Read the article and answer the question. 1 -2 paragraphs.

1.  It is great to read this article and learn about the Nurse Scholars course, a strategy (course) used to promote cultural change among nursing when it comes to EBP.  After reading the article, what is your take on how nursing engagement can make a difference? 

EBP nursing

Implementing EBP Column

Improving Patient Care Through Nursing
Engagement in Evidence-Based Practice
Elizabeth Crabtree, MPH • Emily Brennan, MLIS • Amanda Davis, MPH, RD •
Andrea Coyle, MSN, MHA, RN, CMSRN

This column shares the best evidence-based strategies and innovative ideas on how
to facilitate the learning of EBP principles and processes by clinicians as well as
nursing and interprofessional students. Guidelines for submission are available at
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787

INTRODUCTION AND BACKGROUND
The Medical University of South Carolina (MUSC) is a large
academic health science center, with a 700-bed medical cen-
ter (MUSC Health), and six colleges that train approximately
2,600 healthcare professionals annually. The MUSC Center
for Evidence-Based Practice (EBP), housed jointly in the Li-
brary and the Quality Management department of the MUSC
Hospital, aims to promote scientific inquiry, EBP, and quality
outcomes at MUSC. Through education, the development of
evidence-based clinical decision support tools and outcomes
research, the Center for EBP has begun to transform the cul-
ture of MUSC into one that incorporates best evidence into
clinical practice on both an individual and system level.

One of the strategies implemented by the Center for EBP
to promote cultural change is an educational course: the EBP
Nurse Scholars course, where nurses are taught about the the-
ory, practice, and dissemination of EBP.

DETAILED DESCRIPTION OF STRATEGY
Nurses serve on the frontline of health care, and have a
unique opportunity to improve patient care through EBP
(Hockenberry, Walaen, Brown, & Barrera, 2008). The staff
nurse is a critical link in bringing evidence-based changes into
clinical practice. Best practice only occurs when staff continu-
ally ask questions about treatment and care, have the resources
and skills necessary to search for and appraise research ev-
idence, implement the evidence in practice, and evaluate its
effectiveness (Dawes et al., 2005; Hockenberry et al., 2008).

MUSC’s experience in preparing practicing nurses to do
EBP was limited. To address this, the Center for EBP, in part-
nership with the Center for Professional Excellence, developed
a 12-week, project-based course to prepare nurses to engage in
EBP. The Center for Professional Excellence collaborates with

internal and external customers to create growth and devel-
opment opportunities for registered nurses. Additionally, the
center is responsible for Magnet application and designation.
The EBP Nurse Scholars course provides nurses with a com-
prehensive overview of EBP, prepares them to frame clinical
questions, perform literature searches, analyze and evaluate
evidence, and translate that knowledge into something clini-
cally meaningful. Members of the Center for EBP staff and
library faculty provided lectures and individual consultations
on framing clinical questions, conducting comprehensive lit-
erature searches, understanding statistics commonly reported
in research articles, and appraising and summarizing evidence
using the GRADE criteria. As part of the course, nurses se-
lected a specific hospital policy and applied their knowledge
to evaluating the evidence base for it. They then updated the
policy to ensure it reflected current evidence and best practice.

RESULTS
The EBP Nurse Scholars course resulted in successful com-
pletion of 15 projects related to nursing care and practice, and
led to significant practice improvements (Table 1). In addition,
several nurses have presented their findings at regional and
national conferences.

Pre- and post-course surveys demonstrated that the course
improved nurses’ confidence with EBP methods and skills re-
lated to research tools, statistical concepts, and study designs.
Data collected included responses from students from two EBP
Nurse Scholars courses: Spring 2013 and Spring 2014.

Participant Demographics
The majority of students who participated in the course were
BSN-level nurses working with adult populations at MUSC.

172 Worldviews on Evidence-Based Nursing, 2016; 13:2, 172–175.
C© 2016 Sigma Theta Tau International

Implementing EBP Column

0

1

2

3

4

5

Use of
research

Cochrane
Database of
Systema�c

Reviews

CINAHL Na�onal
Guideline

Clearinghouse

PubMed UpToDate

(1= Never, 2= Once per month, 3= Once per week, 4= Few
�mes per week, 5= Once per day, 6= Mul�ple �mes per day )

Median (Pre) Median (Post)

Figure 1. Use of research tools in practice.

Table 1. Examples of Completed EBP Nurse Scholars
Course Projects

Abdominal X-Ray forNG/OGTubePlacement

ClosedArterial Line LabSamplingSystem forPCICUPatients

DischargePlanning for Psychiatric Patients

ImprovingCare of Elderly in theAcuteCareSetting

InternationalNormalizedRatioCut-Off forHeart Catheterizations

Lidocaine4% forNonemergent IVStarts

Oral Care for Infants

Peripheral Administration ofChemotherapyAgents

Postoperative Education

Postpyloric Feeding toReduceRisk of AspirationPneumonia

PreoperativeBathing

PreventingTurniquet-Related Injuries inPatientsUndergoingTKA

Safety of “QuickStart”DepoProvera

ThermoprotectiveWraps inVery LowBirthWeight Infants

The majority of participants were ICU nurses, and students
typically had 0–5 years of experience.

Survey Results
Study data were collected and managed using Research
Electronic Data Capture (REDCap) electronic data capture
tools, hosted at MUSC. Due to the continuous nature of the

variables assessed in the pre- and post-tests for the EBP Nurse
Scholars course, we used pre- and post-test median scores and
the Mann-Whitney U test to measure significant changes in
confidence with EBP methods, use of research tools in clinical
practice, and understanding of statistical concepts and study
designs. A complete listing of the survey questions can be
found in Appendix 1, available with the online version of this
article.

After the course, there were significant increases in nurses’
confidence in critically reviewing literature (p < .001), their belief that EBP was necessary in nursing practice (p = .052), and their interest in improving skills necessary to use EBP in practice (p = .002). There were also significant increases in the use of EBP resources in clinical practice, including the Cochrane Database of Systematic Reviews (p < .001), CINAHL (p < .001), National Guideline Clearinghouse (p = .049), PubMed (p = .005), and UpToDate (p = .018), as well as in the understanding of statistical concepts and study design methods (p < .001). Pre- and post-test median scores representing the improvements in EBP resource utilization and understanding of research concepts are included in Figures 1 and 2.

The success of the EBP Nurse Scholars course led to
the development of a project-based course for interprofes-
sional teams of pediatric clinicians, all of which included
a nurse. These teams received EBP education and worked
together during this Interprofessional EBP course to frame
clinical questions, systematically search for, and critically ap-
praise and synthesize a body of research evidence for a par-
ticular disease topic. Based on their review of the evidence,
teams developed clinical practice recommendations for each
of the clinical questions they framed. These recommenda-
tions were used to develop admission and emergency depart-
ment order sets which were integrated into MUSC’s electronic

Worldviews on Evidence-Based Nursing, 2016; 13:2, 172–175. 173
C© 2016 Sigma Theta Tau International

Improving Care through EBP

0
1
2
3

(1= Do not understand, 2= Understand somewhat,
3= Understand completely)

Median (Pre) Median (Post)

Figure 2. Understanding of Research Concepts.

medical record. Finally, participants who completed either
the EBP Nurse Scholars course or the Interprofessional EBP
course were invited to participate in an EBP Leadership Pro-
gram. This program focused on implementation of their EBP
project, evaluation of results, outcomes, and dissemination of
findings.

Through these courses, the Center for EBP is transforming
the institution’s culture into one that builds EBP capacity, and
incorporates best evidence into clinical practice on both an
individual and system level.

DISSEMINATION
The Center for EBP staff has supported nurses in translating
their projects into scholarly work. The EBP Leadership
Program, the follow-up to the EBP Nurse Scholars course,
provided nurses with the skills to both implement and evaluate
practice change projects, but it also provided nurses with tools
and resources for developing abstracts for poster and podium
presentations. As a result of these efforts, numerous course
participants have had their work accepted for presentation
at regional and national conferences. The Center for EBP
applied for and received a competitive, internally funded
grant to support nurses in attending conferences where
they present the results of their EBP projects. The grant
covers the cost of printing a poster for nurses who have
had abstracts accepted. Funding the printing cost of the
posters further encouraged nurses to attend conferences, and
present their work, and motivated departments and units to
provide support for nursing engagement in EBP scholarly
work.

Supporting professional growth and development is a
nursing strategic priority at MUSC. To support and promote

nursing clinicians, three EBP Nurse Scholar projects were
highlighted in MUSC’s Magnet document. Additionally,
videos of nurses engaging in the EBP process were produced
and disseminated internally. The videos highlighted scholars
performing a literature search, analyzing and evaluating evi-
dence, and translating that knowledge in to changes in nursing
practice. WVN

LINKING EVIDENCE TO ACTION

� Organizational cultures can be transformed
through provision of EBP education and mentored
implementation of EBP knowledge and skills.

� A project-based EBP education program can re-
sult in an increase in utilization of EBP resources,
and in improvements in knowledge and attitudes
related to EBP.

� The implementation and dissemination of EBP
projects creates opportunities for nurses to partici-
pate in the development of scholarly products, and
results in professional growth and development.

Author information

Elizabeth Crabtree, Director of Evidence-Based Practice, Qual-
ity, Management, and Assistant Professor, Library & Infor-
matics, Medical University of South Carolina, Charleston,
SC; Emily Brennan, Informationist, Research Librarian, and
Assistant Professor, Library & Informatics, Medical Univer-
sity of South Carolina, Charleston, SC; Amanda Davis,

174 Worldviews on Evidence-Based Nursing, 2016; 13:2, 172–175.
C© 2016 Sigma Theta Tau International

Implementing EBP Column
Clinical Evidence-Based Practice Analyst, Medical University
of South Carolina, Charleston, SC; Andrea Coyle, Professional
Excellence Coordinator, Clinical, Services Administration,
Medical University of South Carolina, Charleston, SC

Address correspondence to Elizabeth Crabtree, Library
& Informatics, Medical University of South Carolina, 171
Ashley Avenue, Library, Suite 408, Charleston, SC 29425;
crabtr@musc.edu

Accepted 15 August 2015
Copyright C© 2016, Sigma Theta Tau International

References
Dawes, M., Summerskill, W., Glasziou, P., Cartabellotta, A., Mar-

tin, J., Hopayian, K., & . . . Osborne, J. (2005). Sicily statement
on evidence-based practice. BMC Medical Education, 5, 1.

Hockenberry, M., Walaen, M., Brown, T., & Barrera, P. (2008).
Creating an evidence-based practice environment: One hospi-
tal’s journey. Journal of Trauma Nursing, 15(3), 136–142.

doi 10.1111/wvn.12126
WVN 2016;13:172–175

Worldviews on Evidence-Based Nursing, 2016; 13:2, 172–175. 175
C© 2016 Sigma Theta Tau International

Copyright of Worldviews on Evidence-Based Nursing is the property of Wiley-Blackwell and
its content may not be copied or emailed to multiple sites or posted to a listserv without the
copyright holder’s express written permission. However, users may print, download, or email
articles for individual use.