Just as it takes time for research findings to be published, so too, does it take time for research to find its place in the practice setting. And, sometimes, research findings may never be completely integrated in practice (Dontji, 2007). The Institute of Medicine published a report that it takes almost two decades to implement a research finding into clinical practice (Schaffer, Sandau, & Diedrick, 2013). There are many challenges that EBP has to overcome for it to be fully embraced by the nursing community (Dontji, 2007). Thus, to facilitate the goal of the EBP movement to hasten the time with which research findings get integrated into patient care (Bauer, 2010), several models have been developed that are designed to shorten the gap-time …show more content…
This model employs the problem-focused triggers that lead the staff to take a closer look at and question the current practice to see if there is something that can be improved. Just like the other models for EBP, the Iowa model consists of several steps – each of which helps the nurses translate research findings into clinical practice and refine patients’ outcome (Brown, …show more content…
In forming a team, the best approach would be the bottom-up to show that the change is initiated by the staff rather than by management (Doody, n.d.). However, management has a key role in the team by providing necessary resources and managerial involvement and support ( Doody, n.d.).
Step 3: Search for Evidence
In searching for evidence, the best places to search for relevant data are through electronic databases, e.g., CINAHL, Medline, Cochrane, Web of Science, and Blackwell Synergy (Doody, n.d.). It is at this stage that most nurses may need help on how to navigate and search these databases.
Step 4: Determine if there is Sufficient Research Base In evaluating the evidence, the relevance of the evidence can be graded on its effectiveness, appropriateness, and feasibility. If it has been deemed that there is sufficient research base the next step is pilot the change in practice.
Step 5: Setting the Timeline and Evaluation After the practice change has taken place, an evaluation of the practice change is undertaken and the outcomes of the practice change are shared with others in the form of an article or poster (Bauer,
An example of evidence based practice would be to find relevant studies for a specific topic area being researched. For example, to find the research paper titled ‘The efficiency of cotton cover gowns in reducing infection in nursing Neutropenic patients,’ the journal in which the article was published in this case, The International Journal of Nursing, would need to be found. Medline, an online database would be one method of finding this. A list of relevant search terms would then need to be researched by using the PICO Framework, this limits the search to only relevant items and ensures that a well built clinical question will then be formulated (Drummond,1998).
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.
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.
EBP incorporates an organized search for the best up to date empirical research, with clinical expertise, to answer a focused clinical question concerning a patient or a quality improvement issue in the clinical environment. The focused question addresses the patient population, area of interest, comparison intervention or control group, and desired outcome (PICO). Using this question style saves the nurse time and will yield the best available relevant evidence.
Quality of care and patient outcomes rely heavily on practice based on evidence found in systematic reviews of randomized-control trials. While administration often-times implements core measures that involve EBP in their regulations, it is ultimately the nurse’s responsibility to include EBP into their care of patients. Nurses have an obligation to include EBP into their care because “it leads to the highest quality of care and the best patient outcomes” (Melnyk & Overholt, 2015). The nurse leaders really have a responsibility here because it is their responsibility to stress the importance of EBP as well as reviewing research to determine the best possible findings to implement into their unit’s care. Careful monitoring must be performed to assure compliance because “despite the multitude of positive outcomes associated with EBP and the strong desire of clinicians to be the recipient of evidence-based care, an alarming number of healthcare providers do not consistently implement EBP” (Melnyk & Overholt, 2015). Often times, I find seasoned nurses act putout with anything that changes their methods of care. The important thing to remember is that seasoned nurses, while often-times set in their ways, are great nurses and presenting EBP findings and their success during implementation will keep them involved with EBP because they ultimately want to do what’s best
..., Watson, and Westley Planned Change Model consists of seven phases which the change is planned, implemented, and the evaluated (Yoder-Wise, 2011). The outcome of this issue is an ongoing process; the need has been submitted to the nurse practice council which has submitted the issue to the hospital policy board for implementation into policy (T. personal communication, April 2, 2014).
Research based practice is arguably the hallmark of professional nursing and is essential for high quality clinical and cost effective nursing care (ICN 2009)
Burns, N., & Grove, S. K. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders
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
For nursing, research has played a major role in the way clinical practice is done. Research has allowed nurses to provide appropriate care to patients. It allows them to perform their job by providing them the tools and information they need in order to make the decisions on the concerns for caring the patient (Polit & Beck, 2006). Moreover, research can also take focus on the workers themselves in order to improve the practice both on a professional and personal level. An example of a study conducted by King, Vidourek, and Schweibert of University of Cincinnati created a study to determine if there is a correlation between ...
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).
Evidence - Based Nursing, An introduction (2008, p.1) “ At is core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”.
The team needs to establish a policy and procedure which would be a step toward an organizational structure. This process will be a framework that defines formal reporting relationships between the different levels of management. For example, the guidelines can be used as a protocol of the process managers needs to follow to assist their employees through the change process. The team also needs to provide in house trainings for all departments so employees can be aware and implement the new changes. The training will increase skill level and improve staff productivity.