Background: Heart failure (HF) is considered a condition in which a portion of hospital admissions are preventable if timely and appropriate outpatient care management occurs. Facility readmission rates for HF are reportable and subject to penalty. Both military and civilian healthcare systems have fiscal responsibility and are accountable for successful disease management. Therefore, best practices and evidence-based strategies to reduce readmissions are in critical demand. However, translating best evidence into practice can be challenging due to the complexities of the healthcare system.Aims: This crosswalk paper provides strategies and considerations for nurses planning HF readmission reduction initiatives.Methods: Insight regarding implementation strategies, challenges, successes, and lessons learned is shared through a framework-guided description of two separate but similar HF readmission reduction projects conducted in military and civilian healthcare facilities.Results: Lessons learned suggest defined and attainable outcomes, multidisciplinary inclusivity, redundancy in roles, greater collaboration, and engagement with stakeholders are most beneficial when initiated before dedicating resources and continuously throughout practice change implementation, maintenance, and sustainment.Linking Evidence to Action: The authors advocate for interdisciplinary evidence-based practice consortiums to share lessons learned that may promote success potential and optimize return on invested time and efforts in the same or similar initiatives-in this instance, reducing 30-day readmissions for HF patients.

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Introduction: Implementation and sustainment of evidence-based practices (EBPs) are common challenges faced by healthcare organizations. The Clinical Research and Practice Collaborative, an evidence-based initiative implemented at a large Military Treatment Facility, addresses EBP implementation and sustainment by expanding the culture of nursing clinical inquiry and broadening nursing research efforts to include EBP. The evidence-based intervention of scheduled, intentional, intraprofessional collaboration between PhD nurse scientists and advanced practice registered nurses as compared to previous methods of spontaneous, consultative collaboration, focuses on developing support for nursing research and EBP initiatives. Materials and Methods: A 2-year pre- and 2-year post-implementation timeframe compared outcomes (proposals, publications, posters) from individual and collaborative nursing research and EBP initiatives. Results: Although nursing research initiatives remained stable, research publications and posters were reduced by 63%, EBP initiatives grew 450%, EBP publications and collaborative nursing initiatives for both research and EBP increased. Additionally, EBP Council membership rose 300%, and an intraprofessional cadre was formed during the implementation. Conclusions: Intentionally scheduled collaboration between PhD nurse scientists and advanced practice registered nurses is a promising model to promote an expanded culture of nursing clinical inquiry and should be considered for medical facilities seeking to enhance EBP and nursing research efforts.

Background In 2017, the TriService Nursing Research Program completed a strategic planning session, which identified key barriers to implementing evidence-based practice (EBP) within the U.S. Military Health System (MHS) including a focus on readiness training and deployments, frequent staff moves for military members, and relatively junior nurses in clinical roles. To facilitate EBP at individual military treatment facilities (MTFs), an EPB Facilitator role was developed using an evidence-based model and based on validated EBP competencies. Methods This new role was implemented at four MTFs in 2018: Naval Medical Center Portsmouth, 59th Medical Wing at Joint Base San Antonio Lackland, Naval Medical Center San Diego, and David Grant USAF Medical Center at Travis Air Force Base. This case series provides a description of the initial implementation of this role. Results Common enablers and challenges were identified from the experiences at all four sites. These included the importance of incorporating efforts into existing organizational efforts and infrastructure; the value of nurse leaders inviting EBP facilitators to participate and engage in scheduled meetings and committees; the significance of engaging with existing quality, process improvement, and training initiatives; and the benefit of collaborating with advanced practice nurses within the organization. The common challenges for all EBP facilitators were the frequent staff turnover at all levels and a lack of standardization to review and approve EBP initiatives, which makes it difficult to navigate the complete process of project implementation and collaboration across sites. Another challenge has been the difficulty to measure the impact of this role at the MTF and MHS levels. Conclusions As EBP efforts continue and the program matures, it is anticipated that the outcomes from the individually completed projects, to include decreases in safety events, fiscal savings, and other improvements in organizational metrics, can be compiled to demonstrate the collective impact of these roles within the MHS.

Background: Military nurse scientists are embedded in service-affiliated branches (Army, Navy, Air Force) with different missions, but with the singular purpose of generating and disseminating research impacting the health and well-being of DoD beneficiaries. Purpose: This project examines collaboration among TriService Nursing Research Program (TSNRP) members, seeking opportunities to strengthen, diversify, and expand research collaboration. Method: Social network analysis (SNA) is the empirical inquiry of relations among social actors at different levels of analysis. An electronic SNA assessment and total enumerative sampling were used to explore current collaborations among PhD-prepared military nurse scientists (N = 136). Findings: The TSNRP collaboration network has a complex service-driven structure with high status actors whose advice, knowledge, or skills are sought by others, and who function as connectors or bridges across service branches. Discussion: For military scientists, SNA is instrumental in identifying influential individuals, visualizing opportunities for intraservice mentoring, designing responsive policy, and directing career opportunities for novice scientists.