Mentoring nurses in evidence-based projects.

F or those of you who have just started to integrate evidence-based practice into your work environment, mentoring a clinical nurse who has come to you for help for a project may seem like a dream. Yes, you think, and now can I please have two or three more clinical nurses who are excited and passionate about using evidence in practice?! If you are in this position, it may seem unbelievable that there could be too many projects in your future. When evidence-based practice becomes the norm in an institution, as it has become in ours after 15 years of working to build evidence-based practice into standards of practice, performance, and infrastructure, the number of nurses lined up outside your door clamoring for help will amaze you! Although this situation is a wonderful dilemma, it means that one has to be prepared and organized with structures in place so projects progress smoothly and all those involved know the expectations and processes. If these components are not in place and learned in the early years of evidence-based mentoring, you will find yourself frazzled, taking on more than what is feasible and losing the feeling of excitement and fun that should be a part of mentoring clinical nurses in this important activity. This column will focus on the critical steps of project management when mentoring clinical nurses on their evidence-based journey. A first and critical step in this process is to assess the source of the evidence-based project with the clinical nurse. Always the most valuable evidence-based projects with the highest probability for success are those in which the nurse has identified a clinical problem or issue that the nurse is passionate to address. We have found over the years that a project that has been ‘‘assigned’’ or a project that is really the nurse manager’s or the direct supervisor’s may result in a clinical nurse not caring much about it, so interest drops over time. If such a gap exists, you may find that you end up doing the workVnot the desirable outcome. Exploring how the nurse became interested in the project and understanding the context, the degree of nurse engagement with the issue, and the commitment to follow through are quite important. If this first step is successfully completed, move on to the next stage of mentoring: outlining a plan for the project. This plan needs to start with these four basics: 1. Time. Has the clinical nurse discussed the project with the manager and is there an agreement that administrative time can be used for this project? If not, how does the nurse plan to create time to make the project a reality? Some institutions require a contract, signed by the nurse manager and clinical nurse, outlining the plan along with the agreed administration time for the project. The project must not only meet the nurse’s goals but also be of value to the unit or hospital. 2. Type of project. It is very important when initiating the mentoring process to determine if the project is research, quality, program evaluation, or simply using existing evidence to change practice. This can be a slippery slope (Newhouse, Pettit, Poe, & Rocco, 2006). This step is critical as it determines whether or not application for institutional review board (IRB) approval is necessary. We have started to use a grid developed by the system’s IRB, which includes a checklist by our system’s IRB type of criteria for each category. This grid can be accessed through the IRB Web site (Colorado Multiple Institutional Review Board, 2011). I review this grid line-by-line with the nurse, discussing each criterion and checking the appropriate boxes in the decision-making process to decide on the category, then all parties sign the back page with a copy provided to the mentee. This review process helps facilitate the project discussion and also serves as a map so that everyone involved is clear about how to proceed, since there is a significant difference in time and energy if IRB approval needs to be obtained. If you encounter any lack of clarity in the process, consult your IRB, because each functions differently in the interpretation of regulations. Mary Krugman, PhD, RN, NEA-BC, FAAN, is Director, Professional Resources, University of Colorado Hospital, Denver, Colorado. E-mail: mary.krugman@uch.edu.