JNPD
Administration Column Editor: Joyce A. Johnson, PhD, RN-BC
Why are Nurses so Reluctant to Implement Changes Based on Evidence and What can We Do to Help?
‘‘I
mplementation of evidence is essential for patients to receive the best care possible’’ (Fineout-Overholt & Johnson, 2006, p. 194). ‘‘The existence of a gap between science and practice is universally recognized Iand many interventions never reach those who could benefit. It is estimated that it takes an average of 17 years to translate 14% of original research into benefit for patients and an average of 9 years for interventions recommended as evidence-based practices (EBPs) to be fully adopted’’ (Tinkle, Kimball, Haozous, Shuster, & Grochowski, 2013, p. 1). ‘‘Part of this extensive delay in translation of research into practice is that nurses tend to view research findings as something someone else should be concerned with versus a critical element of their daily practice’’ (Fineout-Overholt & Johnson, 2006, p. 194). These past few months, I have worked to integrate evidence into a simple policy for intramuscular injections (IMs). The policy needed approval from the leaders in ambulatory care. The group was willing to go along with the change from the dorsogluteal to the ventrogluteal site for injection but did not accept the evidence that all IMs should be administered Z track. They also could not support the evidence that gloves were not required unless it could be reasonably anticipated that the staff might have hand contact with blood, other potentially infectious material, mucous membranes, and/or nonintact skin. Why was it so difficult for them to accept the evidence? Cost was certainly one issue on the side of Z track technique. The medical assistants had not been using the Z track for injections although it is within the scope of their practice. Although they were trained in school, they would have to be retrained now at a cost. On the other hand, gloves are expensive; however, the group believed that gloves Joyce A. Johnson, PhD, RN-BC, is Regional Director of Education and Research, Kaiser Permanente, Pasadena, California. The author has disclosed that she has no significant relationships with, or financial interest in any commercial companies pertaining to this article. ADDRESS FOR CORRESPONDENCE: Joyce A. Johnson, PhD, RN-BC, Kaiser Permanente 100 S. Los Robles Ave. Suite #501, Pasadena, CA 91188 (e
Administration Column Editor: Joyce A. Johnson, PhD, RN-BC
Why are Nurses so Reluctant to Implement Changes Based on Evidence and What can We Do to Help?
‘‘I
mplementation of evidence is essential for patients to receive the best care possible’’ (Fineout-Overholt & Johnson, 2006, p. 194). ‘‘The existence of a gap between science and practice is universally recognized Iand many interventions never reach those who could benefit. It is estimated that it takes an average of 17 years to translate 14% of original research into benefit for patients and an average of 9 years for interventions recommended as evidence-based practices (EBPs) to be fully adopted’’ (Tinkle, Kimball, Haozous, Shuster, & Grochowski, 2013, p. 1). ‘‘Part of this extensive delay in translation of research into practice is that nurses tend to view research findings as something someone else should be concerned with versus a critical element of their daily practice’’ (Fineout-Overholt & Johnson, 2006, p. 194). These past few months, I have worked to integrate evidence into a simple policy for intramuscular injections (IMs). The policy needed approval from the leaders in ambulatory care. The group was willing to go along with the change from the dorsogluteal to the ventrogluteal site for injection but did not accept the evidence that all IMs should be administered Z track. They also could not support the evidence that gloves were not required unless it could be reasonably anticipated that the staff might have hand contact with blood, other potentially infectious material, mucous membranes, and/or nonintact skin. Why was it so difficult for them to accept the evidence? Cost was certainly one issue on the side of Z track technique. The medical assistants had not been using the Z track for injections although it is within the scope of their practice. Although they were trained in school, they would have to be retrained now at a cost. On the other hand, gloves are expensive; however, the group believed that gloves Joyce A. Johnson, PhD, RN-BC, is Regional Director of Education and Research, Kaiser Permanente, Pasadena, California. The author has disclosed that she has no significant relationships with, or financial interest in any commercial companies pertaining to this article. ADDRESS FOR CORRESPONDENCE: Joyce A. Johnson, PhD, RN-BC, Kaiser Permanente 100 S. Los Robles Ave. Suite #501, Pasadena, CA 91188 (e
