How Ready Is This Hospital for Evidence-Based Practice? An Organizational Commitment Survey and What Its Answers Mean for Practice Change
[Student Name]
University of Phoenix
NSG/509: Research and Applied Statistics for Quality Improvement
Week 3 Assignment
[Instructor Name]
[Date]
The hospital, responses and scores are a composite written for a model paper.
Evidence-based practice depends on individual nurses' knowledge and beliefs, but it also depends on whether the organization around them makes evidence-based practice possible. A nurse who knows how to appraise a study cannot change practice in a hospital with no library access, no time for projects and no leader who asks what the evidence says. This paper reports the results of an organizational culture and readiness survey completed about a composite 280-bed community hospital where the writer works as a medical-surgical charge nurse. The survey confirmed what nurses on the units already sensed: the hospital believes in evidence-based practice on paper and funds very little of what it takes to do it.
The Survey
The survey used was a 25-item organizational culture and readiness scale for system-wide integration of evidence-based practice, developed by Fineout-Overholt and Melnyk and described in their evidence-based practice text alongside companion scales for individual beliefs and implementation (Melnyk & Fineout-Overholt, 2023). Each item asks to what extent a feature of evidence-based practice is present in the organization, rated from 1, not at all, to 5, very much, so total scores range from 25 to 125. The individual scales in the same family have shown good reliability and validity in nursing samples (Melnyk et al., 2008). For this paper, the items were grouped into five domains: leadership support, resources and infrastructure, mentorship and expertise, culture and expectations, and integration into policy and practice.
Results
The writer's total score was 62 of a possible 125, an average item rating of 2.5, which falls in the lower middle of the scale. Results varied across domains.
Leadership support averaged 3.4. The chief nursing officer publicly endorses evidence-based practice, the strategic plan names it and nursing leaders refer to it in meetings. However, managers rarely ask staff for the evidence behind a proposed change.
Culture and expectations averaged 2.8. Many nurses value evidence and a unit practice council exists on each floor, but evidence-based practice is not part of performance evaluations or clinical ladder criteria, and staff describe it as extra work rather than part of the job.
Integration into policy and practice averaged 2.6. Policies list references, but many are more than ten years old, and there is no routine process for reviewing policies against new evidence.
Resources and infrastructure averaged 1.9. Nurses have remote database access through the hospital library, but the library has one part-time librarian, there is no protected time for evidence-based projects and data for measuring outcomes must be requested through the quality department with long delays.
Mentorship and expertise averaged 1.7, the lowest domain. The hospital has no nurse scientist or evidence-based practice mentor, only two nurses hold doctoral degrees and neither has a role in supporting staff projects.
Interpreting the Pattern
The pattern is common: stated commitment exceeds practical support. Leadership support and culture scored higher than resources and mentorship, which suggests that the hospital values evidence-based practice as an idea but has not invested in the structures that make it happen. National data show that this gap is widespread. Melnyk et al. (2012), surveying more than 1,000 nurses across the United States, found that while most nurses valued evidence-based practice, many reported barriers such as lack of time, organizational culture and resistance from leaders and managers, and that nurses in organizations with more support were more likely to report practicing it consistently.
The lowest domain, mentorship, may be the most important. Evidence-based practice requires skills that most bedside nurses were not taught in depth, including searching databases, appraising studies and measuring outcomes. Melnyk's work has repeatedly identified evidence-based practice mentors as a key factor in building those skills and sustaining projects (Melnyk & Fineout-Overholt, 2023). Without mentors, the unit practice councils have ideas but no guide for turning them into projects.
Recommendations
The results point to three changes the hospital could make within a year, aimed at the weakest domains.
1. Develop evidence-based practice mentors. Select one experienced nurse per service line and support each through a structured mentor development program, with four hours per week of protected time to guide unit projects. This addresses the mentorship domain directly.
2. Fund protected project time. Give each unit practice council a small bank of paid hours per quarter for evidence reviews and project work, so that evidence-based practice is part of the workday rather than an unpaid extra.
3. Build evidence-based practice into expectations. Add a requirement to the clinical ladder that nurses at the advanced levels lead or participate in an evidence-based project, and revise the policy review process so that each policy is checked against current evidence every three years, with unit councils assigned to the review.
The hospital should repeat the survey in 12 months with a sample of nurses from every unit, rather than relying on one respondent, and compare domain scores to see whether the investments changed the organization's readiness.
What the Survey Suggests About Current Projects
The survey results also explain the fate of recent projects on the writer's unit. Two years ago, a staff nurse proposed changing the unit's practice for flushing peripheral intravenous catheters after reading a systematic review. The idea was approved by the unit council, but the nurse had no time to search further, no one to help her appraise the evidence and no data on catheter complications to measure a baseline. The project stalled within three months. A second project, on reducing unnecessary urinary catheters, succeeded because an infection preventionist with research training adopted it and provided data. The contrast illustrates the survey's central finding: projects succeed where a mentor and data happen to exist, not because the organization has built them in. A hospital that relies on chance to supply mentors will see evidence-based practice succeed only occasionally, which matches the low scores in the resources and mentorship domains.
Limitations
These results reflect one nurse's perceptions on one unit, which may not represent the hospital as a whole. Nurses in the intensive care unit, for example, may experience more support than those on medical-surgical floors. The survey also measures perceptions of readiness, not actual evidence-based practice behaviors or patient outcomes. A hospital-wide survey, paired with measures of evidence-based projects completed and their results, would give a fuller picture.
Conclusion
An organizational culture and readiness survey showed that this community hospital supports evidence-based practice in its statements and leadership messages but provides little of the mentorship, resources and protected time that practice change requires. That pattern matches national findings. Developing mentors, funding project time and building evidence-based practice into expectations and policy review would address the weakest domains and move the hospital from commitment on paper toward commitment in practice.
References
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417. https://doi.org/10.1097/NNA.0b013e3182664e0a
Melnyk, B. M., Fineout-Overholt, E., & Mays, M. Z. (2008). The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing, 5(4), 208-216. https://doi.org/10.1111/j.1741-6787.2008.00126.x
How this NSG 509 Week 3 example is structured
Course materials describe the NSG/509 Week 3 assignment as an Evidence-Based Practice Organizational Commitment exercise in which students answer survey questions about an organization's commitment to and readiness for evidence-based practice. The paper reports the answers by domain rather than item by item, so the pattern is visible, then interprets that pattern against published evidence. The recommendations target the weakest domains, which is what makes the survey useful rather than a checklist. Students search this week as NSG 509 Week 3, NSG509 Wk 3 or NSG/509 Wk 3; all three are the same assignment.
NSG/509 Week 3 questions, answered
What does NSG/509 Week 3 usually ask for?
Course materials describe the Week 3 assignment as an evidence-based practice organizational commitment exercise: answering survey questions about an organization's commitment to and readiness for evidence-based practice and reflecting on the results. Your instructions decide which survey and what the written part must include.
Which organization should I assess?
Usually your current employer or a clinical site you know well. Describe it without confidential details, and base your answers on what you have observed, not on what policy documents say should happen.
How do I make the survey results useful?
Group the items into themes, identify the strongest and weakest areas, compare them with published findings and recommend specific changes for the weakest areas. A list of scores with no interpretation earns little credit.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official University of Phoenix document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.