Evidence Based Practice
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2020NSG5111EBPModelsWeek4PPT.pptEVIDENCE-BASED PRACTICE (EBP) MODELS AND ORGANIZATIONS
NSG 5111
Evidence and Practice
Nova Southeastern University
Ron and Kathy Assaf College of Nursing
EBP MODELS
- Purpose
- Assists in implementing research findings into nursing practice
- Breaks down complex challenges of translating research into nursing practice
- Promotes return on investment of time and resources
- Provides a belief system to guide practice
EVIDENTIARY DYNAMICS
- EBP is dynamic and not linear
- Fluid, mobile and portable
- Continuous and unending movements
- Interacting elements that constantly change
- Provide a basis for good practice, creativity and innovation
Characteristics:
ORGANIZATIONS AND CULTURES OF CARING
- Culture of innovation
- Innovation not driven from the top down
- Narrow locus of control
- Open to ideas, questioning, and diving deeper into issues
- Operating in a constantly changing environment
- Associational thinking and planning to seek out uncommon and unrelated partners, issues, and processes that result in new knowledge and different perspectives
MODELS TO CHANGE PRACTICE
- Identify a problem
- Identify stakeholders
- Identify a practice change
- Identify potential barriers
- Provide strategies to disseminate the change
- Evaluate the practice change
- Identify strategies to sustain a change
Commonalities of Models:
STEVENS STAR MODEL OF KNOWLEDGE TRANSFORMATION
Five steps:
- Discover new knowledge
- Summarize the evidence after a rigorous review
- Translate evidence for nursing practice
- Integrate changes into practice
- Evaluate practice and its contribution to quality improvement
JOHNS HOPKINS NURSING EVIDENCE-BASED PRACTICE MODEL
- 3 major steps: Practice evidence translation
Identify practice question using a team approach
Collect the evidence
Translate evidence into practice
STETLER MODEL
- Practitioner model
- Critical thinking focus
- Utilization of research findings
- Five phases:
- Preparation
- Validation
- Comparative/evaluative decision making
- Refinement
- Evaluation
IOWA MODEL
- Represented as an algorithm
- Defined decision points and feedback loops
- Incorporates input from entire organization
- Nursing is involved in each step
- Advocates a pilot step before full implementation of practice change
ADVANCING RESEARCH AND CLINICAL PRACTICE THROUGH CLOSE COLLABORATION (ARCC)
- Five steps:
Assessment of organizational culture and readiness for implementation
Identification of barriers and strengths of the EBP organization process
Identification of EBP mentors
Implementation of evidence in to organizational practice
Evaluation of outcomes from practice change
ITEMS TO CONSIDER WHEN CHOOSING A MODEL FOR YOUR ORGANIZATION
- Fit with quality improvement programs
- Ease of implementation by educators
- Likelihood of success
- Cost and time expenditures
- Patient population
- Inter- and Intra- disciplinary focus
- Practicality and sustainability
- Engagement of stakeholders
REFERENCES
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia: WoltersKluwer/Lippincott Williams & Wilkins.
