Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC)

Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model for Military Treatment Facility (MTF) Implementation of Nursing Evidence-Based Practice (EBP)

The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be evidence-based includes nursing interventions and practice. Models and frameworks have been developed to meet the demand for practice transformation. While magnet facilities require a commitment to evidence-based nursing practice, military facilities currently lack such a requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful path toward developing high-reliability organizations. Currently, little is known regarding the effectiveness of specific EBP models and frameworks within the military culture. The purpose of this investigation is to determine the effectiveness of the Advancing Research and Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment Facility (MTF) beginning with nursing services.

Research questions:

1. What is the current state of organizational culture and readiness for EBP within the MTF's nursing services?
2. Will utilization of the ARCC model significantly improve EBP beliefs, knowledge, and practice in MTF nurses over a two-year period?
3. Is the ARCC model feasible for implementation in Air Force MTF's?

This study includes an intervention group (n=70) of active duty nurses and technicians who attend an intensive 5-day EBP Immersion Workshop and a control group (n=70) who do not. The intervention group will have access to specialized resources such as: a) Center for Transdisciplinary Evidence-Based Practice (CTEP) expert EBP mentors, b) EBP toolkit and resources, c) one year of free access to the Ohio State University (OSU) virtual library. Control group participants will have standard MTF education opportunities. Established valid and reliable survey measures (EBP attitudes, knowledge, beliefs) will be hosted electronically by CTEP at baseline, three, and twelve months. Online measures include institutional and nursing process measures (EBP implementation, policy changes, and publications) over the two-year study period. De-identified data from the anonymous survey measures will be shared by CTEP with this study team. Data analysis will include Student's t-tests to explore differences between groups. Repeated measures ANOVA or the nonparametric equivalent (Friedman's test or Skillings-Mack test) will be used to compare three time points within groups. Feasibility metrics and demographics will be reported with descriptive statistics.

Further study details as provided by David Grant Medical Center, Travis Air Force Base, California

Inclusion Criteria:

• Nurse (active duty) assigned to DGMC
• Medical/Surgical technician (active duty) assigned to DGMC
• 15 month retain-ability from time of enrollment

Exclusion Criteria:

• Disciplines outside of Nursing (PA, MD, Occupational Therapy (OT), Physical Therapy (PT), etc.)
• Nurse/technician General Schedule (GS),VA, Contractor employed at David Grant Medical Center (DGMC)
• Anticipated/Scheduled Permanent Change of Station (PCS) in next 15 months