VIEWS: 9 PAGES: 4 CATEGORY: Medicine POSTED ON: 6/18/2010
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Research and Theory for Nursing Practice: An International Journal, Vol. 23, No. 2, 2009 EVIDENCE-BASED PRACTICE Implementing Practice Changes: Walk Before You Run W e can learn a lot from the practice improvement literature (Langley, Nolan, Nolan, Norman, & Provost, 1996) about how to walk before we run when implementing evidence-based innovations in our health care organiza- tions. Specifically, the cycle known as PDSA—Plan, Do, Study, Act—informs us about how to conduct “small tests of change” before implementing a larger pilot test or spreading a change throughout an organization. This RTNP issue’s Evidence-Based Practice column focuses on describing the components of PDSA cycles, suggesting how they fit into an EBP approach to improving the quality of care, and providing an actual example of how the PDSA cycle was used to implement a nursing practice change in a hospital. A PDSA cycle (see Figure 1) consists of the four components or phases stated above (Langley et al., 1996). During the first Plan phase, a project team develops specific objectives for the cycle, makes predictions about how the project will turn out, and develops a protocol for implementing the small test of change. In the second or Do phase, the test of the innovation is conducted, process issues are elicited from participants, problems or issues with implementation are shared with the project team, and, finally, team members begin to analyze initial feedback or data. Data accumulated during phase two is evaluated completely during the Study phase of the PDSA cycle. This data is then compared to the predicted or hoped for implementation pro
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