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This article describes a new model and process to implement evidence-based practice. This model builds on concepts from the Iowa Model of Evidence-Based Practice, the Stetler model, and Rosswurm and Larrabee's model. The new model focuses on the centrality and involvement of staff nurses in making evidence-based practice clinical changes. Two figures illustrate the model and the implementation process. A detailed case study based on the model is included. Barriers identified in the literature review are addressed in the case study. Implementation of this model creates opportunities for staff nurses to recognize ownership of their practice and their role in changing the practice setting to a culture of evidence-based practice.
J Contin Educ Nurs 2008;39(4):166-172.
The principles of evidence-based practice provide a pathway to expert nursing. Evidence-based practice in nursing is defined as "integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families and communities who are served" (Sigma Theta Tau International, 2004, p. 69). All aspects of nursing, from education to management to direct patient care, should be based on the best evidence available at the time.
Transitioning this goal from theory to practice began with a partnership between a local university and a large regional medical center located in the northwest United States. A joint faculty appointment for nursing research at the medical center was established. The initial agenda was implementation of evidence-based practice to foster a cultural change in the medical center. This article describes a new theoretical model designed to guide change for evidence-based clinical nursing practice. Staff nurses are central to the model.
Beneficial outcomes of the implementation and use of evidence-based practice by staff nurses include increased ability to offer safe, cost-effective, and patient-specific interventions. Critical thinking skills and leadership abilities can also grow because of the use of evidence-based practice; it is a way for staff nurses to become involved in change and regain ownership of their practice. On the other hand, barriers exist inhibiting implementation of evidence-based practice at the level of staff nurse. Among those barriers are management styles and individual learning styles. It was a perceived lack of staff nurses' involvement in the evidence-based practice process and their subsequent lack of ownership that provided the impetus...