A Model for Change to Evidence‐Based Practice

Associate Professor, West Virginia University School of Nursing, Morgantown, WV.
Journal of Nursing Scholarship (Impact Factor: 1.61). 11/1999; 31(4):317 - 322. DOI: 10.1111/j.1547-5069.1999.tb00510.x
Source: PubMed

ABSTRACT 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.

  • Actas Dermo-Sifiliográficas 09/2011; 102(7):545-546.
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    ABSTRACT: Background A collaborative project was initiated in Norway between a university college and a hospital in order to improve RNs' and nursing students' research utilization in clinical placements. This paper describes the model (CMBP) that was developed, its first application, and evaluation. Aim The evaluation aimed at describing nurses' and students' experiences of the CMBP related to collaboration, facilitation, learning, and impact on nursing care. Methods Thirty-eight students from the second and third year of nursing education, and four nurses answered questionnaires with closed and openended questions. In addition two of the nurses wrote diaries. Data were subjected to qualitative and quantitative analysis. Findings Almost all participants reported that collaboration between nursing college and nursing practice had been beneficial. Most students and all nurses reported about valuable learning, increased understanding of research utilization, and improved quality of nursing care. Both students and RNs recommended the CMBP to be used in all clinical placements to support academic learning and increase research utilization in clinical practice. Conclusion Despite study limitations the findings indicate that the CMBP has a potential to be a useful model for teaching RNs' and students EBP. However, further refinement of the model is needed, followed by a more comprehensive implementation and evaluation.
    Nurse education in practice 01/2013;
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    ABSTRACT: Objective: To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred). Methods: The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology. Results: A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician. Significance of results: Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.
    Palliative and Supportive Care 10/2013; · 0.98 Impact Factor


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