A nurse-led EBP intervention inevitably has to interact with healthcare systems at a local level. The majority of nurses do not have the pull and the resources to solicit a large-scale intervention. At the same time, any EBP must first be generated at the local level. The purpose of this paper is to evaluate the academic evidence available for the importance of understanding healthcare systems at a local level.
The article by Warren et al. (2016), which was published in Worldviews on Evidence-Based Nursing peer-reviewed journal, highlights the importance of understanding the local healthcare settings in order to interpret the results of the study. Localities differ from one another based on their population, culture, customs, and the overall level of healthcare provided to the patients. Therefore, an intervention that is successful in one particular healthcare setting may be less successful in another due to the critical influence of one or several of the factors mentioned above.
The peer-reviewed book guide by Melnyk, Gallagher-Ford, and Fineout-Overholt (2016) underlines the importance of understanding local healthcare systems in planning EBP interventions based on the materialist perspective. Some interventions require additional resources and expertise in order to be effective. A hospital in New York has more resources to offer than a primary healthcare center of an isolated rural community. Nurses are required to understand the limitations of their supporting structure in order to plan effective interventions. Otherwise, the proposals they make might not pass the approval stage, as they would threaten to overextend the available budget. Another important resource, as stated by Melnyk et al. (2016), is the skill level of the participating personnel. Some interventions may require additional training to be performed. As it is possible to see, understanding the local healthcare settings is paramount in framing the scope and size of the proposed intervention.
Melnyk, B. M., Gallagher-Ford, L., & Fineout-Overholt, E. (2016). Implementing the evidence-based practice (EBP) competencies in healthcare: A practical guide for improving quality, safety, and outcomes. Indianopolis, IN: Sigma Theta Tau.
Warren, J. I., McLaughlin, M., Bardsley, J., Eich, J., Esche, C. A., Kropkowski, L., & Risch, S. (2016). The strengths and challenges of implementing EBP in healthcare systems. Worldviews on Evidence‐Based Nursing, 13(1), 15-24.