Implementing evidence based practice nursing using the PDSA model: process, lessons and implications

Evidence Based Practice (EBP) is recognised as a problem-solving approach to clinical practice that integrates the most relevant evidence with clinical expertise and patient preferences and values, to answer clinical questions and aid decision making. Although the value of EBP is widely accepted, it is not standard in healthcare systems globally. Similarly in Zambia EBP is not a standard and nursing care is mainly routine and characterized by poor quality. An Evidence Based Practice Pilot Project was conducted in University Teaching Hospital. The project utilized a quality improvement approach including modified experience-based co-design, rapid reviews of evidence and practical implementation of evidence. It was implemented through a five phased process using the Plan Do Study Act (PDSA) Model. It focused on four “hacks” subdivided in 12 areas of implementation. From the four “hacks”, and the subsequent 12 areas of implementation, the project met set target for improvement in eight out of 12. The four where set targets were not met included; awareness of rights and responsibilities by patients, explaining patient’s condition to at least one relative, completing nursing care plans and regular multi-disciplinary team meetings. The eight areas where set targets were met included; display of patients’ rights, educational materials and hand washing guidelines. Others were orientation and mentorship for junior nurses and students, use of task allocation, and use of hand washing soap and decontamination buckets. Implementers of EBP should take stock of the enablers and detractors and put appropriate measures to sustain the former and minimise the later