Implementing evidence-based practice: walking the talk

Russworm and Larrabee's (1999) six-step model for evidence-based practice (EBP) was used by 10 nursing teams to seek answers to clinical questions. These teams, primarily composed of staff nurses, participated in a health region-wide EBP program over 1 year. Overall, the model served as a useful mechanism for examining practice-derived questions. However, additional strategies needed to be incorporated by the project teams. These included making decisions about change/no change at an earlier stage than was suggested by the model; seeking additional evidence including survey data to benchmark "best" practices; and ensuring colleagues' and managers' input, support, and involvement. Four project teams (three of which addressed nursing procedural questions) found insufficient empirical evidence on which to base change; the outlook for directing evidence-based practice was promising for the remaining six projects. The EBP program was judged to be highly satisfactory to participants and their managers.