The health care industry acknowledges a 17-year gap from research completion to implementation of an evidence-based practice (EBP) change in the clinical setting-known as the leaky pipeline.1-3 Typically, clinical nurses comprise the largest workforce of any hospital or health care system; therefore, they are the leading providers of EBPs. However, there are indications of a disconnection between the evidence-based daily practice of nurses and the actual conduct of literature reviews and appraisals to determine best evidence.4,5 Additionally, the literature indicates that in order for nurses to engage in EBP they need the proper education, supportive leadership, and resources.6-8 Moreover, during their fundamental education, the majority of clinical nurses receive minimal exposure to research methods, quality improvement frameworks, and EBP models. Once embedded in the practice environment, they are ill-equipped to challenge, sustain, or improve current practices with confidence and competence. However, nurses demonstrate natural curiosity, a passion for learning inquiry work, and a drive to provide the best possible care to their patients. To that end, the Center for Nursing Inquiry was developed.
MISSION AND VISION
The Johns Hopkins Center for Nursing Inquiry (CNI) was launched in 2018 as a resource for nurses engaging in inquiry work and as a conduit to build capacity for more nurse-led inquiry work across the system. The CNI began with a research coordinator and an evidence-based practice coordinator within the Johns Hopkins Hospital and has transformed to include a nurse scientist, an evidence-based practice coordinator, 2 inquiry coordinators, and an administrative coordinator to support all 6 Johns Hopkins Health System affiliates. Each affiliate has one or more inquiry representatives on the inquiry council, who meet monthly to discuss capacity-building measures and affiliate needs. The mission of the center is to increase the competence, confidence, and capacity of Hopkins nurses to engage in meaningful scholarly activities. Our vision is to exemplify EBP, quality improvement, and research excellence. Our values align with Johns Hopkins Medicine (Excellence and Discovery, Leadership and Integrity, Diversity and Inclusion, and Respect and Collegiality) as well as the core values of the nursing Professional Practice Model (We Care, We Influence, We Excel, and We Empower).
STRATEGIC PLAN
The CNI aligned strategic priorities related to capacity building in nursing with the core strategies developed by Johns Hopkins Medicine: push the boundaries of science and education, make Johns Hopkins Medicine easy, support the well-being of our people and our communities, improve the quality and affordability of health care, work like one organization, and aim for precision in everything we do. The CNI developed a 3-year strategic plan to include outcomes such as value-added nursing inquiry projects, increased participation in CNI platforms and content, increased participation in interdisciplinary projects, and increased professional engagement and satisfaction. When the COVID-19 pandemic forced the Center to pivot to a virtual or hybrid platform, it allowed for greater reach and engagement across the health system.
PROFESSIONAL DEVELOPMENT AND ENGAGEMENT
The CNI serves as an overarching structure that facilitates the professional development and recognition of nurses through multiple modalities. The offerings include, but are not limited to, a podcast that covers topics from navigating the Institutional Review Board to how to disseminate inquiry work, quarterly workshops on fundamental subjects like the differences between the 3 forms of inquiry (establishment of evidence, quality improvement and research), and monthly office hours for consultations. The CNI holds journal clubs and highlights the published work of Hopkins nurses. Additionally, the CNI coordinates the annual Johns Hopkins SHINE (Showcasing Hopkins Inquiry and Nursing Excellence) conference to feature the impactful work nurses conduct. In 2021, during the pandemic, nurses submitted and presented over 50 nurse-driven inquiry projects across every health system affiliate.
The CNI also leads more in-depth development opportunities: the Nurse Scholars Cohort and the Evidence-based Practice Cohort. The Nurse Scholars Cohort is a 12-month program designed to provide foundational knowledge in quality improvement, EBP, and research. The cohort of nurses complete intensive didactic training and a project informed by the Directors of Nursing and strategic priorities at the Johns Hopkins Hospital. Past cohorts have disseminated their work internally and externally, and have published their findings. The EBP cohort is a 4- to 6-month program designed to build expertise, using the Johns Hopkins Evidence-Based Practice model, to conduct an EBP project at any of the 6 affiliates. Recently, cohorts have completed EBP projects that led to ongoing interdisciplinary research on music for pain relief and institutional restructuring of nurse preceptor programs.
RELATIONSHIPS
Relationships are foundational to the success of inquiry work. The CNI strives to build bridges between Hopkins institutions, facilitating partnerships with the schools of public health, nursing, and medicine. The CNI promotes learning opportunities within the Armstrong Institute to further our nurses' understanding of quality improvement and data-driven patient outcomes, and connects with the patient and family advisory council to consider their perspectives related to inquiry work. Nurses who participate in the Center's offerings, or engage in inquiry work, have the chance to network with a variety of disciplines and learn from practitioners in different environments.
CONCLUSION
Nurses play an integral role in developing, questioning, and sustaining EBPs. Their unique perspectives provide value to any research, quality improvement, or EBP project. Building capacity in nursing inquiry work serves the dual purpose of developing nurses and meeting the strategic priorities of Johns Hopkins Medicine. The CNI is designed to support the needs of nurses engaging in meaningful, high-quality inquiry work, to further their professional development and to contribute to the science of nursing.
The CNI has an externally facing website (where the above-mentioned content is housed), and a presence on Facebook, Instagram, LinkedIn, and Twitter (https://www.hopkinsmedicine.org/nursing/center-nursing-inquiry/).
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