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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    • "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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    • "The original conception of EBM was defined as a process oriented model (Evidence-Based Medicine Working Group, 1992; Gambrill, 2007; Walker, Briggs, Koroloff, & Frieson, 2007). EBM was later expanded as EBP, which eventually made its way into the field of social work, as well as into other professions such as nursing and speech therapy (Rosswurm & Larrabee, 1999; Upton, 1999; Vallino–Napoli & Reilly, 2004). EBP has been defined in various ways by different scholars. "
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    ABSTRACT: In this study the researchers examined the knowledge, skills, and use of Evidence-Based Practice in a sample of social workers from different practice settings. Using an electronic survey, data were collected from a group of social work practitioners (N = 200). Participants in their 30s and 40s demonstrated the most knowledge and use of Evidence-Based Practice. In addition, a high percentage of social workers reported to be knowledgeable about social work research databases; a smaller percentage actually used online resources in their practice. Through this study the researchers add to what is currently known about social workers' perceptions, knowledge, and use of Evidence-Based Practice.
    Journal of Evidence-Based Social Work 07/2011; 8(4):349-68. DOI:10.1080/15433710903269149
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