Preparing Nursing Contexts for Evidence-Based Practice Implementation: Where Should We Go From Here?

Area of Science:

• Nursing implementation science
• Healthcare context analysis
• Evidence-based practice (EBP) adoption

Background:

• Context significantly influences the adoption and sustainability of evidence-based practices (EBPs).
• Current implementation research often focuses on specific EBPs rather than general context preparation.
• The dynamic nature of EBPs and healthcare necessitates a broader approach to context readiness.

Purpose of the Study:

• To highlight the need for adaptable healthcare contexts that support continuous change.
• To address the dynamic nature of EBPs and the evolving healthcare landscape.
• To promote proactive preparation of nursing contexts for implementation.

Main Methods:

• Synthesis of previous work by nursing implementation scientists.
• Comprehensive literature review (2006-2019) in implementation science, knowledge translation, and sustainability.
• Analysis of Canadian and American healthcare contexts.

Main Results:

• Nursing contexts must be flexible and conducive to ongoing EBP implementation.
• Environments that embrace change are more effective at de-implementing ineffective interventions and sustaining new EBPs.
• Future research should focus on building nurse capacity, organizational change support, co-producing evidence, and advancing implementation science.

Conclusions:

• Supporting adaptable contexts is essential for bridging the evidence-to-practice gap.
• Proactive context preparation is key to sustaining improvements in patient and health system outcomes.
• Further understanding is needed on creating change-embracing contexts before EBP implementation.