FACILITATOR GUIDE for Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals, Fourth Edition: Model and Guidelines

The dynamic and competitive US healthcare environment requires healthcare professionals who are accountable to provide efficient and effective care. New evidence is continually surfacing in nursing and medical environments. Consumer pressure and increased patient expectations place an even greater emphasis on the need for healthcare professionals to deliver true evidence-based care in their daily practice.

Johns Hopkins Nursing is steadfastly dedicated to making it easy for frontline nurses, health professionals, and students to use best evidence in their everyday practice. With each edition, we revise based on the honest, frank, and generous feedback we receive from frontline users of the Johns Hopkins Evidence-Based Practice Model from across the globe. In this fourth edition, we are excited to be able to share these changes.

The 2021 revised JHEBP Model underscores the need for organizations to cultivate both a spirit of inquiry and an environment of learning that encourages questioning and seeking best evidence and its implementation and adoption in practice. Although our model was developed, tested, and implemented by and for nurses, we have had numerous requests and feedback from other health professionals to use the Hopkins model. Thus, we introduce the fourth edition with a new title-Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals. This change reflects the growing evidence base of the importance for interprofessional collaboration and teamwork, particularly when addressing complex care issues such as those often tackled by EBP teams. In this edition, our overarching aim is to provide practical and pragmatic explanations, approaches, and tools to guide and support teams engaging in EBP projects:

• We explicitly reflected the interprofessional nature of the EBP process and its use by all disciplines who serve, interact with, and care for those who seek services.
• We revised the flow of the book chapters across the sections to reflect the progression of steps in the EBP process.
• We included a new introduction for the evidence section that includes background on the use of evidence hierarchies, tips for differentiating research from quality improvement, and further explanation of the summary and synthesis steps in the evidence process.
• We made significant enhancements to the appendices by including flowcharts, decision supports, and greater specificity in the directions.
• We provided real-world examples for how to complete all tools using feedback from our global users as well as tried and tested helpful hints.
• We added a new chapter to expand and amplify strategies for dissemination that includes how to create a dissemination plan, audience-specific recommendations for internal and external dissemination venues, details of the pros and cons of different types of dissemination, guidance on submitting manuscripts for publication, and an overview of the journal review process.
• Chapter-specific enhancements:
• Chapter 3: Defines critical thinking and clinical reasoning and differentiates their use in the PET process.
• Chapter 4: Outlines stakeholder selection criteria and an algorithm to determine the need for an EBP project.
• Chapter 5: Includes new information on the literature screening process to navigate a large number of results Chapter 6: Provides useful clarifications of research approaches, designs, and methods with a focus on frontline staff as the target audience
• Chapter 8: Includes revised synthesis and translation steps; assesses risk prior to translation; prioritizes translation models accessible to frontline staff with a focus on the QI methodology and PDSA; and describes an expanded list of outcome measures to determine the success of an EPB project.

Deborah Dang, PhD, RN, NEA-BC, is the Senior Director of Nursing Inquiry and Research at the Johns Hopkins Health System. She developed the strategic vision for evidence-based practice (EBP) for Johns Hopkins Nursing and built an infrastructure that has enabled the transformation to practice based on evidence. In her role as Director of Nursing for Practice, Education, Research at The Johns Hopkins Hospital, she led and championed nursing professional practice, cultivating its growth from the initial model development to final implementation. She cocreated, with clinical nurses and nurse leaders, The Johns Hopkins Hospital Professional Practice Model: clinical advancement program, professional development for frontline leaders and staff, salaried compensation, shared governance, and evidence-based practice, thus building an infrastructure to continually advance nursing excellence. As a health services researcher, her funded studies focused on disruptive behavior, positive psychology, and mindful leadership. She received the inaugural New Investigator Award for the Academy Health Interdisciplinary Research Group on Nursing Issues, is a Fellow of the Wharton Nurse Executive Program, and was recognized as a Distinguished EBP Trailblazer by Fuld National Institute for EBP in 2019. Dang has published, consulted, and presented nationally and internationally on the subject of EBP. She also holds a Joint Appointment with the Johns Hopkins University School of Nursing.

Sandra L. Dearholt, DNP, RN, NEA-BC, is Assistant Director of Nursing for the Departments of Neurosciences and Psychiatry Nursing at The Johns Hopkins Hospital. Dearholt has written numerous articles on EBP and has extensive experience in the development and delivery of EBP educational programs. Her areas of interest focus on strategies for incorporating EBP into practice at the bedside, the development of professional practice standards, promoting healthcare staff well-being, and fostering service excellence. She is a coauthor of the first edition of Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines and a contributing author to Johns Hopkins Nursing Evidence-Based Practice: Implementation and Translation.

Kim Bissett, PhD, MBA, RN, is a nurse educator and director of EBP at the Institute for Johns Hopkins Nursing. She was the inaugural Evidence-Based Practice Coordinator at The Johns Hopkins Hospital, following two years of serving as the EBP Fellow. She assisted with the development and publication of the second and third editions of Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines. Bissett has presented and consulted on the topic of evidence-based nursing practice both nationally and internationally. Her research interests include building EBP competencies, self-compassion, and fostering nurse well-being.