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     Change is a challenging phase to adapt and overcome. Change comes with perseverance, dedication and persistence. Nursing continues to evolve and change over time. “Evidence-based practice (EBP) is a life-long problem-solving approach to the delivery of health care” and improving patient outcomes and work environment (Melnyk, Gallagher-Ford, Long & Fineout-Overholt, 2014). Effectively disseminating my evidence-based change proposal would be to use both internal and external methods. One internal method would be to use the Emergency Department Management Team, including my manager, assistant manager, director and nursing educator to promote my idea of improving policies and practices in place for workplace violence. The use of effective leaders can lead a project proposal to success and with the support and the best intentions of staff to create a healthy and safe emergency department.

     External methods would include presenting to the Emergency Nurses Association to gain their support and enhance ideas of improving workplace violence. Using an organization that is specific to the Emergency Department can help promote ideas of change and can help facilitate changes within a department. 

     Both internal and external methods provide support and guidance to such an important topic. Having both internal and external support will help facilitate the best patient outcomes and the safest environment for employees. These methods also allow the spreading of evidence, information and presenting information to both groups will help facilitate an increase in interest.

     Communication strategies will be different because internal groups will be more patient and employee based where external will include state and regional levels of data to determine the need for change among different facilities. The internal board of the Emergency Department and the hospital will be more interested in its employees and safety whereas an external board like a national organization (ENA) will want to know if this is a facility problem or a national problem.

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