Knowledge Gaps in Applying Evidence to Practice

There are several interventions we employ to identify knowledge gaps in nursing practice in the department of behavioral health. The most impactful process is the monthly chart audits that are completed on each nurse, APP, and MD who provide care in our department  The data that we collect during the audit process is based on EBP and reported up through our Quality Committee. Three years ago during our quality audits, we noted that depression inventories were not being completed on a regular basis. According to Dham et. al (2017), depression screens assure not only quality care that is cost-effective but also helps guide clinicians in diagnosis and treatment.

    When we identify a knowledge gap, we complete an evidence search to determine what EBPs are available to overcome the gap. Linking the evidence to the practice environment is challenging and a Quality Improvement model is crucial in supporting staff as they adapt their practice models (Taylor et al., 2013)  Our QI team takes the forefront on educating staff through team meetings, department meetings, one on one training as well as mandatory LEAP modules. The Learning Engagement and Performance (LEAP) system modules are used at MetroHealth Medical Center to cover information required by several compliance and accreditation organizations to help keep our staff, our patients, and our visitors safe. The Plan-do-study-act model is another QI model that can be used to adopt changes.

I believe empowering staff is paramount in maximizing their potential to overcome knowledge gaps. Individuals involved in the process are engaged in the process, and in return are committed to the process. We utilize TeamSTEPPS to place the problem in the hands of those who are entrenched in the problem- they know it best.  By tasking them to take ownership we build a competent and connected workforce. TeamSTEPPS has five key principles and is based on team structure, communication, leadership, situation monitoring, and mutual support.

I will guide evidence-based practice by leading when necessary and facilitating when needed. Arming staff with knowledge on how research, EBP, and QI work together to overcome knowledge gaps is an important foundation to lay when addressing needed process changes. I will also be open and non-dismissive with others who are naïve to the process, cultivating an environment where learning and creativity can blossom.    

REFERENCES            

Dham, P., Colman, S., Saperson, K., McAiney, C., Lourenco, L., Kates, N., & Rajji, T. K. (2017). Collaborative care for psychiatric disorders in older adults: A systematic review. Canadian Journal of Psychiatry, 62(11), 1–11. https://doi.org/10.1177/0706743717720869 (Links to an external site.)

Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2013). A systematic review of the application of the plan–do–study–act method to improve quality in healthcare. BMJ Quality & Safety, 23, 290–298. https://doi.org/10.1136/bmjqs-2013-001862

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