Feasibility and Effectiveness of the Advancing Research and Clinical Practice Through Close Collaboration (ARCC)

The Institute of Medicine's (IOM) ambitious goal for at least 90% of clinical decisions to be
evidence-based includes nursing interventions and practice. Models and frameworks have been
developed to meet the demand for practice transformation. While magnet facilities require a
commitment to evidence-based nursing practice, military facilities currently lack such a
requirement but are instituting evidence-based practice (EBP) initiatives in a purposeful
path toward developing high-reliability organizations. Currently, little is known regarding
the effectiveness of specific EBP models and frameworks within the military culture. The
purpose of this investigation is to determine the effectiveness of the Advancing Research and
Clinical Practice through Close Collaboration (ARCC) model in an Air Force Medical Treatment
Facility (MTF) beginning with nursing services.

Research questions:

1. What is the current state of organizational culture and readiness for EBP within the
MTF's nursing services?

2. Will utilization of the ARCC model significantly improve EBP beliefs, knowledge, and
practice in MTF nurses over a two-year period?

3. Is the ARCC model feasible for implementation in Air Force MTF's?

This study includes an intervention group (n=70) of active duty nurses and technicians who
attend an intensive 5-day EBP Immersion Workshop and a control group (n=70) who do not. The
intervention group will have access to specialized resources such as: a) Center for
Transdisciplinary Evidence-Based Practice (CTEP) expert EBP mentors, b) EBP toolkit and
resources, c) one year of free access to the Ohio State University (OSU) virtual library.
Control group participants will have standard MTF education opportunities. Established valid
and reliable survey measures (EBP attitudes, knowledge, beliefs) will be hosted
electronically by CTEP at baseline, three, and twelve months. Online measures include
institutional and nursing process measures (EBP implementation, policy changes, and
publications) over the two-year study period. De-identified data from the anonymous survey
measures will be shared by CTEP with this study team. Data analysis will include T-tests or
Mann Whitney U test for group comparisons. Repeated measures ANOVA or the nonparametric
equivalent, Friedman's test will be used to compare three time points within groups.
Feasibility metrics and demographics will be reported with descriptive statistics.