Topic 4 DQ 2

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Please respond with a paragraph to the following question, add citations and references:

When implementing evidence-based practice (EBP), it is important to understand the local health care system when it will be implemented. If one is in a rural area with limited resources, an EBP practice change made for a large facility in a large city may not work the same as in the rural area. “Models for EBP implementation provide stepwise guidance; however, particular contextual factors act as facilitators or barriers to the process” (Kueny, Shever, Mackin, & Titler, 2015, para. 5). For example, attempting a trial of labor after cesarean section (TOLAC) has numerous studies of being safely implemented pending the patient’s obstetrical history. In the city I am originally from, it is a rural area where anesthesia does not have to be in house and there is no neonatal intensive care unit. Due to health care system there, they do not allow women to have a TOLAC due to lack of resources in the area.

One thing my mentor has mentioned to me is to also consider the population I am wanting to educate in regard to the benefits of breastfeeding. We live in a poor state that is 50th for education, therefore that needs to be considered when presenting evidence-based research to be implemented. She also pointed out that since we do live in a poor state and Medicaid is the main insurance for a lot of our population, cost factors must be assessed as well. My research has to prove to be cost effective and done in a frugal way.


Kueny, A., Shever, L. L., Mackin, M. L., & Titler, M. G. (2015, June 24). Facilitating the implementation of evidence-based practice through contextual support and nursing leadership. Journal of Healthcare Leadership, 7, 29-39.