Evidence-Based Practice Models to Guide Practice Change.

Posted: November 4th, 2022

Evidence-Based Practice Models to Guide Practice Change.


Facilities often establish EBP committees who are charged with reviewing the evidence and proposing changes in practice. The committees work together to synthesize plans and engage in activities that will promote EBP in to promote quality care and patient safety. Integral to developing and implementing EBP change are the need to utilize effective communication and leadership skills. Evidence-Based Practice Models to Guide Practice Change.
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The required readings this week provide an overview of different evidence-based models that can be used as guides to conducting evidence-based practice change projects. In the videos for Week 5, an EBP committee discusses the evidence-based steps they used to identify, assess, propose and implement a practice change in their work settings. For this Discussion, you will see a committee as it completes it work. There are two scenarios with the videos. In the first one, there are issues that develop that need to be resolved. You will be asked to pause the video and identify how you would address the conflict that seems to be developing over the EBP change. In the second scenario, you will see how leadership skills are utilized to help focus the committee on the EBP project. Evidence-Based Practice Models to Guide Practice Change.
After viewing the videos, use the flow chart in the [Iowa EBP Model to Promote Quality Care] found in the Grove, Gray, and Burns text, to discuss how closely the EBP project did or did not follow each step in this model. In what ways do you think the project would have benefited from implementing any step(s) that were not used?

Evidence-Based Practice is the most recommended approach for improving the quality of healthcare service delivery and reducing healthcare-related costs. There are numerous models and theories used in translation of EBP research findings to clinical practice. However the Iowa EBP model is the most preferred since it promotes interdisciplinary collaboration and is easy to understand. The 1st step in the model is the identification of a problem-focused trigger which may require an EBP change (Nilsen, 2015). The EBP project followed this step by identifying the clinical problem that most of the patients in the home health agency were developing pressure ulcers post-hospitalization. The team unanimously agreed that the clinical problem of pressure ulcers was a priority since the number of those affected gradually increased. This is the second step in the Iowa EBP model. Evidence-Based Practice Models to Guide Practice Change.

The 3rd step is the formation of a team comprising of members tasked with the role of developing, evaluating and implementing the change. As highlighted by Michele, Laffoon & Kealey, 2015), this team should comprise of staff within and outside a nursing unit for interdisciplinary collaboration. The EBP project implemented this step by forming a team of five professionals: a nurse manager, a staff nurse in a home health agency, a certified wound care nurse and a nurse manager of a wound care center in a local hospital. The team gathered and analyzed research materials linked to the desired practice change which included clinical practice guidelines and wound care articles. However, the team failed to formulate a PICOT question that could guide the search for literature on studies related to the clinical problem. According to Buckwalter et al., (2017), if the team would have implemented this step, the search strategy for literature could have a much clear focus. Evidence-Based Practice Models to Guide Practice Change.

The 5th step which involves critiquing and synthesizing literature was followed by the EBP team to determine whether the proposed change was scientifically sound. Steps 6, 7 and 8 which are: deciding if research found is adequate to implement a practice change, change implementation to a pilot program and evaluation of outcomes respectively, were not followed. As supported by Schaffer, Sandau & Diedrick (2013), failure to follow these steps resulted to the team’s inability to ascertain whether the findings from the literature were effective or not effective in solving the clinical problem. Evidence-Based Practice Models to Guide Practice Change.

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