For better patient outcomes, new knowledge must be transformed into clinically useful forms, effectively implemented across the entire care team within system context  and measured in terms of meaningful impact on performance and health outcomes. The entry of EBP onto the health care improvement scene constituted a major paradigm shift .This shift was apparent in the way nurses began to think about research results. The way nurses framed the context for improvement and the way nurses employed change to transform health care (Stevens,Kathleen.,May 2013). It is important to understand the local health care system prior to implement the change so they can better educate the staff and prepare the facility to transform to the change with  all supplies for the EBP.