Evidence-based practice is researched based changes to our health care.  It is implemented for the good of the patient, as well as the staff.  It has a solid, scientific background for it, making it a logical next step in the care of the patient.  But how do we implement it?  That is usually the issue with new practices.  It is at the individual, local level, that it needs to be implemented at.  What happens in a lab, or research facility, is not always how each individual place is. “As noted by others, the same TRIP intervention may meet with varying degrees of effectiveness when applied in different contexts” (Titler, 2008).  While the research may be sound, and the results conclusive, it may not always apply at every location.  As Kourntey Chaires noted, “What may work at one clinic within the Ben Archer system, may not work at another”.  She goes further in saying that every clinic sees a different patient load, and has different specialties, so not every new practice will work for them all (Chaires, 2017).  TRIP stands for “translating research into practice” (Titler, 2008).  Knowing the staff at the local level, and indirectly the patients and how they are cared for, help to determine how an EBP would be received and learned. “Members of a social system (e.g., nurses, physicians, clerical staff) influence how quickly and widely EBPs are adopted” (Titler, 2008).  One example Titler (2008) mentions is a study conducted in a nursing home.  They were introducing a prompted voiding intervention for those with incontinence.  It was working great, until the investigators turned over the task to the nursing staff.  It was no longer feasible and required more staffing that the average nursing home has. “The availability of strong leadership and financial resources were key components to initial implementation success” (Bonham, et al., 2014). Knowing the local level helps to understand what can help, how it can help, and how it can be implemented.  While EBP is in itself a method for improving care for our patients, it needs to be able to adapted to the location it is going to be used at. References: Bonham, C. A., Sommerfeld, D., Willging, C., & Aarons, G. A. (2014). Organizational Factors Influencing Implementation of Evidence-Based Practices for Integrated Treatment in Behavioral Health Agencies. Psychiatry Journal, 2014, 1-9. doi:10.1155/2014/802983 Titler, M. G. (2008). The Evidence for Evidence-Based Practice Implementation. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2659/


Evidence-based practice (EBP) is a vital aspect of healthcare delivery that involves implementing changes based on research evidence. EBP aims to improve patient outcomes and enhance the quality of care provided by healthcare professionals. There is a solid scientific background supporting EBP, making it a logical approach to patient care. However, the implementation of EBP can be a challenge at the individual and local levels, as what works in one healthcare setting may not necessarily work in another.

Contextual Considerations in EBP Implementation

The effectiveness of EBP interventions can vary depending on the context in which they are applied. As noted by Titler (2008), the same intervention may have different degrees of effectiveness when implemented in different contexts. This means that what may work in one clinic or healthcare facility within a system may not work in another. Factors such as patient load, specialties, and available resources differ across settings, making it necessary to adapt EBP interventions to suit the specific context.

Understanding the Local Level

Understanding the local level, including the staff, patients, and care delivery processes, is essential for successful EBP implementation. The characteristics and dynamics of the social system, including nurses, physicians, and clerical staff, can influence the adoption of EBPs (Titler, 2008). For example, a study conducted in a nursing home introduced a prompted voiding intervention for incontinence management, which initially showed promising results. However, when the intervention was handed over to the nursing staff for implementation, it became unfeasible due to staffing constraints typical of nursing homes (Titler, 2008).

Strong Leadership and Resources

Strong leadership and adequate financial resources are crucial components for successful implementation of EBP interventions (Bonham, Sommerfeld, Willging, & Aarons, 2014). These organizational factors play a significant role in facilitating the initial implementation of EBPs. Without strong leadership support and sufficient resources, the adoption and sustained use of EBP interventions may be challenging. Therefore, it is important to consider these factors when planning and implementing EBP interventions at the local level.

Adapting EBP to Local Context

While EBP is inherently focused on improving patient care, it is essential to adapt interventions to the specific needs and constraints of the local context. This adaptation may involve tailoring interventions to accommodate differences in patient population, available resources, and organizational structure. Successful implementation of EBP requires a comprehensive understanding of the local level, including the specific challenges and opportunities that exist within the healthcare setting.


EBP implementation is a critical step towards improving patient care and enhancing healthcare delivery. However, it is important to recognize that the effectiveness of EBP interventions may vary across different contexts. Understanding the local level, including the characteristics of the social system and the resources available, is crucial for successful implementation. Strong leadership and adequate resources are essential for initiating and sustaining EBP interventions. Adapting EBP interventions to the local context ensures that they are feasible and can be effectively implemented in real-world healthcare settings.