A Model for Change to Evidence‐Based Practice

Associate Professor, West Virginia University School of Nursing, Morgantown, WV.
Journal of Nursing Scholarship (Impact Factor: 1.64). 11/1999; 31(4):317 - 322. DOI: 10.1111/j.1547-5069.1999.tb00510.x
Source: PubMed


Purpose:To describe a model that guides nurses and other healthcare professionals through a systematic process for the change to evidence-based practice. The tremendous increases in clinical research and accessibility to research findings have prepared the way for the paradigm shift from traditional and intuition-driven practice to evidence-based practice. Although several models have emerged to guide practitioners in research utilization, practitioners continue to have difficulty synthesizing empirical and contextual evidence and integrating evidence-based changes into practice.Organizing Framework:The model is based on theoretical and research literature related to evidence-based practice, research utilization, standardized language, and change theory. In this model, practitioners are guided through the entire process of developing and integrating an evidence-based practice change. The model supports evidence-based practice changes derived from a combination of quantitative and qualitative data, clinical expertise, and contextual evidence.Methods:The model was developed using sources identified on searches of Medline, CINAHL, and systematic reviews available on the Internet. Review topics were focused on evidence-based medicine and nursing, research utilization, and change process. Other sources included clinical expertise and quality-improvement information.Conclusions:Practitioners need skills and resources to appraise, synthesize, and diffuse the best evidence into practice. Patient outcomes must reflect discipline-specific and interdisciplinary accountabilities. Collaboration between researchers and practitioners within and among disciplines will enhance the diffusion of evidence-based practice innovations.

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    • "A pivotal methodology, so-called evidence-based design, promotes the integration of traditional, predominantly intuition-driven architectural design with evidence-based decisionmaking (Brown & Ecoff, 2011; Rosswurm & Larrabee, 1999). The approach involves systematically tracking, comparing, and evaluating the consequences of architectural decisions on human health and wellbeing, so that the obtained findings can be applied to the design of new buildings (Lohr, 2004). "
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    ABSTRACT: Through advances in production and treatment technologies, transparent glass has become an increasingly versatile material and a global hallmark of modern architecture. In the shape of invisible barriers, it defines spaces while simultaneously shaping their lighting, noise, and climate conditions. Despite these unique architectural qualities, little is known regarding the human experience with glass barriers. Is a material that has been described as being simultaneously there and not there from an architectural perspective, actually there and/or not there from perceptual, behavioral, and social points of view? In this article, we review systematic observations and experimental studies that explore the impact of transparent barriers on human cognition and action. In doing so, the importance of empirical and multidisciplinary approaches to inform the use of glass in contemporary architecture is highlighted and key questions for future inquiry are identified.
    Frontiers in Psychology 09/2015; 6. DOI:10.3389/fpsyg.2015.01381 · 2.80 Impact Factor
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    • "In the design process, it is necessary to determine which sources are scientifically valid and how the resulting findings are to be incorporated best into design decisions. The methodology of EBD offers a way of acquiring, appraising, weighting, and transferring the existing evidence into design practice (Rosswurm & Larrabee, 1999). This circular process is shown in Figure 1. "
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    ABSTRACT: Keywords: Decision-making, evidence-based design, methodology.
    HERD 03/2013; 6(2):119-27. DOI:10.1177/193758671300600210 · 0.39 Impact Factor
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    • "Third, following the initial review of the literature, two models described in the Melynk and Fineout-Overholt text (Ciliska et al. 2011) were excluded and one other model was added. An EBP change model, originally developed by Rosswurm and Larrabee (1999), was excluded because it was not predominant in current literature. Also, the Clinical Scholar Model (Schultz 2005) was excluded because it focused on strategies for preparing nurses to conduct and use research. "
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    ABSTRACT: AIM: To provide an overview, summary of key features and evaluation of usefulness of six evidence-based practice models frequently discussed in the literature. BACKGROUND: The variety of evidence-based practice models and frameworks, complex terminology and organizational culture challenges nurses in selecting the model that best fits their practice setting. DATA SOURCES: The authors: (1) initially identified models described in a predominant nursing text; (2) searched the literature through CINAHL from 1998 to current year, using combinations of 'evidence', 'evidence-based practice', 'models', 'nursing' and 'research'; (3) refined the list of selected models based on the initial literature review; and (4) conducted a second search of the literature on the selected models for all available years to locate both historical and recent articles on their use in nursing practice. DISCUSSION: Authors described model key features and provided an evaluation of model usefulness based on specific criteria, which focused on facilitating the evidence-based practice process and guiding practice change. IMPLICATIONS FOR NURSING: The evaluation of model usefulness can be used to determine the best fit of the models to the practice setting. CONCLUSION: The Johns Hopkins Model and the Academic Center for Evidence-Based Practice Star Model emphasize the processes of finding and evaluating evidence that is likely to appeal to nursing educators. Organizations may prefer the Promoting Action on Research Implementation in Health Services Framework, Advancing Research and Clinical Practice Through Close Collaboration, or Iowa models for their emphasis on team decision-making. An evidence-based practice model that is clear to the clinician and fits the organization will guide a systematic approach to evidence review and practice change.
    Journal of Advanced Nursing 08/2012; 69(5). DOI:10.1111/j.1365-2648.2012.06122.x · 1.74 Impact Factor
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