Background: Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP.
Objectives: The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process.
Methods: A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP.
Results: Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation.
Discussion: Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a common mission of providing high-quality care for war-injured service members. Lessons learned from this project can be generalized to civilian facilities.
Deborah J. Kenny, LTC, AN, USA, PhD, RN, is Executive Director, TriService Nursing Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Maggie L. Richard, CAPT, USN, NC, PhD, RNC, is Director, Navy Human Research Protection Program, Bureau of Medicine & Surgery, Washington, DC.
Xochitl Ceniceros, MS, RN, is Research Assistant, Department of Orthopedic Surgery, National Naval Medical Center, Bethesda, Maryland.
Kelli Blaize, BS, MA, is Program Manager, Nursing Research Services Department, National Naval Medical Center, Bethesda, Maryland.
Accepted for publication April 30, 2009.
This project was funded by an award from the TriService Nursing Research Program, "Research to Practice," Grant N03-P18 by CAPT Patricia W. Kelley, principal investigator. The Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814-4799 is the awarding and administering office.
The views and opinions expressed in this article are solely those of the authors and do not reflect the policy or position of the Department of the Army, Department of the Navy, Department of Defense, or the U.S. Government. This project was sponsored by the TriService Nursing Research Program, Uniformed Services University of the Health Sciences; however, the information or content and conclusions do not necessarily represent the official position or policy of nor should any official endorsement be inferred by the TriService Nursing Research Program, Uniformed Services University of the Health Sciences, the Department of Defense, or the U.S. Government.
Corresponding author: Deborah J. Kenny, LTC, AN, USA, PhD, RN, 350 S. Clinton St. Apt 1D, Denver, CO 80247 (e-mail: firstname.lastname@example.org).