Welcome back to the Excellence in Nursing blog. Today, I want to share some helpful tips for writing Empirical Outcome (EO) exemplars. In my experience, drafting EOs is often easier than non-EOs. Why? Because in EOs, the data drives the story.

The key to writing a strong EO is presenting a clear, evidence-based narrative that demonstrates measurable improvements in patient care and nursing practice. There’s no need to embellish—let the facts speak for themselves.

This post will focus on building a solid EO narrative. We’re not diving into data analysis or heavy editing here (we’ll cover that in a future post)—our goal in this post is to give you a straightforward process so you can create a clear and compelling EO draft. So, let’s dive in:

Step 1: Read the SOE Statement Thoroughly

Start by carefully reading the Sources of Evidence (SOE) statement in your Magnet Manual. This might seem obvious, but it’s easy to miss small details that can make a big difference later. For example, some SOEs focus on "clinical nurse(s)" versus "nurse(s)"—this distinction is critical.

I recommend highlighting or underlining key terms you need to address in the EO. For this blog, we’ll work with a generic SOE example: an improved patient outcome through clinical nurse involvement.

In this case, your exemplar must show how clinical nurses were involved in the work and how their involvement led to measurable improvements (an improved patient outcome). By defining these elements upfront, you’ll stay aligned with the SOE criteria from the outset.

Step 2: Verify That All Elements Are in Place

Before you start writing, pause to make sure all the required elements are there. Don’t waste time drafting an exemplar if you’re missing key pieces.

Using our SOE example from Step 1, you’ll need to ensure you have the following:

1. Clinical Nurse Involvement: Clear, documented evidence that clinical nurses were actively involved.

2. Improved Patient Outcome: Solid, measurable data demonstrating an improved patient outcome as a direct result of the intervention.

   Tip: Be sure your understanding of terms aligns with ANCC’s definitions. Green-font words in the Magnet Manual have corresponding definitions in the Glossary. Familiarizing yourself with these terms is crucial.

If you’re missing these elements, stop and get what you need. Moving forward without verifying will only lead to wasted time and unnecessary rewrites later.

For more detailed guidance on differentiating between EOs and non-EOs, download our free MPD Handbook here. The handbook walks you through some key elements to better understand EOs—which will save you time and energy in the long run.

Step 3: Define and Verify Your Data Set

Before you start writing, outline and verify your data. Your data must meet EO exemplar criteria and align with the SOE requirements to avoid issues down the line. Here are some tips for defining and verifying your data set:

• Assess Your Data: Make sure you have at least one pre-intervention data point and three post-intervention data points showing a positive trend. Your data should also fit within your 48-month reporting window. Additionally, determine the units of time you’ll be using (e.g., quarters, months), and ensure these units are consistent for both pre-intervention and post-intervention periods.

• Outline Your Data Set: Clearly organize and outline pre-intervention, intervention, and post-intervention data points. This organization will help keep your narrative focused and coherent.

• Verify Alignment: Double-check that your data supports the exemplar’s requirements to avoid costly rewrites later.

Example:

Continuing from the SOE example focused on an improved patient outcome through clinical nurse involvement, let’s say the story you want to capture is centered on reducing patient falls. You’ve determined to use monthly data and verified that your data falls within your 48-month reporting window. Your data set might look like this:

• Pre-Intervention: January 2023 – an average of 4 falls per month. Ensure this data is presented as a ratio (e.g., falls per 1,000 patient days).

• Intervention Period: February to June 2023 – implemented interventions (hourly rounding and patient education).

• Post-Intervention: July to September 2023 – sustained reduction to 0-1 falls per month (again, presented in ratio format).

Step 4: Organize and Outline your EO by Timeline

Now that you have your data set organized, it’s time to structure your EO exemplar by timeline. Detail what happened during each phase (pre-intervention, intervention, and post-intervention). Be specific about dates and who was involved in each phase.

In the example outline below, we will continue building on the same hypothetical scenario from Steps 1-3.

Example Timeline:

(Note: For brevity, individual participants are omitted in the example below; however, in your own EO, be sure to list all the key players. In this particular example, highlighting clinical nurse contributions would be essential to demonstrating their direct impact on the improved patient outcome.)

Pre-Intervention Phase: January to March 2023

• January 2023: Falls Prevention Task Force collected baseline data indicating an average of 4 patient falls per month across Unit 1A, calculated as falls per 1,000 patient days.

• The task force established a goal to reduce the fall rate on Unit 1A to enhance patient safety and care quality.

Intervention Phase: February to June 2023

• February 2023: Falls Prevention Task Force conducted a root cause analysis involving frontline clinical nurses, identifying gaps in hourly rounding and patient education.

• March 2023: Launched an hourly rounding protocol to increase patient engagement and reduce fall risks, led by nursing educators and task force nurses.

• April 2023: Nurse educators conducted training sessions for staff on fall prevention strategies, emphasizing adherence to new protocols.

• May 2023: Rolled out a patient education program focused on fall prevention awareness, led by nursing educators and taskforce nurses.

• June 2023: Monitored fall rates weekly and made adjustments to the rounding protocol based on staff feedback to optimize effectiveness.

Post-Intervention Phase: July to September 2023

• July 2023 to September 2023: Collected post-intervention data, noting a sustained decrease to 0-1 falls per month.

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Step 5: Drafting and Putting It All Together

With your data, timeline, and details in place, it’s time to draft your EO. EO exemplars follow a specific structure, so refer to the latest ANCC Magnet Application Manual for guidance. Here are some tips for each section:

• Background/Problem Statement: Define the problem and why it matters. What’s the core issue? Why is it critical to patient care? What are the stakes involved?

• Pre-Intervention: Present the data that drove the need for intervention. What data signaled the urgency for change? What actions were taken beforehand? Who were the key players?

• Goal Statement: Clearly state your measurable goal. Ensure that the outcome measure aligns with the goal and that it specifies the location of the desired improvement.

• Participants: List the key contributors and their roles. Include names, disciplines, titles, and departments of those involved in both the pre-intervention and intervention phases.

• Description of the Intervention: Detail what was done and how it was implemented. What specific interventions were executed? How did they directly address the problem? What evidence supported their effectiveness? Include at least two APA-formatted references that are relevant to the intervention.

• Outcome(s): Present the measurable results and their significance. What quantitative results were achieved? How does your data substantiate the narrative? What broader impacts were realized as a result of the interventions?

Additional Tips for Drafting an EO Exemplar

After drafting each section, consider these elements to strengthen your draft:

• Develop a Logical Flow: Ensure your narrative is coherent and flows logically from one section to the next, guiding the reader through the story.

• Emphasize Evidence-Based Practice: Highlight the research and evidence that informed your intervention. What evidence or data drove your decision-making process?

• Use Clear, Concise Language: Avoid jargon and be direct in your descriptions. Clarity is key, so aim for simplicity in your writing.

• Highlight Key Achievements: What were the standout results, and how do they reflect the success of your intervention?

Example of a Full EO Draft

Here is what the example EO draft might look like when it’s all pulled together:

Clinical Nurses on Unit 1A Reducing Patient Falls at Acme Hospital

Background/Problem(s)

Acme Hospital's Unit 1A is a 26-bed medical-surgical unit known for delivering comprehensive care, including post-surgical recovery, chronic disease management, and acute medical services. 

In January 2023, the unit's Falls Prevention Task Force—comprising clinical nurses, unit managers, the nurse educator, and patient care partners—recognized an increase in fall rates on Unit 1A, which had reached an unacceptable level of 4 falls per month (calculated as falls per 1,000 patient days). In response, the task force set a clear goal to decrease the number of falls by implementing targeted, evidence-based interventions.

Key stakeholders, including Jane Doe, BSN, RN, Clinical Nurse III, John Smith, MSN, RN, Nursing Manager, and members of the Falls Prevention Task Force, played vital roles in planning corrective measures.

Goal Statement

Reduce the fall rate on Unit 1A at Acme Hospital, calculated as falls per 1,000 patient days.

Participants

The intervention was spearheaded by a dedicated team of professionals:

• Jane Doe, BSN, RN, CMSRN: Nursing, Clinical Nurse III, Unit 1A

• John Smith, MSN, RN: Nursing, Nurse Manager, Unit 1A

• Falls Prevention Task Force and Nursing Educators

  (I am not going to list hypothetical names here, but you would list all the individuals who played critical roles in identifying, planning, executing, and monitoring the work. Remember to include their names, disciplines, titles, and departments.)

Description of the Intervention(s)/Initiative(s)/Activity(ies)

The intervention process at Acme Hospital’s Unit 1A began in February 2023, when the Falls Prevention Task Force conducted a comprehensive root cause analysis. This involved frontline clinical nurses, including Jane Doe, BSN, RN, CMSRN, Clinical Nurse III, and aimed to identify critical gaps in hourly rounding and patient education practices. The analysis highlighted key areas for improvement and laid the foundation for evidence-based interventions supported by current research (Smith et al., 2022; Johnson & Lee, 2021).

In March 2023, the unit launched a new hourly rounding protocol. This protocol was guided by evidence (Smith et al., 2022) and collaboratively developed by the Falls Prevention Task Force. Nursing educators and frontline clinical nurses from the task force played crucial roles in training all nurses and care partners to implement these new practices effectively. This initiative focused on increasing the frequency and consistency of patient interactions to proactively address potential fall risks.

By April 2023, intensive training sessions on fall prevention strategies were underway. Led by nursing educators (consider listing names here if appropriate), these sessions emphasized improving staff awareness and adherence to safety protocols. The educators provided hands-on guidance and competency checkoff, ensuring that all staff members were fully prepared to execute these strategies in their daily practice.

In May 2023, the focus shifted to patient education, implementing an evidence-based program (Johnson & Lee, 2021) aimed at raising awareness of fall prevention among patients and their families. Nursing educators and clinical nurses from the Falls Prevention Task Force led the program, which empowered patients to take an active role in their own safety, fostering a collaborative patient and family-centered approach to fall prevention.

From May to June 2023, the team monitored fall rates weekly and made necessary adjustments to the rounding protocol based on feedback from frontline clinical nurses and care partners. This iterative approach ensured that the interventions were continually refined and adapted to meet the evolving needs of the unit, with the Falls Prevention Task Force overseeing these efforts to maintain momentum and effectiveness.

Outcome(s)

By July 2023, post-intervention data showed a substantial reduction to 1 fall per month, effectively achieving the goal. This positive trend continued through September, with an average of 0-1 falls per month. The intervention not only enhanced patient safety but also reinforced nursing excellence in achieving Acme Hospital’s organizational goals. To sustain these outcomes, continuous monitoring and monthly review meetings are held, led by the Falls Prevention Task Force.

• Graphed Data Table here

References: (hypothetical, of course)

Smith, A., Johnson, B., & Williams, C. (2022). Implementing hourly rounding to reduce patient falls: A systematic review. Journal of Nursing Practice, 15(3), 123-134. https://doi.org/10.1016/j.jnpr.2022.01.005

Johnson, D., & Lee, E. (2021). The impact of patient education on fall prevention in hospitals: Evidence-based practices. International Journal of Healthcare Improvement, 28(4), 456-467. https://doi.org/10.1002/ijhi.2021.1128

Summing It Up and Moving Forward

Drafting a Magnet exemplar is an iterative process for both EOs and non-EOs. Don’t expect to get it perfect on the first try. Stay focused on your data and goals, and refine the narrative as needed.

In an upcoming post, we’ll cover editing strategies to ensure your final draft is polished and ready for submission. Remember—when it comes to Magnet, excellence is non-negotiable. 🙂

If you have questions or need clarification, don’t hesitate to reach out. And if you have your own tips and techniques for drafting EO exemplars, I’d love to hear from you!

Until next time, onward and upward, Magnet colleagues!

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