Nurs Admin Q
Vol. 35, No. 1, pp. 21–33
Copyright c 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fostering Evidence-Based
Practice to Improve Nurse
and Cost Outcomes in a
Community Health Setting
A Pilot Test of the Advancing
Research and Clinical Practice
Through Close Collaboration Model
Rona F. Levin, PhD, RN; Ellen Fineout-Overholt, PhD, RN,
FNAP, FAAN; Bernadette Mazurek Melnyk, PhD, RN,
CPNP/PMHNP, FNAP, FAAN; Michael Barnes, PhD;
Mary Jo Vetter, MS, RN, NPC
Although evidence-based practice (EBP) improves health care quality, decreases costs, and empow-
ers nurses, there is a paucity of intervention studies designed to test models of how to enhance
nurses’ use of EBP. Therefore, the specific aim of this study was to determine the preliminary ef-
fects of implementing the Advancing Research and Clinical practice through close Collaboration
(ARCC) model on nurses’ EBP beliefs, EBP implementation behaviors, group cohesion, productiv-
ity, job satisfaction, and attrition/turnover rates. A 2-group randomized controlled pilot trial was
used with 46 nurses from the Visiting Nurse Service of New York. The ARCC group versus an at-
tention control group had stronger EBP beliefs, higher EBP implementation behaviors, more group
cohesion, and less attrition/turnover. Implementation of the ARCC model in health care systems
may be a promising strategy for enhancing EBP and improving nurse and cost outcomes. Key
words: cost, evidence-based practice, nursing, nurse turnover, randomized controlled trial
E
VIDENCE-BASED PRACTICE (EBP) is a
problem-solving approach to the delivery
Author Affiliations: Lienhard School of Nursing,
Pace University, New York (Dr Levin); College of
Nursing and Health Innovation, Arizona State
University, Phoenix (Drs Fineout-Overholt and
Melnyk); Clinical Psychology, Hofstra University,
Hempstead, New York (Dr Barnes); and Clinical
Product Development, Visiting Nurse Service of New
York (Ms Vetter).
Funding for this study was provided by the Hugoton
Foundation.
Correspondence: Rona F. Levin, PhD, RN, Lienhard
School of Nursing, Pace University, 1 Scarsdale Rd. - Apt.
408, Tuckahoe, NY 10707 (rlevin@pace.edu).
DOI: 10.1097/NAQ.0b013e31820320ff
of care that integrates the best evidence from
well-designed studies with a clinician’s ex-
pertise and patient preferences and values.
1,2
As an established method of improving clin-
ical care, EBP has been shown to improve
health, safety, and cost-effectiveness of patient
care as well as decrease patient morbidity and
mortality.
3−9
Evidence-based practice also has
been described as “essential for nurses to es-
tablish who they are, what they do, and what
effect they have on patient outcomes.”
4
Although federal agencies, national orga-
nizations, health care leaders, and recent
EBP and health care professions’ education
summits have promoted its widespread use
among health care professionals, only a small
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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