Evidence-based practice is based on integrating clinical research, research, and the preferences of the patients to promote individualized care and decision making. Evidence-based care is associated with positive patient and nursing outcomes. Many health organizations have adopted competency-based and evidence-based programs that are reshaping the delivery of healthcare services to increase effectiveness and quality while also reducing the cost and safety risks (Stevens, 2013) . The introduction of a successful and sustainable evidence-based care is challenging and requires the nursing leadership to embrace the evidence-based practice culture. Readiness by the leaders avails the resources and support required to make the practice a success. Currently, most nurses and nurse leaders have developed initiatives that increase the contribution of nurses to deliver quality services through EBP. Some of the initiatives adopted include education, engagement of research, practice adoption, among others. Among the main benefits of EBP is the promotion of patient safety. Organizational culture is vital in the delivery of quality services and patient safety (Mannion & Davies, 2018) . A healthcare organization's culture should have attitudes and behaviors that related to the safety of the patients. Nursing leaders should evaluate the safety culture of their organization and develop structures that guide the nurses and other employees to providing quality and safe services.
In Hospital Hope's scenario, the attitude and readiness of the management and all the workers to embrace evidence-based practice was the factor that brought practice change in the SICU. To develop sustainable and successful evidence based practice, every stakeholder in the organization must be on board. The management plays an important role in providing support and the resources required to formulate the policy. Similarly, the workers, who are the engine for the hospital, must follow suit and be ready and prepared to provide the best care services depending on the resources provided. In Hospital Hope scenario, the move for practice change was guided by the mission, which was to be pacesetters in the community by providing patient-centered care, which observes high quality and safety standards. The leadership of the hospital drove the change by first understanding that leadership influences the culture. The hospital management understood that they had the responsibility of ensuring that patients received quality, cost-effective, and safe services. In addition, the management understood that measuring the safety culture in the hospital would provide information on what should be improved in the organization (Sammer & James, 2011) . After carrying out an SAQ, the management understood that less than 50% of the workers believed that the hospital had the best safety culture.
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The management made a huge effort to promote quality and safety serves by advancing the mission to an evidence-based organization. Joining the IHI aligned the organization to its new goals of promoting safety. The organization, through the nurse manager, investigated the safety concerns, which were addressed. The management and the workers at the organization were prepared and embraced the CUSP model, to promote patient’s safety. The care providers in the organization embraced all safety culture measures. According to Sammer & James (2011), teamwork allowed the nurses to collaborate with respiratory therapists to prevent hospital-acquired pneumonia. The workers also collaborated with the management to get a diabetes educator to understand how they would prevent hypoglycemia. The new culture promoted effective communication, which is crucial in healthcare. The nurses at the organization agreed to be accountable and responsible. Each member would be held responsible for their actions, which further helped bolster quality and safety in the hospital.
Embracing the new culture also improved transparency in the organization. The cases recorded in the organization were recorded and compared to the national data. All employees and visitors were able to see the reports; this increased transparency, which increased awareness and brought change to the organization. All employees also agreed to act as the patient's advocates and leaders by having the right attitude, supporting and empowering the patients, and honoring the decisions of the patients. All these activities showed the preparedness and readiness of the management and nurses to provide services that met high quality and safety standards.
In promoting quality care, I would use the CUSP in the organization. This model is used to improve patient safety. The model is important, particularly for educating employees on how to promote the safety of the patients (AHRQ, 2017) . In addition, using this model helps care providers understand common mistakes that jeopardize patient safety, how to learn from them, and how to integrate this in the daily work routine. The change of practice depends on the willingness of the management and the workers to embrace the change. Providing education regarding this model would be essential to all the care providers by making them understand the benefits of evidence-based care and how they can improve the safety and quality and services they provide to the patients.
In conclusion, evidence-based care has numerous advantages to both the organization and the patients. It ensures that patients receive high-quality services while also improving reducing the cost of the services and improving the patient's safety. Adoption of the EBP requires preparedness and readiness form the management and the care providers. In Hospital Hope, the practice change was influenced the collaboration between the management and the workers in embracing the culture of evidence-based care. The efforts by the management to initiate a procedure to promote quality care was also essential in promoting practice change. While advocating for practice change, the CUPS would be the best as it provides guidelines for patient safety improvement practices. Organizations should adopt EBP to promote high-quality services and patient safety.
References
AHRQ . (2017, September). Retrieved from AHRQ Website: https://www.ahrq.gov/hai/cusp/summary/index.html
Mannion, R., & Davies, H. (2018). Understanding organizational culture for healthcare quality improvement. The British Medical Journal . doi:https://doi.org/10.1136/bmj.k4907
Sammer, C., & James, B. (2011, September). Patient Safety Culture: The Nursing Unit Leader’s Role. OJIN: The Online Journal of Issues in Nursing, 16 (3). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No3-Sept-2011/Patient-Safety-Culture-and-Nursing-Unit-Leader.html
Stevens, K. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. OJIN: The Online Journal of Issues in Nursing, 18 (2). Retrieved from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html
