The Pulse | Tuesday, July 25, 2017

Advancing Your Practice with Evidence-Based Model Toolkits

SGNA Editor

As an integral part of the nursing profession, you have likely used — or at least heard about — the various evidence-based practice models to assist your career. As we’ve covered in past blog topics on The Bottom Line, evidence-based practice is especially important in the field of GI. We recently took a closer look at two of the most frequently used models, and how these different models can act as valuable tools in your profession.

Model 1: The John Hopkins Nursing Evidence-based Practice Model

In the John Hopkins Nursing Evidence-based Practice Model, or JHPM, the three foundational prongs of evidence-based practice remain:

1. Clinical practice/expertise
2. Best research and evidence
3. Patient values and preferences

Like most other models, the JHPM is a problem-solving approach to clinical decision-making within a healthcare organization and integrates scientific evidence with best available experiential evidence — what a mouthful! Simply put, the JHPM works in a step-by-step phase system coined as “PET” with an over-arching goal “to ensure that latest research findings and best practices are quickly and appropriately incorporated into patient care.”

PET stands for:

Practice question

The practice question allows you to develop and refine your question and your team as your needs see fit.

Evidence

The evidence phase is a time to search, appraise, summarize, and synthesize both internal and external sources of such evidence.

Internal

• Culture
• Environment
• Equipment/supplies
• Staffing
• Standards

External

• Accreditation
• Legislation
• Quality measures
• Regulations

Translation

Translating your work consists of creating and implementing an action plan, evaluating outcomes and disseminating findings.

Within the PET phases, you’ll encounter what is both research and non-research:

Research

• Experimental
• Quasi-experimental
• Non-experimental
• Qualitative

Non-Research

• Organizational experience
  • Quality improvement
  • Financial data
• Clinical expertise
• Patient preference

While the JHPM is a more in-depth example of a standard evidence-based practice model, other models are less extensive but offer similar results. For example, the Iowa Model to Improve Quality Care, or the Iowa model, is a theoretical model that is specifically geared toward the nursing profession.

Model 2: The Iowa Model to Improve Quality Care

Similar to the JHPM, the Iowa model has three distinct goals:

1. To ensure better patient outcomes
2. To inform decision, actions and interactions
3. To deliver best possible care

A high standard of quality care is a dominant theme of practice in the Iowa model. This model promotes a continuous review and evaluation of best practices with no necessary relationship between quantity and quality.

Whereas the JHPM is a complex, multi-step model with endless variables and differentiating factors, the Iowa model differs in that it is a simpler seven-step model. While there are, in fact, more steps to this model, they are to-the-point and do not separate further than the step itself. This circular step process consists of the following:

1. Selection of topic
2. Forming a team
3. Evidence retrieval
4. Grading the evidence
5. Developing and EBP standard
6. Implement the EBP
7. Evaluation

In Conclusion

You can’t go wrong in selecting an evidence-based practice model to better your nursing practice. Determining what you need to evaluate, and the ease of doing so, will depend on your practice, team and needs. Access the John Hopkins Evidence-based Practice Toolkit for Nursing and the Iowa Model to Improve Quality Care.