We have an approximately 14- to 17-year gap between the inception of research discovery and the implementation of findings into clinical practice. As a profession, nurses have a shared responsibility to address the challenge of identifying and overcoming barriers to evidence-based practice (EBP) implementation to provide the best possible clinical care for patients. My primary area of focus as a researcher is on using EBP to improve patient, staff, and organizational outcomes through the Science and Practice Aligned Within Nursing (SPAWN) model, a framework for applying EBP to clinical nursing care.
SPAWN was developed to incorporate best evidence into oncology nursing practice through research synthesis, application, and evaluation. The process improves nursing-sensitive outcomes by identifying and addressing clinical questions that prompt EBP implementation. SPAWN supports a nursing-led interprofessional team approach that includes nursing administrators as well as clinicians from other disciplines. SPAWN works through a stepwise process:
- Cultivating a spirit of inquiry and formulating a team
- Conducting a literature review, appraisal, and synthesis
- Formulating a PICOT question
- Implementing and evaluating the EBP project
- Disseminating outcomes
Through my research incorporating the SPAWN approach, my team led an interprofessional effort in the gastrointestinal (GI) cancer treatment center at the Dana-Farber Cancer Institute (DFCI) in Boston, MA, to improve patient and family experiences during treatment. Most patients with GI cancer have a high symptom burden related to the disease and treatment. Research has established the essential components required to prepare patients for chemotherapy, yet patients and families are often overwhelmed at the start of treatment and have difficulty processing the information.
Our specific objectives were to evaluate patient knowledge, acceptability, and feasibility of using the intervention in nursing workflows. With patient and family input, my team developed the About Your Care workbook, a multimedia tool designed for incremental delivery in four planned nurse-patient encounters, starting at the initial treatment planning visit. DFCI’s GI cancer treatment center has successfully implemented the intervention, and we’ve expanded it to multiple DFCI disease centers.
EBP leads to high-quality, safe, and cost-effective care. Oncology nurses need to identify appropriate strategies for promoting EBP implementation, deimplementing practices that are known to be ineffective or harmful, and evaluating other factors that influence use of evidence in practice. In addition, PhD and doctorate of nursing practice collaboration on implementation science research and EBP projects has great potential for promoting EBP in oncology nursing.
Developing nurse clinicians’ competence and confidence in EBP implementation consequently leads to safer, more effective oncology care. Whether EBP informs consistent practice standards, a nurse’s knowledge exemplified in care, or processes that improve patient outcomes, it empowers nurses to employ a multitude of effective care methods that benefit nurse-patient relationships.