BUSI 418 Week 5 Discussion Board Forum 6 Example

Discussion Board Forum 6: Translating Evidence Into Practice

BUSI 418 Research and Evidence Based Practice in Healthcare, Discussion Board Forum 6

Thread by [Student Name]

The hospital, its project and the classmates are composites; the textbook, Scripture and the peer-reviewed articles cited are real.

Two years ago, our hospital adopted a policy allowing nurses to remove urinary catheters when no criteria for keeping them applied. Infection control sent a memo, the policy was posted online and catheter days fell by less than 3% in the following six months. Everyone agreed with the evidence; almost no one changed what they did. When we asked nurses why, most said they had never seen the memo, and the few who had were unsure whether physicians would object if they removed a catheter without an order. Hall and Roussel (2017) describe this gap between evidence and practice as the central challenge of evidence-based practice, and they stress that implementation requires planning as deliberate as the search for evidence.

When we looked back, the barriers matched the research closely. Huang et al. (2023) pooled 34 studies on what clinical staff know and do about preventing catheter infections and reported that heavy workload, understaffing, differing physician practices, variation in technique and poor documentation stood in the way, whereas leadership, staff education, teamwork, backing for protocols that let nurses act on their own and prompts to take catheters out all made prevention easier. Our units were short-staffed, several physicians routinely ordered catheters to stay and no one was reminded to check, so every barrier on the list was present and almost none of the facilitators.

The way we introduced the change also mattered. In a systematic review of how health care organizations use formal change models, McDonnell et al. (2026) found that change went better under leaders who communicated well and worse when teams followed a model mechanically or had no way to track how the change was going. A memo offered neither leadership nor monitoring, and nobody owned the result once it was sent.

Our second attempt matched strategies to barriers: a nurse champion on each unit, ten-minute education at huddles, an electronic prompt in the shift assessment, a conversation with the physicians who most often kept catheters and monthly reports of catheter days. James warns against being hearers of the word who deceive themselves rather than doers (English Standard Version Bible, 2001/2016, James 1:22). An organization that knows the evidence but does not act on it has done the easy half of evidence-based practice.

Reply to Courtney

Courtney, you asked whether sending units their own data really changes behavior, since your hospital already posts quality reports that few staff seem to read. Evidence suggests it helps when the data are timely, specific to the unit and paired with a plan for what staff should do differently. Kamel et al. (2025) credited a catheter-use dashboard, along with a multidisciplinary team, for helping a Veterans Affairs hospital cut catheter infections after adopting a nurse-driven protocol. Reynolds et al. (2022), by contrast, tracked results with control charts but saw no change from the protocol alone, which suggests data must be paired with action. Hall and Roussel (2017) include evaluation and feedback as parts of implementation, not afterthoughts. The Preacher says the end of a matter is better than its beginning (English Standard Version Bible, 2001/2016, Ecclesiastes 7:8), and monthly results are how a unit sees the end it is actually reaching. Would your units see their data monthly, or only once a year in an annual report? Monthly results, discussed at a huddle, give staff a chance to connect what they did with what changed.

Reply to Marcus

Marcus, you wondered how to choose champions for a practice change on your rehabilitation unit, where staff have seen several initiatives come and go. Research suggests influence among peers matters more than title or seniority. McDonnell et al. (2026) identified leadership and communication as key enablers of change, and champions extend both onto the units. Huang et al. (2023) found that teamwork and support for nurse-led protocols helped prevention efforts, which points to champions who are respected by peers rather than appointed for convenience. Hall and Roussel (2017) describe champions as people who model the change and answer questions where the work actually happens, on the unit and during the shift. Paul urged believers to imitate him as he imitated Christ (English Standard Version Bible, 2001/2016, 1 Corinthians 11:1), a reminder that people follow examples more than memos. Would your staff choose the champions themselves, perhaps by asking whom they go to with questions on a busy shift? Those people are often the natural leaders a change needs.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Hall, H. R., & Roussel, L. A. (2017). Evidence-based practice: An integrative approach to research, administration, and practice (2nd ed.). Jones & Bartlett Learning.

Huang, A., Hong, W., Zhao, B., Lin, J., Xi, R., & Wang, Y. (2023). Knowledge, attitudes and practices concerning catheter-associated urinary tract infection amongst healthcare workers: A mixed methods systematic review. Nursing Open, 10(3), 1281-1304. https://doi.org/10.1002/nop2.1384

Kamel, M., Harris, N., Berry, A., Warsavage, T., Bessesen, M. T., & Kon, S. E. (2025). Implementation of a nurse-driven protocol for indwelling urinary catheter removal and novel utilization dashboard: A pre/postintervention observational study. Therapeutic Advances in Infectious Disease, 12, 20499361251317900. https://doi.org/10.1177/20499361251317900

McDonnell, R., Chauhan, A., Adams, C., Cardenas, A., Moscova, M., Walsan, R., Sina, M., Munro, A., Manias, E., Mitchell, R., Gust, A., Sabesan, S., & Harrison, R. (2026). Applying change models and methods during a period of vast digital transformation: A systematic review of practice in healthcare. International Journal of Health Planning and Management, 41(5), 1032-1053. https://doi.org/10.1002/hpm.70092

Reynolds, S. S., Lozano, H., Fleurant, M., & Bhandari, K. (2022). Using statistical process control charts to measure changes from a nurse-driven protocol to remove urinary catheters. American Journal of Infection Control, 50(12), 1355-1359. https://doi.org/10.1016/j.ajic.2022.03.005