Evidence-based practice models for nurse practitioner development

EBP

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Evidence-based practice

As a nurse practitioner who works in a diverse range of settings spanning from hospitals to nursing homes to clinics, evidence-based practice is part of my daily routine. Virtually all of the facilities at which I work prioritize evidence-based practice given that the facilities' scarce resources means that time, energy, and money cannot be wasted on untested treatments or treatments based merely upon 'hunches.' Evidence-based practice is based upon demonstrated benefits from particular approaches to patient care in recent literature. I strive to remain current in my own knowledge of EBP, frequently reviewing nursing journals and articles online as well as the websites of professional associations so I am aware of new treatments, approaches, and evidence of what works and what does not work in the field of nursing.

Because I practice in various healthcare environments, I do not have a specific, unified EBP model which I use under all circumstances. However, one which I have discovered and which I would like to use more often is that of the ACE Star Model of Knowledge Transformation. The model is relatively straightforward and flexible and can be tailored to the needs of the patient -- a critical component of EBP when it is applied in a situational fashion. EBP must be both flexible and rigorous. "The Star Model depicts various forms of knowledge in a relative sequence, as research evidence is moved through several cycles, combined with other knowledge and integrated into practice. The ACE Star Model provides a framework for systematically putting evidence-based practice processes into operation" (ACE Health Star Model, 2013, UTHCSA).

The model contains five stages: "1) discovery research, 2) evidence summary, 3) translation to guidelines, 4) practice integration, and 5) process, outcome evaluation" (ACE Health Star Model, 2013, UTHCSA). During the discovery phase, the nurse engages in preliminary research. Then comes the most difficult phase: reviewing the research so the nurse can "synthesize the corpus of research knowledge into a single, meaningful statement of the state of the science" and generate new knowledge (ACE Health Star Model, 2013, UTHCSA). From this knowledge that has been generated from high-quality evidence, clinical practice guidelines (CPGs) are issued which reflect the "benefits, harms, and costs of various decision options" and maximize benefits and minimize harms (ACE Health Star Model, 2013, UTHCSA). Practice integration involves making a meaningful change to integrate the EBP into the standard operating procedures of the organization, followed by evaluating the extent to which it was successful in that particular setting (ACE Health Star Model, 2013, UTHCSA).