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.

 References

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.

          communication/research-protocolLinks to an external site.

National Health and Medical Research Council. (2019) Guidelines for Guidelines: Dissemination and

           communication. https://www.nhmrc.gov.au/guidelinesforguidelines/implement/dissemination-and-communicationLinks to an external site..

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

“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.  

References

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.xLinks to an external site. 

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.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.Links to an external site.Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f 

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.

References

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.1007704Links to an external site.

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

                                                                                                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.

References

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

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.

References

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.1007704Links to an external site.