This week you will be creating an Implementation Plan that will be attached to your final Evidence-Based Project. In the article read last week, “EBP Step by Step Following the evidence: Planning for sustainable change” an Implementation Plan is provided for an example.  In your text (4th ed) the ‘ARCC Model Timeline for an EBP Implementation Project” (Appendix I) template is available for guidance.

The thought process includes:  Based on my review of literatures comparing the DASH diet and the low/restricted sodium diet, the DASH diet significantly reduced the blood pressure of the hypertensive patients in the studies. The effect was additive when both diets where combined.

These studies established evidence that the DASH diet in addition to pharmacotherapy is effective in reducing the blood pressure of hypertensive patients.

My objective now is to introduce this diet method (DASH diet) to all the hypertensive patients that will be seen in my place of practice. My implementation plan will involve the identification of the other stakeholders/beneficiaries of this new method or approach to management of hypertensive patients. The other stakeholders mentioned in my implementation plan were the healthcare providers (ARNPs and physicians), the insurance companies, and the owner or employer of these healthcare providers.

I intend to implement my EBP through discussion groups. These identified stakeholders will be invited to a group discussion so that barriers will be identified, and solutions will be worked out during these group discussions.

For the discussion board this week—outline your implementation plan–the early steps have been complete–the checkpoints noted in the template should guide your plan.

Implementing an Evidence-Based Practice Change
Beginning the transformation from an idea to reality.

This is the ninth article in a series from the Arizona State University College of Nursing and Health Innovation’s Cen-
ter for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to
the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise
and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture,
the highest quality of care and best patient outcomes can be achieved.

The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one
step at a time. Articles will appear every other month to allow you time to incorporate information as you work to –
ward implementing EBP at your institution. Also, we’ve scheduled “Chat with the Authors” calls every few months to
provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will
be published with May’s Evidence-Based Practice, Step by Step.

In January’s evidence-based prac tice (EBP) article, Rebe -cca R., our hypothetical staff
nurse, Carlos A., her hospital’s
ex pert EBP mentor, and Chen
M., Rebecca’s nurse colleague,
began to develop their plan for
implementing a rapid response
team (RRT) at their institution.
They clearly identified the pur-
pose of their RRT project, the
key stakeholders, and the vari-
ous outcomes to be measured,
and they learned their internal
re view board’s requirements for
re viewing their pro posal. To de-
termine their next steps, the team
consults their EBP Implementa-
tion Plan (see Figure 1 in “Fol-
lowing the Evidence: Plan ning
for Sustainable Change,” Jan –
uary). They’ll be working on
items in checkpoints six and

seven: specif ically, engaging the
stakeholders, getting administra-
tive support, and preparing for
and conducting the stakeholder
kick-off meeting.

ENGAGING THE STAKEHOLDERS
Carlos, Rebecca, and Chen reach
out to the key stakeholders to tell
them about the RRT project by
meeting with them in their offices
or calling them on the phone. Car –
los leads the team through a dis-
cussion of strategies to promote
success in this critical step in the
implementation process (see Strat ­
egies to Engage Stakeholders). One
of the strategies, connect in a col­
laborative way, seems espe cially
applicable to this project. Each
team member is able to meet with
a stakeholder in person, fill them
in on the RRT project, describe
the purpose of an RRT, discuss
their role in the project, and an –
swer any questions. They also tell
each stakeholder about the initial
project meeting to be held in a few
weeks.

In anticipation of the stake-
holder kick-off meetin

Rolling Out the Rapid Response Team
The pilot phase begins.

This is the 10th article in a series from the Arizona State University College of Nursing and Health Innovation’s Center
for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the
delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise
and patient preferences and values. When delivered in a context of caring and in a supportive organizational cul-
ture, the highest quality of care and best patient outcomes can be achieved.

The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one
step at a time. Articles will appear every other month to allow you time to incorporate information as you work to-
ward implementing EBP at your institution. Also, we’ve scheduled “Chat with the Authors” calls every few months
to provide a direct line to the experts to help you resolve questions. See details opposite.

I n March’s evidence-based prac -tice (EBP) article, Rebecca R., our hypothetical staff nurse,
Carlos A., her hospital’s expert EBP
mentor, and Chen M., Rebecca’s
nurse colleague, conducted their
stakeholder kickoff meeting to
explain to rapid re s ponse team
(RRT) members and stakeholders
the details of their plan to imple-
ment an RRT at their institution.
At the meeting, the stakeholders
were engaged and supportive, of-
fering valuable feedback and sug-
gestions to enhance the project.
By the end of the meeting, all
RRT members and their respec-
tive managers committed to par-
ticipate. No major changes were
made to any of the draft docu-
ments; however, one minor ad-
justment was made when the
advanced practice nurse (APN)
hos pitalist suggested that the EBP
team include all the systemic in-
flammatory response syndrome
(SIRS) criteria in the RRT protocol.

Among the many commitments
made by stakeholders to move the
project forward were the following:
• The Finance Department rep-

resentative offered, during the
dis cussion of RRT project
outcomes, to determine the

cost per day of unplanned ICU
admissions (UICUA) and to
create a report to establish the
baseline average length of stay
for the UICUA in their hos-
pital (for a list of outcomes,
see Table 1 in “Implementing
an Evidence-Based Practice
Change,” March).

• The Health Information Man-
agement Systems/Medical
Records Department repre-
sentative committed to create
a data documentation tool to
facilitate the collection from
completed RRT records of the
following: code rates outside
the ICU, RRT response time and
duration, UICUA, and RRT
events that prevent ICU stays.

• The vice president of medical
affairs and the APN hospitalist
agreed to notify the hospital’s
medical staff of the RRT proj-
ect in a letter and in the