Closing the Gap: Transforming Evidence-Based Practice From Knowledge to Action in High-Acuity Nursing Environments

An Interactive Educational Intervention to Improve EBP Beliefs and Implementation

Tonika Bruce, DNP, MSN, MBA, RN

Bridging the gap between what clinicians know and what is consistently applied in practice.

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Project Summary

Despite a strong emphasis on evidence-based practice, a persistent gap remains between knowledge and clinical implementation. It is estimated that it takes an average of 17 years for evidence to be translated into practice, limiting the impact of research on patient outcomes.

This quality improvement project focused on strengthening both EBP beliefs and implementation behaviors within a high-acuity pediatric hematology and oncology setting through an interactive educational approach.

Key Highlights

  • High-acuity pediatric specialty setting
  • Interactive EBP Escape Room intervention
  • Pre, post, and follow-up evaluation
  • Validated EBP measurement tools
  • Focus on sustained practice change

Clinical Question

In registered nurses working in a pediatric hematology and oncology setting, how does participation in an interactive EBP educational intervention, compared to no intervention, affect evidence-based practice beliefs and implementation behaviors over time?

Intervention Design

A structured, interactive EBP Escape Room experience designed to reinforce key evidence-based practice concepts through collaboration, problem-solving, and application of real-world clinical scenarios.
Focus areas included:
  • Formulating PICOT questions
  • Identifying and appraising evidence
  • Applying evidence to clinical decision-making
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Project Design

Design: Quasi-experimental, pre-post with follow-up
Sample: Registered nurses n=18
Setting: Pediatric hematology/oncology unit
Measures:
  • EBP Beliefs Scale
  • EBP Implementation Scale
Data Collection:
Baseline → Immediate Post (beliefs) → 4-week Follow-up

Key Outcomes

Primary Statements
Increase in EBP Beliefs
Improvement in EBP Implementation Behaviors
Sustained Change at Follow-Up

Interpretation

Findings support the use of interactive, experiential learning approaches to strengthen engagement with evidence-based practice in high-acuity environments. Participants demonstrated increased confidence in EBP, along with improved application in clinical decision-making over time.

Implications for Practice

Supports integration of interactive EBP education in clinical settings
Reinforces the value of engaging, application-based learning strategies
Provides a scalable model for broader implementation across units

Implementation Context

Strengths
  • Strong EBP culture
  • Leadership support
Weaknesses
  • Time constraints
  • Small sample
Opportunities
  • Expansion to additional units
  • Integration into onboarding
Threats
  • Staffing demands
  • Competing priorities

Contextual factors influencing implementation

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Tonika Bruce, DNP, MSN, MBA, RN
Evidence-based practice remains central to advancing clinical decision-making and improving patient outcomes across complex care environments.