Today, evidence-based practice (EBP) is progressively regarded as a likely solution to a range of challenges encountered within the clinical environment. Changes introduced by EBP seek to improve the quality of care provided, better patient outcomes and promote noteworthy developments in expertise among clinical staff (Melnyk et al., 2011). EBP practitioners, therefore, contribute greatly to the practice by sharing study results while actively promoting their application for posterity. Internal and external strategies are some of the most effective approaches in nursing which I would be inclined to use in my practice, in addition to considering possible barriers likely to be encountered during this process.
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The internal strategy of dissemination targets the spread of clinical evidence within a specific healthcare setting. At the core of this strategy is a commitment to ensuring relevant information gathered by the EBP practitioner in question is distributed to clinical staff within all levels of management within the facility (Christenbery, 2017). The idea behind this strategy is to identify a practice problem commonly encountered by clinical staff, followed by a corresponding solution likely to address it in the long haul. Furthermore, this strategy ensures the information presented is distributed to a wider audience; improving the reach of relevant information among the target clinical practice audience. According to Newhouse et al., (2007), the hospital leadership plays a crucial role in supporting the maturation of EBP and ultimately influences better patient outcomes and proper allocation of human and material resources. The benefit of applying the internal strategy of dissemination is often seen in its ability to motivate clinical staff and their ability to apply such methods in practice.
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The hospital board is the most suitable conduit for the distribution and dissemination of EBP findings within the internal strategy framework. It typically comprises of healthcare professionals from different fields capable of objective evaluation of the evidence presented, before either supporting or denouncing any of the recommendations made. The face to face interactions common during internal dissemination are also appropriate due to their personal nature during subsequent implementation routines (Rolfe, 2015). This technique provides a unique opportunity for proponents of new clinical practice to obtain useful feedback from their audience and work on concerns requiring improvements. Yet, the presence of multiple healthcare practitioners as part of the hospital board is a major barrier to the implementation of the internal process of dissemination. They represent a rigid bureaucracy within the healthcare system that may not readily accept novel proposition by EBP practitioners in a bid to maintain the status quo and protect the system from a barrage of propositions for changes in practice.
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The external strategy for the dissemination of EBP results is also a workable solution to addressing practice challenges encountered within the contemporary clinical environment. This strategy encapsulates strategies to disseminate EBP information through a multifaceted distribution channel with the sole aim of reaching a wider clinical audience.This method incorporates strategies such as publishing study results in journal articles and in leading searchable database. Results could also be distributed through e-mail, postal, mass and social media with the end goal being the dissemination of evidence to a wider population pool (Sturmey, 2014). Furthermore, it also provides an opportunity to conduct comparative analysis with relevant literature while being keen to incorporate a multicomponent framework to dissemination.
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Leading organizations in the nursing profession, such as the American Nurses Association (ANA) provides an invaluable platform for the distribution of EBP results through the external method. Information provided by an EBP practitioner to the organization is likely to reach a larger audience and with a high likelihood of being implemented given its profile among its contemporaries. Conferences are an ideal avenue for evaluation of the attainability of the objectives identified by EBP which then improves focus on the usefulness of consultations and further discussions before implementation (Morrison & Harms, 2018). However, the most common barrier associated with the external method of dissemination is the competitive nature of the avenues provided by online repositories for the distribution of results. An EBP practitioner may eventually fail to reach their target audience due to the oversaturation of literature exploring a similar perspective within the clinical environment.
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