CHAPTER 13 Building an Evidence-Based Practice

Nurses have been Actively Involved in conducting research. commit Reviews

their strong support for practice. Reviews These activities ment to EBF, the
which could be by the Iowa agency. This was the model EBP Practice provide
direction for the development of EBP in a clinical 13-7). In a health. and
revised in 2001 (Figure care there are that initiate the need for change, and
the focus should always be to the make changes based on the best research
Reviews These triggers be and evolve from data management, process
improvement data. benchmarking of data, financial da research findin and
problems, triggers can also be change in agencies or standards and
expanded evaluated f care, or from the organizational committee. The
triggers are pri and prioritized based on the needs of the clinical agency. If a
trigger is an agency is formed to search for the best evidence to manage the
clinical concern (titres et al, 2001).

in some situations, the research evidence is inadequate to the make changes

in practice, and addi tional studies are needed to Strengthen the knowledge
base. Sometimes the research evidence can be combined with other sources
of knowledge (eg theories, scientific principles, expert opinion, and case
reports) to provide fairly strong evidence for use in developing research-
based protocols for practice. Research-based protocols are structured
guidelines for implementing inter ventions in nursing practice that are based
on current research evidence. The strongest evidence comes from
systematic reviews that include meta-analyzes of RCTs. However, meta
syntheses, mix methods systematic reviews, and individual Also studies
provide important evidence for changing practice. The levels of research
evidence Described in Chapter 1 (see Figure 1-3) and also pre sented inside
the front cover of this text .

research-based evidence based protocols particular unit and then evaluated

to Determine the impact on patient care. If the outcomes are favorable from
the pilot test, the change would be made in practice and monitored over
time to 2001). If an impact on the agency staff costs, and patient and family
care based on the agency strongly supports the use of Towa models,
implements patient the best research evidence, and monitors changes in
practice to Ensure quality care, the agency is promoting EBP

Application of the Iowa Model of evidence-Based Practice Preparing to use

research evidence in practice raises some important questions. Which
findings tcsearch are ready for use in clinical practice? What are the most
effective strategies for implement ing research-based evidence-based
protocols ar guidel ines in a clinical agency? What are the out comes from
using the research eidence in practice? Do the risk management of data, the
data process improvement, benchmarking data. or financial support of data
making the change in practice based on the research evidence? Is the
research-based change proposed an agency priority gest that effective
strategies for using research evidence in practice will tequire mu approach
that takes into consideration the evidence available, attitudes of the
practicing Nunes philosophy and national organizational standards and
guidelines (ANO the organization's 2014; Brown, 2014: Melnyk & Fineout-
Overholt, 2011 The loint Commission, 2014). In this sec tion, the steps of the
Iowa model of Titet eta. 2001) guide the use of a rescarch hospital-based
intervention to Facilitate EBP