Evidence-Based Practice in the Ambulatory Care Unit


Graduate nurses are well equipped with knowledge on EBP to bring change in the healthcare sector by improving outcomes related to patient care. There are various benefits associated with EBP as highlighted by previous studies, which emphasize the need for its implementation in healthcare organizations. According to Kim et al. (2017), EPB is essential for nursing practice, and most nurses have the willingness to acquire skills and knowledge associated EPB even though most of them are unfamiliar with it due to lack of EPB practice in actual healthcare settings. Malcolm (2016) argues that nursing is a dynamic field with changes in demographic compositions such as age creating new challenges, which require proper knowledge to resolve. Similarly, Newhouse et al., (2007) state that nurses need to incorporate evidence-based practice into their workplaces to enable them to provide reliable solutions to nursing challenges. For instance, Newhouse et al., (2007), gives an example of the increasingly ageing baby boomers generation, who are continually changing the dynamics of care by creating the need for care for the elderly and increased cases of age-related illnesses such as heart failure, diabetes, and obesity. Another study by Titler (2008), argues that EBP is available in healthcare settings to cater for conditions such as heart failure, asthma, and diabetes. However, most organizations do not have policies and implementation procedures to ensure that they are fully utilized to improve the outcomes of patient care.

In this project, the nurse leader plans to implement EBP in an ambulatory care setting that mainly serves patients with heart failure, diabetes, and respiratory problems. The nurse leader believes that through evidence-based practice, a sustainable solution will be found for the chronic health problems that cause patients to visit the health care setting around the year with the same symptoms and diagnostics. The leader seeks to find a long-lasting solution by encouraging, modelling and mentoring colleagues to adopt and implement the use of EBP to improve patient care outcomes. Through EBP, nurses will be able to use available knowledge and skills, benchmark, conduct researching, and consult with scholars and fellow practitioners. In this way, nurses will be acquainted with the best approaches that have been researched or tried previously to care for a various illness that are common among patients visiting the unit. The change in care practice among nurses will most likely reduce incidents of recurrent disease symptoms after a patient undergoes treatment and care.

System Setting

Healthcare systems such as hospitals are equipped with healthcare professionals such as nurses who provide care to diverse groups of patients with different illnesses. The healthcare system has policies and regulations that govern the conduct of healthcare professionals. Besides, it provides the standards that should be considered for one to be accredited as a healthcare professional in various levels of professional education. Moreover, the system provides for patient safety measures and ways of improving care outcome, which include EBP.

The nurse leader works at an ambulatory care unit which was created to reduce congestion at the main hospital due to insufficient bed units to accommodate more inpatient. The mobile unit serves twenty to forty patients daily. It has five specialized nurses who care for patients with special needs in their areas such as developmental disability, heart failure, and diabetes. Besides, the unit has seven nurses who help physicians with surgical operations. The nurses are sometimes forced to work together regardless of specialization especially when there is an influx of patients due to emergencies such as accidents. The teamwork among nurses at the facility is commendable even though they are diverse regarding their cultural backgrounds, race, and talent. The ambulatory care unit is run a government-owned hospital.it has four doctors and thirteen nurses.

There are specific challenges that the clinical nurse leader (CNL) may experience in the implementation of EBP within the unit. First, the staff may be unwilling to adopt new ways of doing things within the unit because they are used to doing things a certain way. They may feel that their previous methods have been working without much effort and see no need to adapt to the EBP system. To counter this barrier, the CNL will remind the nurses of the benefits of EBP to the nurses and the patients. For instance, they will have to make care decisions based on substantial evidence that has worked before or has been tested by professionals. Besides, the leader will involve them in formulating ways of implementing the EBP. In this way, they will be part of the process and see sense in applying it. One advantage of the unit is that nurses are willing to learn new ways of doing things and are always interested in engaging in projects that can improve care outcomes. The leader will take advantage of the enthusiasm to promote EBP within the system for the betterment of care practice and outcome.

CNL Role

A clinical nurse leader is responsible for formulating, implementing, and coordinating nursing care activities within the clinical level of a healthcare team. In this project, the leader will coordinate the implementation of EBP by mobilizing, monitoring and evaluating nurses on the success of the project. The CNL will begin by communicating the importance of EBP to all stakeholders. In this way, they will see sense for its implementation. Additionally, the CNL will involve stakeholders including the administration and other staff in formulating the ways of ensuring successful implementation EBP in the ambulatory care. By doing this, they will feel that they are part of the change; prompting them to support its implementation. The CNL understands nursing challenges better because he/she is on the ground with other nurses (National Academies Press, 2004). Besides, he/she has experience from benchmarking, expertise, and years of practice thus understands nursing dynamics better hence the best to spearhead the change.



Kim, S. C., Ecoff, L., Brown, C. E., Gallo, A. M., Stichler, J. F., & Davidson, J. E. (2017). Benefits of a regional evidence‐based practice fellowship program: A test of the ARCC Model. Worldviews on Evidence‐Based Nursing14(2), 90-98. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/pdf/10.1111/wvn.12199

Malcolm, K. A. (2016). The Nurse Executive Role in Implementing Evidence Based Practice (EBP) at the Point of Care (Doctoral dissertation, Otterbein University).Retrieved from https://etd.ohiolink.edu/!etd.send_file?accession=otbn1460366135&disposition=inline

National Academies Press (US); 2004. Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety; Page A, editor. Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington, (4), Transformational Leadership and Evidence-Based Management. Available from: https://www.ncbi.nlm.nih.gov/books/NBK216194/

Newhouse, R. P., Dearholt, S. L., Poe, S. S., Pugh, L. C., & White, K. M. (2007). Johns Hopkins nursing evidence-based practice model and guidelines. Indianapolis, IN: Sigma Theta Tau International Honor Society of Nursing. Retrieved from https://books.google.co.ke/books?hl=en&lr=&id=SZU6DwAAQBAJ&oi=fnd&pg=PP1&dq=Benefits+of+Evidence+based+practice+in+healthcare&ots=_gnMxqOtAb&sig=hF1CwYjOX4dRl2LX4L2Xl7EW5PI&redir_esc=y#v=onepage&q=Benefits%20of%20Evidence%20based%20practice%20in%20healthcare&f=false

Titler M., G. (2008). The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); Chapter 7.Available from: https://www.ncbi.nlm.nih.gov/books/NBK2659/