In recent years, nursing scholars have developed many Evidence Based Practice (EBP) models to improve the implementation of research findings into nursing practice. Application of evidence based models can reduce the complexity of the challenge of transforming evidence into clinical practice. Effective EBP models to guide translation of research into practice are vital to avoid failure accompanied by a costly investment of time and resources. There are many EBP models, at times it can be confusing for clinicians to select an appropriate EBP model due to excess availability of models and various approaches in implementing EBP. Therefore, it is important for clinicians to aware about these models and select an EBP model that best-fit for their …show more content…
This model has five levels, includes (1) assessment of organizational culture and readiness for implementation in the healthcare system; (2) identification of strengths and barriers of the EBP process in the organization; (3) identification of EBP mentors; (4) implementation of the evidence into organizational practice; and (5) evaluation of the outcomes resulting from the practice change. The key feature of this model is the use of an EBP mentor to improve nurse’s skills and knowledge in implementing EBP projects effectively. In addition, scales are developed based on this model to assess the organizational culture and measurement of effectiveness of EBP in practice. ARCC model has been used in hospitals and community practice settings to improve practice outcomes. To implement evidence based practice in St. Louis Hospital, ARCC model is ideal as it identifies organizational strengths and barriers to EBP and identifies mentors to work with direct care workforce, which is an important step in developing an organizational culture that supports EBP (Schaffer, Sandau, & Diedrick, …show more content…
This model is represented as an algorithm and has defined decision points and feedback loops. The first decision is to make sure the problem or knowledge focused trigger is a priority for the organization. A positive decision leads to formation of a team to search, critique and synthesize the literature. The second decision evaluates the capability of evidence to change practice. If the evidence is inadequate, the practitioners will select a choice between conduction of research or utilization of alternative types of evidence. When the evidence is adequate, a pilot of the change is conducted and evaluation of the pilot leads to the third decision point, whether to adopt the change in practice. Ongoing evaluation of the change and dissemination of the results are the components of this model. Many practitioners without prior EBP experience found Iowa model algorithm was helpful. This model utilizes input from the entire organizational system, including the patient, providers, and organizational infrastructure and includes nurses in each steps (Schaffer, Sandau, & Diedrick,
Evidence-based practice (EBP) entails the use of explicit, reliable, and judicious evidence to make effective decisions about the care of patients. This DNP student will introduce EBP with the IOWA model. The IOWA model applies to this DNP proposal. The IOWA model is an EBP applicable in healthcare setting and implemented to show the applicability of evidence in nursing to give the best outcome. Doody and Doody (2011) noted that the IOWA model focuses on problem-focused triggers and knowledge in undertaking quality improvement study. The steps involved include topic selection, team formation, evidence retrieval, grading evidence, developing an EBP evidence, implementation of EBP, and evaluation of the progress. These steps apply to this DNP proposal, showing best practices, guidelines, procedures, and policies
Evidence Based Practice (EBP) is useful to practice because it aids practitioners development and widens their knowledge and insight, therefore enhancing the experience of the practitioner. This ensures that the best quality of care is given to the patient (Duncan, 2006).
The Iowa model is the research translation model that was developed by Marita G. Titler, PhD, RN. The Iowa model depicts the importance of a holistic approach to the entire health care system spanning from the provider to the patient, and the supporting infrastructure; all of which utilize the latest research to guide and shape what is known as “best practice.” The Iowa model is designed in such a way that it aids the NP through engagement in problem identification and solution development as it relates to incorporating evidence findings into practice.
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
EBP is a method of finding evidence and using it in practice: as Blaney (1986) states, it is used to assess health, plan, implement, and evaluate individualized care (p.182). Finotto et al. (2013) breaks EBP down into steps as follows: Formulate a research question; find the most relevant evidence; appraise evidence; integrate evidence with clinical experience and patient values to make practical decisions; and evaluate the outcome (p.460). Carrazzone (2009) and Moch et al. (2010) argue that didactic components with EBP integrated into the education are believed to be beneficial to studen...
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
Burns, N., & Grove, S. K. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders
Evidence-based practice is important to consider when researching for interventions, further knowledge, or help to guide a new idea in the health professions. Evidence-based practice is comprised of three significant concepts: respect and awareness for the targeted population’s values, previous clinical practice or experience with that population, and systematic research to establish a better understanding of what is already known about the study’s focus. These concepts are all taken into consideration when designing and conducting a study because it provides a more valid and credible source for others.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
The Johns Hopkins Nursing Evidence-Based Practice Model provides nurses with a system to formulate a practice question, appraise both research and non-research evidence, and to develop recommendations for practice (Dearholt & Dang, 2012). This model guides nurses through the evidence-based research process with ease and minimal difficulty using a problem solving approach.
The Ottawa Model of Research Use has been used in nursing to explore the barriers and supports for adoption of new innovations, describe the process of adoption of new innovation or guidelines, implement a new research based guidelines, and to increase evidence-based practice across health-care settings. The feasibility and effectiveness of using the OMRU in actual practice contexts was supported by findings from a number of studies (Scott et al., 2009; Hogan & Logan, 2004; Logan, Harrison, Graham, Dunn, & Bissonnette, 1999; Stacey, Pomey, O'Conner, & Graham, 2006).
Cullum, N. Ciliska D. and R. Haynes, Marks (2008;) Evidence – based Nursing: An Introduction.
A nurse is required to be responsible and accountable, updating their knowledge and skills continually by using professional development (NMC, 2008). This requires an understanding and awareness of what Evidence Based Practice (EBP) is. Nurses make decisions about their practice using EBP. Ways in which this can be utilized in the improvement of knowledge and practice is, for example; using established sources of evidence. (Marquis et al, 2012). Nursing practice uses a range of approaches to improve and develop patient care so as a nurse the skill of evaluating sources of evidence is necessary to do this effectively. Evidence is gathered through research. EBP consists of research, data collection and nursing research. When searching for evidence to improve your practice the range of information available is vast. A distinction must be made between evidence that is reliable under scrutiny and evidence which is unreliable. Fitzpatrick (2007) asserts that, to understand evidence based practice is to understand where to look and what credible sources of evidence are. Sources that are credible include information published by a government body or academic institution. Fitzpatrick (2007) recommends identifying key aspects of information of the source to ascertain its credibility, for example; who is the author and where did the research come from? Is the article true or false and how long has it been there? (Fitzpatrick, 2007). A journal article is scrutinised by peers and editors and publishers, whereas in contrast a piece of information on a general website could be published by any person and make any claim and may not pass scrutiny under a peer review. Databases like EBSCO for example have articles that are peer reviewed.
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.