EVIDENCE-BASED PRACTICE

Evidence-based practice is the integration of clinical expertise, patient values, and the best research evidence to facilitate clinical decision making. There is increasing recognition that practice change should be guided by models or frameworks. The DNP is in the ideal position to evaluate the need for change and propose interventions or solutions based on evidence.

There are seven commonly used models for facilitating change to EBP.

For this discussion:
1.Choose two of the models to compare: •Iowa Model of Evidence-Based Practice.
•The Model for Evidence-based Practice Change.
•The Clinical Scholar Model.
•John Hopkins Nursing Evidence-Based Practice Model.
•Stetler Model of Research Utilization.
•The Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model.
•The Promoting Action on Research Implementation in Health Services (PARIHS) Framework.

2.Compare the two selected models of EBP in terms of: •Components.
•Simplicity or complexity.
•Ease of use by staff nurses.
•Applicability to use in systems.
•Applicability to use with individual patients.
•Strengths and limitations of the models.

3.Consider these questions in your comparison: •Are there specific situations in which one model or the other is most appropriate?
•Which model would be most appropriate in the work setting in which you practice? Why?

While the concept of EBP has strong proponents, it also has its detractors. Consider one of the positions below in relationship to your model and setting:
•EBP ignores patient or community input.
•EBP stifles creative problem solving and clinical judgment.
•EBP emphasizes quantitative research and randomized controlled trial (RCT).
•EBP disregards clinical expertise.
•EBP supports generalizing results to populations not studied.
•EBP is simply another term for research utilization.

Consider the position carefully and argue that position effectively and convincingly in your post (even if you do not personally hold that opinion). Your initial post should demonstrate clarity of thought and precision in writing. Support your discussion with at least one reference other than the required reading.
Compete the following:
References:
•In your Melnyk and Fineout-Overholt text, Evidence-Based Practice in Nursing and Health Care: A Guide to Best Practice:
◾Read Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry.”
◾Read Chapter 13, “Models to Guide Implementation of Evidence-Based Practice.”

Remember that you can access these readings on iGuide or by opening your downloaded VitalSource Bookshelf application.

•To learn about the ACE Star Model of Knowledge Transformation, read Heye and Stevens’s 2009 article, “Using New Resources to Teach Evidence-Based Practice” from Journal of Nursing Education volume 48, issue 6, pages 334–339.
•For general information about EBP: ◾Read the 2007 article, “Sigma Theta Tau International Position Statement on Evidence-Based Practice February 2007 Summary” from Worldviews on Evidence-Based Nursing, volume 5, issue 2, pages 57–59.

•To learn about the Iowa Model of Evidence-Based Practice, read the Titler et al. 2001 article, “The Iowa Model of Evidence-Based Practice to Promote Quality Care” from Critical Care Nursing Clinics of North America, volume 13, issue 4, pages 497–509.

Use the Internet to:
•Select and review at least one tutorial from the list of Web sites in box 14.2 of Chapter 14, “Tutorials on Evidence-Based Practice,” in your Evidence-Based Practice in Nursing and Health Care text.
•Explore the following Web sites: ◾Agency for Healthcare Research and Quality (AHQR).
◾Centre for Evidence-Based Medicine
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