Sacred Cow Contest: Building Enthusiasm in Clinical Nurses for Evidence Based Practice

Purpose:
An innovative, rapid improvement project increased frontline nurse inquiry of evidence based strategies to improve daily patient care. Frontline nurse ability and accountability to translate evidence into practice was enhanced through an educational contest and reinforced through practice changes.

Significance:
Frontline nurse participation is essential to improve patient safety and quality outcomes. An Evidence Based Practice (EBP) Council can cultivate a culture of inquiry, provide meaningful evidence and facilitate practice change that promotes frontline nurse practice leadership.

Strategy and Implementation:
The EBP Council reviewed the literature on improving frontline nurse participation in evaluating quality outcomes and translating evidence into practice. Within the organization frontline nurses were gradually increasing membership in unit and organizational decision making groups. The EBP council called for practice questions through an organization wide Sacred Cow Contest, reviewed related evidence for each “sacred cow” practice and identified possible practice changes. The questions and evidence for all questions were published in the nursing newsletter. Frontline nurses were supported to revise policies and practices based on evidence.

Evaluation:
The initial contest yielded eleven questions. Twenty-seven percent of the questions led to practice changes including tube feeding process, use of Tylenol with febrile patients, and revision of nursing orientation. Staff requested repeat Sacred Cow Contests which are now biannual.

Implications for Practice:
Creating a professional practice environment inclusive of frontline nurse quality care monitoring and implementation of evidence based practices reinforces nursing autonomy and accountability for quality improvement participation.