Durable medical equipment needed to implement the

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durable medical equipment needed to implement the practice change, and a system for measuring outcomes and providing staff and stakeholders with meaningful feedback about outcomes. Clinical Leadership Support The presence of a corporate culture and clinical leadership structure that supports EBP principles may be the single most important factor influencing the adoption of EBP innovations (Fixsen et al., 2005; Rapp et al., 2010). Rapp and coworkers (2010) have evaluated barriers to the implementation of EBP initiatives and observed that the behavior of clinical supervisors forms a substantial barrier to statewide EBP innovation projects. Specifica1ly, they found that although clinical leaders did not oppose the use of EBP principles for clinical decision making, they did not set expectations among front-line clinicians, relying instead on informal methods of practice adoption. Although this approach may not act as a barrier to select clinicians who share an inherent interest in EBP and prac-tice innovation, it ultimately favors maintenance of the status quo rather than organizational adoption of EBP principles and associated practice innovations. Fortunately, several strategies have been identified to avoid this potential barrier to the adoption ofEBP innova-tions. Obtaining magnet status is another strategy for pro-moting an organizational environment that promotes EBP in nursing practice. Magnet status from the American Nurses Credential Center requires the integration of EBP principles into nursing care (Reigle et al., 2008), Although obtaining magnet status is a major undertaking that goes well beyond the implementatiori of a single EBP innova-tion, it has been shown to aid facilities when transforming an organizational culture to one that promotes the prin-ciples of EBP among clinical nursing leaders and front-line clinicians. In addition, the involvement of unit- or dink-based champions has been shown to facilitate adoption of EBP innovations in multiple health care settings (Slaunwhite et al., 2009; Taggart et al., 2012). The unit- or clinic-based champion is a clinician who practices on the unit in ques-tion and agrees to act as a mentor for the implementation of the EBP innovation. Selection of the proper individual is critical; Rogers (2003) noted that group adoption of innovation occurs in a step-wise manner, with some indi-viduals acting as early adopters, followed by most group members who adopted the innovation based on positive results and feedback from early adopters, followed by a second minority of individuals (late adopters) who change practice only after it becomes apparent that the innovation is inevitable. Clinicians who are early adopters, and who are recognized on their units as influential practitioners, 261
262 PART II Competencies of Advanced Practice Nursing are preferred to the appointment of clinicians who are not persuaded that the innovation is advantageous when com-pared with current practice patterns.

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