproductive health. Retrieved January 27, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019998/
Ginex, P. K. (2023, January 13). Overcome barriers to applying an evidence-based process for practice change. ONS Voice. Retrieved January 27, 2023, from https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change
Hi Cassie, great post regarding the method of dissemination, I too believe in continuous communication thru meetings such as in person staff meetings or in-service training as a method of dissemination as this helps employees to be more engaged and voice out any concerns and ideas. According to (Tripathy […], 2017), In recent years, academics have shown an increased interest in nontraditional methods of evaluating their scholarly ‘impact’ known as ‘altimetric’, which is another way in which researchers are able to give the impact and reach of their research instead of the once traditional way.
Tripathy, J., Bhatnagar, A., […] and Harries, A. (2017), Ten tips to improve the visibility and dissemination of research for policy makers and practitioners. Publish Health action. 7(1): 10-14. DOI: 10.5588/pha.16.0090 https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5526489/Links to an external site.
I appreciate your comprehensive discussion of the evidence dissemination process. Organization-level meetings provide ideal opportunities to share evidence with healthcare staff members. The meetings are beneficial because they afford the audience opportunities to question the evidence in the context of clinical practice (Melnyk & Fineout-Overholt, 2022). In addition to the organizational-level meetings, an oral podium presentation is an effective dissemination strategy that allows a direct conversation about the evidence. Addressing the barriers to dissemination ensures optimal evidence translation (Dang et al., 2021). To address the concern of audience availability, the organization should schedule meetings at the end of day shifts to allow all healthcare professionals to participate in the meetings. Additionally, the meetings should be conducted virtually to accommodate off-site staff members (Melnyk & Fineout-Overholt, 2022). The objective is to maximize the understanding and application of evidence by the clinical staff.
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Great post. I believe organizational level meetings such forum or councils would be an effective dissemination strategy. Forums and councils provide space for staff and executives to exchange opinions and ideas, develop plans, and address issues or concerns (Brownson et al., 2018). It would be a good space to distribute information and intervention materials because the intended targeted audience would be willing to hear the information presented. It also allows for discussions and dialogue. I believe that face to face dissemination strategies would have more of an impact than online strategies. Face to face approach is the best way to communicate and ensure that the audience understands and retains the information given to them.
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the Word Out: New Approaches for Disseminating Public Health Science. Journal of Public Health Management and Practice, 24(2), 102–111. https://doi.org/10.1097/phh.0000000000000673
Why must nurse researchers be aware of barriers to dissemination strategies?
“It is well known that evidence-based practice (EBP) improves healthcare quality, safety, and patient outcomes as well as fosters clinicians’ active engagement in their practices” (Melnyk et al., 2017). Furthermore, it is essential to educate and inform all health care team members about EBP studies and interventions that are on the rise to improve patient outcomes. “Using guidelines to inform practice improves the effectiveness and efficiency of healthcare while reducing inappropriate variations in practice” (Medves et al., 2010). Some dissemination strategies include unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, and publication in peer-reviewed journals.
Of the dissemination strategies listed, two that I would be most inclined to use would be poster presentations and unit level presentations within my hospital. These two seem to be strategies that can be used to easily present information quickly and effectively to surrounding staff. With poster presentations, I would hand out informational fliers that engage readers and link resources for further exploration on the topic. I would ensure to only include vital information. With unit-level meetings, keeping the group small, you can ensure that every member is captivated and engaged in the material. This type of strategy also allows for questions during and at the end of the presentation.
Some barriers that may exist with these two strategies would be that with poster presentations and unit level meetings, you may not be able to convey all the information you want to present. There may be a time limit for these meetings as well which could make it difficult to keep everyone engaged in the allotted time. Ways to overcome some of these barriers are to divide unit meetings into different sessions to not over-exhaust staff and keep their full attention. “Nurse schedules needed to accommodate time away from clinical responsibilities for initial training and then later to complete the EBP process” (Newhouse et al., 2017). Also scheduling meetings before work so that they are ready to learn, rather than after a 12-hour shift.
Two of the dissemination strategies I would be least likely to use would be a podium presentation at a national level and a publication in a peer-reviewed journal. Reasons being that attendees of a podium presentation at a national level would be higher-level education individuals such as those with PhDs, and I would fear not being able to answer questions they may have.
Medves, J., Godfrey, C., Turner, C., Paterson, M., Harrison, M., MacKenzie, L., & Durando, P. (2010). Systematic review of practice guideline dissemination and implementation strategies for healthcare teams and team-based practice. International journal of evidence-based healthcare, 8(2), 79–89. https://doi.org/10.1111/j.1744-1609.2010.00166.x
Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomes Links to an external site.. Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188
Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice Links to an external site.Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f
Wonderful job on your response Mellissa! Poster is an excellent strategy especially if it draws immediate attention. A well-designed poster can be an effective way … to convey information but must be visually appealing in order to bring the message across (Berg, 2005). According to Goslin, a “producing a poster of high-quality requires considerable planning and acquisition of a specific presentational skills” : However, the case for dissemination of scientific findings in the form of poster is very enthralling (Goslin, 1999). Posters are a powerful way to convey information and can be used with other presentation formats to enhance knowledge dissemination. Posters also forces the presenter to carefully select content for brevity, and this encourages emphasis of the most vital content. The messages portrayed on a poster are continuous and constant, which reduces variability and enhances reliability (Berg, 2005). The disadvantage to poster presentation is the lack of substance when the findings of a study are simplified into an outline or a poster (Edwards, 2015).
Berg, J. A. (2005). Creating a Professional Poster Presentation: Focus on Nurse Practitioners. Journal of the American Academy of Nurse Practitioners, 17(7), 245–248. https://doi.org/10.1111/j.1745-7599.2005.0041.x
Edwards D. J. (2015). Dissemination of Research Results: On the Path to Practice Change. The Canadian journal of hospital pharmacy, 68(6), 465–469. https://doi.org/10.4212/cjhp.v68i6.1503
Gosling, P. J. (1999). Scientist’s guide to poster presentations. Springer Science+Business Media, LLC. https://eds.s.ebscohost.com/eds/detail/detail?vid=9&sid=31e7bca9-41de-4672-b6a1- 947594b48b5e%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=wal.EBC3080508&db=cat06423a
I find your post very interesting; the disadvantages of these two methods are that you may need to get all the information you want at a poster presentation or a unit-level meeting. Keeping everyone interested in these sessions may be challenging if they are time-limited. Separating unit meetings into separate sessions can help avoid staff burnout and ensure that each team member gives each forum their full attention. Time away from clinical duties for initial training and after that to finish the EBP procedure has to be worked into nurses’ schedules (Newhouse et al., 2017). Moreover, rather than having them learn new things after a 12-hour shift, have them study new items before they start work.
Medves, J., Godfrey, C., Turner, C., Paterson, M., Harrison, M., MacKenzie, L., & Durando, P. (2010). A systematic review of practice guideline dissemination and implementation strategies for healthcare teams and team-based approach. International journal of evidence-based healthcare, 8(2), 79–89. https://doi.org/10.1111/j.1744-1609.2010.00166.x
As an organizational leader, why must the APN be prepared to effectively disseminate EBP research?
Thank you for sharing your post. I agree with you that evidence-based practices enhance healthcare quality and patient outcomes. Effective communication of evidence to healthcare professionals is integral in eliminating variations in evidence application during practice (Melnyk & Fineout-Overholt, 2022). Both unit-level presentations and poster presentations would work for me because they are easier to use and reach a large audience. Any strategy allowing the audience to ask questions about the evidence ensures accurate understanding and use of the information. Time limitation is a notable barrier when using unit-level meetings because of nurses’ tight work schedules (White et al., 2019). I think diving into unit meetings is an appropriate way to ensure all staff members participate in the meetings. The organization should also record meetings and make them available for nurses to view the proceedings during their free time.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare. Springer Publishing Company.
Thank you for your post. It was informative. The gap between research discovery and the application of evidence in practice settings is, as a result, of ineffective dissemination. The message, source, and the audience must be considered when planning to disseminate evidence (Brownson et al., 2018). The importance of effective dissemination remains a priority. Effective dissemination effort allows for acquired knowledge to be shared and create room for more innovations. I agree that poster presentations and unit-level meetings are great ways to disseminate evidence-based research that can be included in clinical practice to improve patient outcomes. No matter where it is used, a well-developed evidence-based practice (EBP) poster is an effective communication tool (Williams & Cullen, 2016). To overcome some of the barriers you mention, such as not being able to include all the information due to the time limit and keeping everyone engaged, is to make the poster presentation visually interesting and informative. In addition, unit-level meeting cans also be held via video conferencing, such as Microsoft Teams meeting on multiple dates within the period to accommodate more people. Offering this flexibility will allow more people to participate on even off days without driving to the hospital or running off to go provide patient care. A question-and-answer session may keep people more engaged in the discussion.
Additional effective dissemination strategies include social media platforms, issue or policy briefs, workshops, seminars, and one-on-one meetings. Effective dissemination strategies can create public awareness, leading to greater intervention based on evidence and policy changes (Brownson et al., 2018).
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102–111. https://doi.org/10.1097/phh.0000000000000673
Williams, J. L., & Cullen, L. (2016). Evidence into practice: Disseminating an evidence-based practice project as a poster. Journal of PeriAnesthesia Nursing, 31(5), 440–444. https://doi.org/10.1016/j.jopan.2016.07.002
Dissemination is a planned process that involves consideration of target audiences, consideration of the settings in which research findings are to be received and communicating and interacting with wider audiences in ways that will facilitate research uptake and understanding (Ross-Hellauer et al., 2020). Considering the audience is a very critical part of choosing a dissemination.
Publishing evidence-based practices in peer-reviewed journals is an effective way of dissemination. It provides a credible and reliable platform through which consumers, purchasers, scholars, clinicians and other providers can access critical information and use it to make informed decisions. When peer-reviewed journals are used to, it reaches more people in positions to implement change. The journal publishing requirements would include the credibility of information in the EBP, which would mean that the evidence would need to be viable (Gallagher-Ford et al., 2011).
In my unit or within my hospital, I will make use of team meetings/nurse hurdles with posters and internal emails. During team meetings, questions can be asked and answered where concerns are raised. clinicians will be able to give feedback on how the proposed policy or topic could affect or improve patient safety or working conditions. Posters will be displayed in common areas in the facility where they would be easily seen and would serve as a good source of information for everyone. Posters may also be useful in educating patients and their families. Emails will be explanatory, brief and straight to the point and will be sent to all clinicians including nurses or providers who are directly concerned with the issue and feedbacks will be encouraged.
The internet or social media and pamphlets are two dissemination strategies I will be least likely to use. Even though, internet websites like ResearchGate boasts of lots of viewers, it may be missing the target audience (Ross-Hellauer et al., 2020). Some social media websites are not professional platforms, where one would be sure the information will not be misconstrued or distorted.
As much as pamphlets serve as good education materials, some nurses may not make time to read them at work. Some pamphlets have been found lying on break room tables while some make it home without been read at all.
Speaking of barriers, using publications in peer-reviewed practices could face challenges such as time and resources. Peer-reviewed journals require the input of professionals and scholars in their fields to contribute toward developing knowledge and analyzing the papers they publish. Collecting enough data to satisfy a journal, for example, could work as a hindrance to publication. Other barriers could be nurses not attending hurdles/team meetings, not giving feedbacks, not paying attention to poster boards, or not reading their emails. Moreover, when posters are not adequately designed or suited for an audience, they can lead to a breakdown in communication (Rojas, 2019).
In overcoming barriers, posters should be more legible and appealing. Nurses should be encouraged to attend hurdles and teams. Also, should be encouraged to use emails to communicate effectively. Most importantly is the readiness to change. I believe the reason why some nurses do not embrace new practices is the fear of the outcome. Changing the “ways we have been doing things” could be very challenging for some nurses. Therefore, nurses should be encouraged to adapt to change in as much it is an evidence-based practice.
Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: implementing an evidence-based practice change. AJN The American Journal of Nursing, 111(3), 54-60.
Melnyk, B. M. (2018). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127-135.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia, PA: Wolters Kluwer.
Ross-Hellauer, T., Tennant, J. P., Banelytė, V., Gorogh, E., Luzi, D., Kraker, P., Pisacane, L., Ruggieri, R., Sifacaki, E., & Vignoli, M. (2020). Ten simple rules for innovative dissemination of research. PLoS computational biology, 16(4), e1007704. https://doi.org/10.1371/journal.pcbi.1007704
Rojas, E. (2019). Advantages and disadvantages of visual communication. Chron. January 25, 2019. Retrieved November 2, 2020 from https://smallbusiness.chron.com/advantages-disadvantages-visual-communication-42511.html
I agree with you that a poster presentation would be a great strategy to use. It will enable you to include the vital information needed to reach your audience. There may be barriers to this, but I believe one strategy that can be used to overcome these barriers is to get the input of the people as they will feel included in the whole process (Gallagher- Ford, 2011). Another barrier that may impede EBP is the lack of support from nurse leaders Melnyk et al., 2019). This may be due to the lack of understanding between leaders and what EBP can bring to nursing practice and patient care.
Gallagher- Ford, L., (2011) Evidence-based practice step-by-step: implementing an evidence-based practice change. American Journal of Nursing, 111(30, 54-60.
Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., Choy, K. (2019). A test of the ARCC model improves and implements healthcare culture and patients.
Audience consideration is indeed vital to choosing dissemination because the audience at times can
make or break the information shared. I’ve lost count of times when I have seen pamphlets passed out at
conferences or presentations and by the end of the conference and or presentation, most of the pamphlets
are on the floor or in the trash. Academic publications and conferences are by far the most popular venues for
disseminating research; however, only 46% of state public health practitioners utilize journals in their daily
work, while only 33% of local public health practitioners use journals (Brownson et al., 2018). The main
obstacle to using journals is access. Time, resource dependability, data credibility, and information overload
are additional hindrances to the utilization of articles.
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: new
approaches for disseminating public health science. Journal of public health management and
practice, 24(2), 102-111.
Thank you for your post!
As I read your post I thought of each of the different types of dissemination strategies and figured that each type has positives and negatives that often decided by the structures within an institution and the nature of healthcare professionals found there. A strategy that works in one health care facility may or may not work in another facility. My recommendation would be to pair different strategies to increase dissemination effectiveness rather than relying on one approach. For example, the unit-level presentation paired with poster presentations because they are able to complement each other in the distribution of evidence= base practice. No matter the method, nurses and other healthcare professionals are obligated to continue education and disseminate knowledge (Milner, 2016).
Another barrier is not enough education on EBP. Staff may not understand EBP or how to implement it. There are ways to overcome this barrier. One of the ways to break this barrier is through research and on the job learning. This should be the culture of the facility. Supporting this type of culture allows for nurses to use EBP and incorporate it into their daily practices as nurses. This becomes natural for them and patients benefit because they are receiving the best evidence-based practices (Mick,2017).
Mick, J. (2017). Funneling evidence into practice. Nursing Management, 48(7), 27–34. https://doi org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000520719.70926.79
Milner, K. A. (2016). Sharing your knowledge. Journal of Infusion Nursing, 39(5), 297–305. https://doi.org/10.1097/nan.0000000000000188
Hello there, Esther. Excellent post and explanation of dissemination. The barriers discussion was valid and understandable. It can be more complex because the input of professionals and scholars in their fields contributes to a large portion of developing knowledge and analyzing the papers they publish. Nurses’ information is also essential, but I can see how this could become a barrier. Dissemination of research findings or other vital messages is becoming increasingly recognized as an important but complex process (Rassool, n.d.). The source, message, medium, and target groups are all examined as critical elements in the dissemination process. (Rassool, n.d.). The dissemination of evidence-based nursing knowledge, research, and findings by nurses to other healthcare professionals or the general public is known as evidence dissemination in nursing (Effective dissemination strategies, n.d.). New knowledge can be obtained through research conducted by nurses to implement high-quality care in clinical practice. Even when new knowledge is acquired, its dissemination remains limited.
Rassool, H. (n.d.). Dissemination of nursing knowledge: The application of the… : Journal of Addictions Nursing. LWW. Retrieved January 27, 2023, from https://journals.lww.com/jan/Abstract/2005/16010/Dissemination_of_Nursing_Knowledge__The.13.aspx
Effective dissemination strategies – proquest. Effective dissemination strategies . (n.d.). Retrieved January 28, 2023, from https://www.proquest.com/openview/594763837de4b919465130e9c87d623e/1?pq-origsite=gscholar&cbl=33100
Initial Discussion Response
Dissemination strategy is the process of providing evidence-based practice (EBP) knowledge in a small or large setting. Effective dissemination is simply delivering peer-review research to professionals who need to maximize their skills by using relevant and reliable interventions (Hagan et al., 2017, p. 4). The two best dissemination strategies that I would consider using a unit-level presentations and posture presentations. Unit-level presentation is the process of delivering evidence-based research (EBR) to hospital staff members for improving patient safety, and the quality of care. For example, at my facility, the quality report response department (QRR) reported 22 patient falls in December. As a result, I introduced a new EBP model called Fall Tailoring Intervention for Patient Safety (TIPS) toolkit in a staff meeting. The presentation was a power point and included infographics on the material to help break down the information. The second dissemination strategy is using posters to help the hospital staff to digest and visualize the information quickly. For example, the TIPS poster will have Fall risk assessment boxes to check off that apply to your patient such as a history of falls, medication side effects, an walking aid, an IV pole or equipment, and an unsteady walk. On the right side of the poster will list evidence-based interventions that will provide clinical decision support to link areas of fall risk with the interventions most reliable to prevent a fall (Ueda et al., 2022, p. 4). Poster presentations are a perfect way for a pictorial version of research, quality, or process improvement of work.
Podium presentations are the fastest way to spread scientific data and expert opinions across the community (Miquel et al., 2018, p. 1). I would least likely be inclined to do podium presentations because there generally in large settings with an limited amount of time to give a presentation. I prefer to present information in small settings such as staff, huddle, or committee meeting settings over using a podium approach. Not gaining support from the healthcare staff due to the lack of interest can become a barrier. For example, even though, the hospital had 22 patients with falls, the new preventative interventions may not win nurse’s support. Nurses have many tasks to complete in a shift and when you add additional interventions, that may not adjust well to their workflow, you will meet resistance. One way of overcoming this barrier is encouraging floor nurses to be the champion of the research project and provide the information to their peers for a better response to the new task. The second barrier is that nurses may overlook the posters in the patient’s room, which results in no participation. An idea to overcome this barrier is to add the TIPS toolkit to their SBAR (Bedside Hand-off) to ensure the form is updated between nurses for every shift.
Hagan, T. L., Schmidt, K., Ackison, G. R., Murphy, M., & Jones, J. R. (2017). Not the last word: dissemination strategies for patient-centred research in nursing. Journal of Research in Nursing, 22(5), 1–16. https://doi.org/10.1177/1744987117709516
Ueda, T., Higuchi, Y., Murakami, T., Kozuki, W., Hattori, G., & Nomura, H. (2022). Fall prevention program using home floor plans in an acute-Care hospital: a preliminary randomized controlled trial. International Journal of Environmental Research and Public Health, 19(17), 1–13. https://doi.org/10.3390/ijerph191711062
Miquel, J., Santana, F., Barrera, A., & Torrens, C. (2018). How do we deliver our findings? analysis of podium presentations at shoulder meetings. Journal of Orthopaedic Surgery and Research, 13(1), 1–5. https://doi.org/10.1186/s13018-018-0942-7
Dissemination is a crucial part of the translation of evidence because, without it, there will be no change in the way people are treated and no adoption of innovations (Dudley-Brown, 2019). The quickest approach to disseminate scientific information and expert viewpoints throughout a community is through podium lectures. Podium presentations provide rich and engaging opportunities for knowledge exchange, learning, and the advancement of clinical skills in the areas of evidence-based clinical practice, case studies of evidence-based quality improvement, program evaluation, and research (Melnyk & Fineout-Overholt, 2018). One way to overcome the time constraint and the fact that you are presenting to a large audience is to practice. By practicing the presentation, the speaker can gain confidence in their ability to present as well as familiarity with the subject and its organization. With practice, the speaker can edit, improve, and restructure the presentation to the satisfaction and comfort level necessary for effectiveness (Melnyk & Fineout-Overholt, 2018).
Dudley-Brown, S. (2019). Dissemination of evidence. Translation of evidence into nursing and healthcare, 255.
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Communication is a critical tool not only in nursing but in healthcare. As practitioners’ communication and its delivery is an essential practice that we continuously evolve in. Dissemination strategies offer the tools to communicate effectively. This is especially important in my current practice as not many practitioners have experience with patients who have special needs and disabilities. Evidence dissemination has several very broad goals: (1) to increase the reach of evidence; (2) to increase people’s motivation to use and apply evidence; and (3) to increase people’s ability to use and apply evidence( McCormack et al , 2013)
Of the many strategies I would be most inclined to use two particular strategies that would allow the communication of knowledge and information effectively. Poster presentation and creating a toolkit for trainings would assist in dissemination and communication of the needs of the community and promote current evidence-based practices. The presenter must consider the learning styles of the audience. Both strategies afford learners the opportunity to hear , see and possibly feel the information being communicated. Get to know your target audiences, their needs and expectations of the research outcomes, as well as their preferred communication channels to develop a detailed understanding of their interests and align your messages and media with their needs and priorities ( Ross-Hellauer et al , 2020).
There are several barriers that I may encounter when using poster presentation and research games to disseminate information. The strategy being used may not capture the attention of the target audience and the information may not be relayed effectively. Another major barrier that I frequently encounter is communicating information on the appropriate literacy level. This barrier is one that I commonly face as a 75% of the staff have absolutely no medical background and limited medical knowledge.
There are multiple barriers to leaders and clinicians succeeding in developing an HRHO and an EBP culture. Some of the major barriers include (a) lack of knowledge and skills in both HRHOs and EBP; (b) perceived lack of time; (c) lack of organizational/administrative support; and (d) educational programs that continue to teach the “traditional way” with a focus on producing research instead of using evidence to improve practice; and (e) lack of mentorship( Melnyk, B.,2012)
One way to overcome this barrier is to meet the learner where they learn. Presentations and tool kits can communicate both knowledge and information very effectively to learners who have literacy issues. Any information that is unclear can immediately be clarified during the presentation via a question and answer session.
One strategy that I would not be inclined to use is delivering information via social media. I would not use this strategy primarily because I am not technology savvy and would hate to underplay the needs of the community by not presenting effectively. Disseminating information appropriately and effectively is a necessity in communicating the needs of an organization and population. It is important to ensure information is delivered not only based on the needs of the organization but also based on the needs of the learner.
Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36 (2), 127-135. doi: 10.1097/NAQ.0b013e318249fb6a.
McCormack, L., Sheridan, S., Lewis, M., Boudewyns, V., Melvin, C. L., Kistler, C., & Lohr, K. N. (2013). Communication and dissemination strategies to facilitate the use of health-related evidence. https://effectivehealthcare.ahrq.gov/products/medical-evidence-Links to an external site.
Ross-Hellauer, T., Tennant, J. P., Banelytė, V., Gorogh, E., Luzi, D., Kraker, P., Pisacane, L., Ruggieri, R., Sifacaki, E., & Vignoli, M. (2020). Ten simple rules for innovative dissemination of research. PLoS computational biology, 16(4), e1007704. https://doi.org/10.1371/journal.pcbi.1007704
Diana, I totally agree that communication is very essential in healthcare in order to promote effective dissemination of information. Research dissemination is as a planned process that includes thinking about target audiences, thinking about the contexts in which research findings will be received, communicated and interacting with a broader audience in ways that will help achieve research uptake and understanding (AHRQ, 2017).
Regardless of the mode of dissemination method the information must be easily understood by the intended audience. Studies have found that scientists admit that there is a “lack of efficient communication methods, and a lack of tools and training for disseminating findings at their institution” (McElfish et.al, 2019). One communication technique in disseminating research results include the uses of narratives which improve information processing and message effectiveness by transporting people into a situation that can significantly improve emotions, attitudes, and behaviors. (AHRQ, 2017).
Ross-Hellauer et.al (2020) Cites, establishing objectives, mapping potential target audience(s), defining mode of communication/engagement, and developing a dissemination plan are critical first steps in strategically planning a project. Regardless of changes in communication technologies and models, some fundamental organizational aspects of dissemination remain important.
Effective Health Care Program, Agency for Healthcare Research and Quality, December 2019. Research Protocol: Communication and Dissemination Strategies To Facilitate the Use of Health-Related Evidence.
McElfish, P. A., Long, C. R., James, L. P., Scott, A. J., Flood-Grady, E., Kimminau, K. S., Rhyne, R. L., Burge, M. R., & Purvis, R. S. (2019). Characterizing health researcher barriers to sharing results with study participants. Journal of clinical and translational science, 3(6), 295– 301. https://doi.org/10.1017/cts.2019.409 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886004/
Ross-Hellauer, T., Tennant, J. P., Banelytė, V., Gorogh, E., Luzi, D., Kraker, P., Pisacane, L., Ruggieri, R., Sifacaki, E., & Vignoli, M. (2020). Ten simple rules for innovative dissemination of research. PLoS Computational Biology, 16(4), e1007704. https://doi.org/10.1371/journal.pcbi.1007704
Healthcare and nursing require communication. We evolve in communication and delivery as practitioners. Dissemination tactics help communicate. The current work is crucial because few practitioners have experience with special needs and disabled patients.
Two ways that effectively communicate knowledge and information are my favorites. Poster presentations and training toolkits help communicate community needs and support evidence-based practices. Presenters must consider audience learning styles. Both methods allow students to hear, see, and feel the material. Know the target audiences, their requirements and expectations of the research results, and their preferred communication channels to understand their interests and fit the messaging and media with their wants and goals.
Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementing the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36 (2), 127-135. doi: 10.1097/NAQ.0b013e318249fb6a.