Purpose:

The Portland VA Medical Center Clinical Nurse Specialist (CNS) committee's purpose for this project was to provide healthcare professionals in clinical settings with a process and tools for incorporating evidence into practice using one-page evidence-based fact sheets (EBFS). The overall objective was to improve outcomes by integrating evidence.

Significance:

Innovative tools for integrating evidence at the bedside improve patient outcomes.

Background/Design:

The PVAMC CNS committee identified that practice across a variety of specialty areas was not always evidence-based. Barriers to utilizing best evidence cited by staff included lack of time to review the literature and difficulty interpreting the evidence. The CNS committee wanted a concise method to educate staff and interpret the evidence needed to improve practice at the bedside. When the EBFS concept was shared by another VA CNS, the PVAMC CNS committee believed it would be a helpful tool to target practice issues. Further, the EBFS development process would serve as mechanism to mentor staff in applying evidence.

Methods:

The CNS committee developed a process for identifying EBFS topics, a standardized template, and instructions for authors that included criteria for evidence, CNS mentorship, and a renewal timeline. Distribution methods and an evaluation tool were also identified, developed, and implemented.

Findings:

Several EBFS on the following topic areas have been developed: infection control, wound care, and insulin management. One infection control EBFS was used to implement a system-wide practice change. The EBFS was utilized as the primary means of educating staff on the evidence based change. As a result, no formal in-service education was required. In addition, the EBFS was available for new staff and as a resource when needed. Evaluations of fact sheets have been positive. Staff were initially reluctant to develop EBFS, but recently, CNSs have received requests for mentorship on EBFS development.

Conclusions:

The EBFS process developed by the committee appears to be useful in bridging the gap between evidence and practice.

Implications for Practice:

CNSs in all practice settings may find EBFS a useful tool to provide staff education and link evidence to practice.