Documenting an EBP Project: Guidelines for What to Include and Why‪.‬

Evidence-based practice (EBP) is being incorporated into nursing curricula at all levels and has become a popular focus of professional conferences and journals. Only 6 years after its inaugural issue, the journal Worldviews on Evidence-Based Nursing is now the 12th most frequently cited nursing journal in the world (Rycroft-Malone, 2009). The once-dominant themes of "what is EBP" and "why is EBP important" are evolving into a greater emphasis on "how do we do EBP" as accrediting bodies increase their attention on use of evidence to make decisions and provide care that will improve patient outcomes. In support and recognition of the importance of EBP implementation, the Foundation of New York State Nurses Center for Nursing Research Planning Committee (CNR-PC) established the Evidence-Based Practice Award in September 2007. The purpose of this award is to "recognize an individual or group using research-based evidence to make a practice change that results in demonstrated improvement in outcomes for the patient and family, staff, community, or organization" (Foundation of New York State Nurses Center for Nursing Research Planning Committee, 2008). During the 2 years since the award was announced, several individuals and groups have submitted EBP projects that they have undertaken. Many of these have demonstrated excellent potential but, to date, what has remained elusive is a direct and logical flow from practice-problem identification through each step of the EBP process to evaluation of effectiveness of the EBP change. If, for example, nurses at a healthcare institution identify a problem of increased rate of falls among their internal medicine male and female patients over 45 years of age, the outcome of interest would be a decreased fall rate among those patients. If appraisal and synthesis of relevant research demonstrates that the "4 for U" toileting protocol is the most effective intervention for decreasing falls among these patients, the "4 for U" protocol should be the practice change actually implemented. Evaluation of effectiveness of the practice change should address both the extent to which the practice change actually was implemented and extent to which the desired outcome was achieved, that is, both process and outcome evaluation.