Employing Strategies to Increase EBP Competency in Frontline Nurses while Aligning Nursing Skills with Current Evidence: A Quality Improvement Project

Stacey L. Spradling, Covenant Health System, Lubbock, TX, USA
Jamie Roney, Covenant


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Background: Clinical nurses are required to demonstrate expertise for diverse patient conditions while balancing efforts to improve both staff satisfaction and clinical outcomes. Nurse leaders must implement and measure the effectiveness of strategies to empower nurses to maintain clinical competence for themselves and their peers to ensure the highest quality of evidence-based care is delivered at the earliest patient touchpoints reliably and consistently.

Purpose: The purpose of this quality improvement project was to engage direct care nurses as skills “champions” to improve the clinical skills of nurses working in a resource pool in a large urban hospital.

Methods/Approach: Clinical nurses were empowered to “champion” and lead a skills competency event. Attendance was required for the skills event by all nurses assigned to the resource pool of a large tertiary hospital located in the Southwestern United States. The skills event encompassed nine skills with 11 direct care nurse leads over a three-day period. Clinical nurse leads were chosen based on clinical experience, career ladder advancement, leadership potential, and career mapping. Nurses selected skills validation for the competency event based on a needs assessment using high-risk and low-frequency rationales. Clinical nurse leads were mentored through validating their assigned clinical skill being taught according to best-known practices using UpToDate and Lippincott Solutions: Lippincott Procedures. One-on-one meetings were held with the nursing professional development specialist leader and clinical nurse lead to design each skills competency checkoff. The nursing professional development specialist engaged nurse leads in searching peer-reviewed literature using the online institutional library resources, organizational policy and procedure, and organizational data trends to equip the clinical nurse leads with information to educate their peers. Objective and subjective data were collected by the nursing professional development specialist immediately following the direct care nurses’ skills checkoff to measure staff perception and compliance in the skills event. Additional data were obtained during leadership rounding by the nursing professional development specialist for two weeks following the skills event. Data were analyzed using descriptive statistics.

Results: Forty-one resource pool nurses participated. Nurses rated the check off as “excellent” (79 %; n = 31); “extremely organized” (66.67%; n = 26); and answered “yes” to “appealed to my learning style” (100.0%; n = 39). All clinical nurses answered “yes” to “skills being applicable and effective for use in their practice” (100.0 %; n = 39). Further debriefing with nurse leads for the skills revealed themes of nurses feeling empowered, bold, and confident to share evidenced-based practices with others.

Conclusion: Nurse leaders are charged with a role to inspire clinical nurses to seize evidence-based practice as imperative to lifelong learning for professional practice. Employing a strategy to teach evidence-based practice skills, develop relationships, and improve care delivery may accelerate skill and leadership development.

Implications for practice: Nurse leaders have a direct impact in tying research findings to nurse clinical skills for improved clinical outcomes and job satisfaction. Developing nurses’ translational research skillset for use at the point of care delivery remains imperative to the delivery of evidence-based care in highly reliable ways.