Discussion Responses 1& 2

 Response 1

The two dissemination strategies that I would most likely use would be the Podium/Oral presentations and the round table strategies. I work in a small facility with approximately 70 nursing staff, so these strategies are best suited for this smaller population. These types of presentations offer opportunities to share and learn knowledge and enhance clinical expertise pertaining to EBP, evidence-based quality improvement, and research (Melnyk & Fineout-Overholt, 2018). This is the type of presentation we use when we are teaching prevention and management of aggressive behaviors to reduce S/R because it fits the audience well. We discuss current evidence-based practices when it comes to ways to prevent seclusion and restraint practices through the use of PowerPoint presentations and handouts that staff can takes notes on. 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 (Gallagher-Ford, Fineout-Overholt, Melnyk, & Stilwell, 2011). The round table strategy is a way to have different disciplines the opportunity to share specific information with a group but also allow the group to discuss the content from their perspective (Melnyk & Fineout-Overholt, 2018). Different disciplines view the use of S/R differently so having the group mixed with different disciplines increases discussion.

            The strategy that I would be least inclined to use would be through published journals. The reason I don’t feel that this strategy would work is because the information we discuss about S/R requires discussion and examples of past experiences that show why current evidence-based practice works and why it is put into place, and staff are busy and don’t have the time available to read articles.  

Barriers

            Barriers to using the podium and round table strategies are that some staff do not like change and may disagree with the reasoning for wanting to change the organizational culture. To help with this barrier, we make sure that we put staff that we know will be a challenge with staff that are flexible and willing to change so that they can hear their perspectives.  

Leadership

 Fostering EBP within organizations requires strong infrastructure, including nursing leadership (Newhouse, Dearholt, Poe, Pugh, & White, 2007). It is important to get the support of the nursing leadership team when it comes to changing policies and procedures, and the culture as they are a crucial part of the team that helps to pass the information onto the employees throughout the organization. Interventions need to be relevant for staff to want to implement them into their daily practices (Sidani et al., 2016).  Ongoing education provided to employees keeps them current on EBP and will help them provide the best quality care to their patients.

References

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B.M., & Stillwell, S.B. (2011).  Evidence-

            based practice, step-by-step:  Implementing an evidence-based practice change.  American Journal of Nursing, 111(3), 54-60.  doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f. Retrieved from http://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/nna_00020443_2007_37_12_552.pdf

Sidani, S., Manojlovich, M., Doran, D., Fox, M., Covell, C. L., Kelly, H., … McAllister, M. (2016). Nurses’ Perceptions of Interventions for the Management of Patient-Oriented Outcomes: A Key Factor for Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(1), 66–74. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12129

Response 2

Dissemination is the last stage in evidence-based practice (EBP) process (Melnyk and Fineout-Overholt, 2018). Dissemination refers to the active distribution and the spreading of the gathered knowledge to the audience it is intended to benefit. Healthcare EBP researchers distribute information and intervention materials to public health or clinician workers with an intent to spread knowledge and the associated evidence-based interventions (Cain and Mittman, 2012). Dissemination serves a critical role in providing healthcare workers knowledge and skills they need to implement EBP consistently (Gallagher-Ford et al., 2011) to provide the highest quality of care and best patient outcomes. There are various ways to share the knowledge content depending on the audience and information to be shared.

Strategies most inclined to use

One of the most effective strategies that I would be inclined to use is an oral presentation at a conference. This strategy offers a rich and dynamic opportunity to share and learn knowledge enhancing clinical expertise about EBP (Melnyk and Fineout-Overholt, 2018). Using this strategy, the presenter has the advantage of using non-verbal cues combined with effective verbal skills adding a broader aspect to the communication. Besides, the individual can also visual aids like pictures, graphics, and slides for emphasis. Using this strategy provides the instant conveyance of information, and the presenter is able to acquire instant feedback for his research by judging audience reactions as well as the body language of the audience. The audience is presented with an opportunity to ask questions and clarifications.

A barrier of an oral presentation is that it takes much time to prepare and relies on the skill of the presenter. Nervousness and anxiety ruin the delivery of the message. Much practice is needed to deliver an effective oral presentation. If the speaker is not good, then an effective transmission of information might not take place. A speaker that is not good would speak with little or no confidence and be unable to provide a clear and concise speech. This barrier may be overcome by preparing well before a presentation. It helps when the presenter understands the topic instead of cramming the topic because it allows the use of own words.

Another strategy I would use is using small groups. An excellent example of such is the interdisciplinary treatment team rounds in my unit every morning. Nursing rounds are a creative way to promote evidence-based learning (Laibhen-Parkes et al., 2015). This would be a perfect time to share the evidence-based knowledge I acquired from my fall or barcoding study. The small group dissemination strategy is advantageous when the individuals involved have an understanding of the topic. Yet another example would be presenting to the nurses of various units. The barrier to this strategy is that usually, there is not much time, and the team often has to see a lot of patients within a short time. This barrier can be overcome by the presenter providing summarized information in cards that can be passed during the rounds.

Strategies least inclined to use

One strategy that I would be least inclined to use is poster presentations. There are several types of poster presentations display, easel, and tabletop, and, more recently, laptop and electronic poster representations (Melnyk and Fineout-Overholt, 2018). While posters may consume a lot of time preparing for the use, they may only contain limited information. At the same time, the size of the posters can make it difficult for a presenter to include all the pieces of information they had initially pl 

nned to post. Such limited information may hinder the presenter from effectively communicating and convincing their intended audience. Posters are also a stationary mode of disseminating knowledge that limits the audience. Besides, posters do not offer a mechanism through which the presenter can get feedback from the readers.

Another strategy I would be least inclined to use is disseminating at a professional committee meeting, which can be a stressful experience (Melnyk and Fineout-Overholt, 2018). Since the participants are experts, a thorough understanding of the topic is needed. Such meetings are also tight on their schedules, meaning that if there is a lot of information to be presented, the speaker needs to determine the most relevant information to be presented.

Conclusion

Dissemination is the last phase in the EBP process, which involves passing out of knowledge to the intended users. The strategy of dissemination depends on the audience and the type of knowledge to be shared.

References

Cain,M., & Mittman, R.(2012). Diffusion of innovation in health care. California HealthCare Foundation. http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20D/PDF%20DiffusionofInnovation.par

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspx 

Laibhen-Parkes, N., Brasch, J., & Gioncardi, L. (2015). Nursing Grand Rounds: A Strategy for Promoting Evidence-Based Learning Among Pediatric Nurses. Journal of Pediatric Nursing, 30(2), 338–345. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pedn.2014.07.008

Melnyk, B. M., & Fieout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.