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Step 13: Implement the changeImplementation begins. When implementing a change, it is important to en-sure that all stakeholders are educated on the practice change, the implementation plan, and the process for evaluating the practice change. This may include verbal and written communication. EBP team members should be available to answer any questions and to troubleshoot problems that may arise during the implementation.Step 14: Evaluate outcomesThe team evaluates the degree to which the identified outcomes were met. Al-though positive outcomes are desired, unexpected outcomes often provide oppor-tunities for learning. When unexpected outcomes occur, the team should examine why these outcomes occurred. This examination may indicate the need to make alterations to the practice change or in the implementation process, followed by re-evaluation. Additionally, the evaluation of change should be incorporated into the organization’s quality improvement (QI) process so that there is a time line for mea-surement, evaluation, and reporting of follow-up action.Step 15: Report the results of the preliminary evaluation to decision makersWhen the evaluation is complete, the team again reports the results to appropri-ate organizational leadership, bedside clinicians, and all other stakeholders. Even if
The Johns Hopkins Nursing Evidence-Based Practice Model and Process Overviewthe results are unfavorable, it is important to share the findings. Sharing the results, whether negative or positive, helps to disseminate new knowledge and the genera-tion of additional practice or research questions.Step 16: Secure support from decision makers to implement the recommended change internallyIf the evaluation of the results of the pilot is favorable, the team then obtains organizational support (human, material, and financial) to implement the change fully throughout the organization.Step 17: Identify the next stepsEBP team members review the process and findings and consider if there are any lessons that should be shared or additional steps to be taken. These may include a new question that has emerged from the process, the need to do more research on the topic, additional training that may be required, suggestions for new tools, writing an article on the process or outcome, or preparing for an oral or poster pre-sentation at a professional conference. There may be other problems identified that have no evidence base, requiring the development of a research protocol.Step 18: Communicate the findingsThis final step of the process is often overlooked and requires strong organiza-tional support. As mentioned above, the results of the EBP project, at a minimum, need to be communicated to the organization. However, depending on the scope of the EBP question and the outcome, serious consideration should be given to the communication of findings external to the organization in appropriate professional journals or through presentations at national organizations.