Take your seat for the evidence-based practice trial

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Instead of running when they heard the words “research” and “evidence-based practice,” staff nurses at UAB Hospital in Birmingham, AL, decided to take the stand.

“We wanted to make evidence-based practice [EBP] fun, accessible, and more approachable for staff nurses, so we created an evidence-based practice mock court session,” says Shannon Graham, MSN, RN, CNS, AOCN, advanced nursing coordinator and ANCC Magnet Recognition Program® (MRP) project director at UAB.

The goals for the EBP court format were to:

  • Help nurses see the EBP process in action
  • Increase nurses’ comfort level regarding research and literature reviews
  • Help nurses understand and translate research into practice

“Staff nurses walked away from the session with a change in attitude about EBP and nursing research,” says Graham.

But before an EBP trial could begin, Graham and Jody White, MSN, RN, advanced nursing coordinator and MRP director, had to create a courtroom with a judge, attorneys, witnesses, and a jury.

Pick a topic

The first step in setting up a mock trial was uncovering a hot topic to discuss. Graham and White presented the mock court format during EBP council meetings, and members brainstormed discussion topics. The council members decided on three pressing issues relevant to nursing:

1. Medication errors (a constant hot topic in the facility)

2. Wireless technology use in the hospital (UAB staff members have voiced concern that staff nurses and physicians are carrying and using their cell phones)

3. ICU visitation (not all UAB staff members follow the no-visitation policy with the family, which can cause problems with other staff members and families)

The three topics were presented in one day for two hours each. A second mock court date with two of the topics was held for people who missed the first session.

Identify court members

Once the topics had been determined, Graham and White approached staff members to act as members of the court. UAB staff members took on the following courtroom roles:

Judge. UAB’s CNO played the role of the judge during the mock trials. She was dressed in a full-length black robe with a gavel in hand. The role of the judge was to:

  • Oversee the cases
  • Call for further evidence
  • Make the final decision on the case

Attorneys. Nurse managers and APNs from the EBP council stepped up to be attorneys because they could devote time to conduct literature searches. Graham and White acted as mentors by sitting down with the attorneys to review the research articles they found and discuss the key points to be brought out during the trial.

Next, the attorneys went back to their witnesses and scripted what they were going to say during the trial.

“Our ultimate goal is for staff nurses to be driving more of the research process, but we knew that we first had to get nurse managers and APNs engaged and then move forward,” says White. “Moving forward, staff nurses will be attorneys.”

The role of the attorney was to:

  • Review literature
  • Create a PowerPoint presentation that integrated points and counterpoints regarding literature findings to display during the trial (Graham, White, and UAB’s PhD nurse researcher reviewed the PowerPoint presentation before the trial to make sure it flowed well)
  • Prepare and mentor witnesses on research findings
  • Present to the court

Jury. All levels of nursing were represented on the jury, including APNs, nurse managers, researchers from specialty areas, staff nurses, and a representative from a local nursing school. There were nine jury members, many of whom were members of the EBP council. The role of the jury was to:

  • Discuss the evidence
  • Vote on the next steps to implementing the EBP project (e.g., look at the idea during an EBP council meeting)

Jury foreperson. UAB’s nurse researcher was the foreperson. Prior to the court date, each group had a one-hour meeting with her to look through the literature “to make sure they had extracted all the educational objectives out of the material that they possibly could to make their case strong,” says Graham.

The role of the foreperson was to:

  • Present a summation of the evidence to the other jurors
  • Lead the jury and audience into discussion of the evidence being presented
  • Tie the evidence presented back to nursing practice and research

Witnesses. Staff nurses and managers played this role. When they were called to the stand, court-themed music would play to add a little entertainment. The role of the witnesses was to:

  • Read, review, and understand the literature
  • Attend prep meetings held by the foreperson
  • Help the attorney formulate questions and possible responses

Bailiff. A staff nurse dressed in a white uniform and a white cap took this role. The bailiff’s duties were to:

  • Call the court into session
  • Swear in the witnesses

Court reporter. This was played by a staff nurse, who was there as a guide to see what direction the organization needed to take to make the EBP change.

Get the word out

Graham and White knew it wouldn’t be a convincing mock trial without general audience participants. They drew a large audience by e-mailing RNs, managers, and educators; by talking to members of shared governance councils; and by posting flyers on nursing units and in the hospital’s newsletter. And because the EBP trial focused on Force of Magnetism 14: Professional development, which falls under Component II: Structural empowerment, everyone who attended the session received continuing education credits (CEU).

“From the CEU evaluations, a staff member said it was the best CEU offering they have ever attended,” says White.

Set the stage

The EBP trial was held in the facility’s auditorium. To create the look and feel of a court room, there was a bench for the judge with a witnesses’ chair next to it. Two tables were placed in front of the judge’s bench for the attorneys and witnesses. The jury table was set sideways by the judge’s bench so the jurors could see the judge, attorneys, witnesses, and the general audience.

Present the results

Medication errors and wireless technology use in the hospital are still under investigation. But thanks to the EBP mock court session, ICU visitation is now allowed.

“Because of the EBP mock court session, we have more staff nurses questioning their practice and pushing forward topics to feature in a trial format,” says Graham.

And White emphasized a top outcome of the session: Staff nurses’ voices were heard.

“Yes, you get to teach EBP and have nurses come together to debate various issues of nursing, but you also get to represent the staff nurse voice,” says White. “Staff nurses got to stand up and say how reviewing literature has changed their attitude about a practice.”

Oath for nurses

All staff members taking part in the evidence-based practice (EBP) mock court session swear in by placing their hand on an EBP book.

The oath they take states:

I promise to tell the truth, the whole truth, and nothing but the Florence Nightingale truth. Further, I promise to uphold the principles of evidence-based nursing practice and to seek out and apply only the best evidence available to my nursing practice. I do this because I am not just another nurse; I am a Magnet [Recognition Program®] nurse with force, and this is what my patients expect of me.