¶ … Joanna Briggs Institute Model (JBIM) Advancing Research Clinical Practice Through Close Collaboration Model (ARCC). The JBIM a strong focus changing practice-based global scientific evidence, includes patient preferences, professional experience judgment. Reflect on the following discussion questions

I think both the Joanna Briggs Institute Model (JBIM) and the Advancing Research and Clinical Practice Through Close Collaboration Model (ARCC) are interesting models to study in conjunction, given that both place a strong emphasis on the social aspects of change. Rather than focusing on individuals alone, they acknowledge that changes in healthcare behavior take place within a lived, social context. However, the ARCC model allows for the fact that even though changes may have their roots in social and organizational factors, the individuals behind the change must be willing to make lifestyle alterations. It is not enough to merely logically convince someone of change: change must be generated in a manner to make the change agents psychologically and spiritually willing to change. JBIM also notes that evidence-based practice recommendations do not 'make change' themselves but must be supported institutionally.

I think that tracking organizational 'outcomes' and constantly judging them as part of the change process is important, although some organizations may have more formal review structures to do so, such as hospitals. Having some formal 'change policy' standard operating procedures and structure is wise for all institutions.

Q2. As a nurse, I too have often found that qualitative research studies are often the most useful to me on a day-to-day basis in structuring my workday and making decisions about how to practice, although I think experimental and evidence-based studies are also necessary to show in a more data-driven method which is a best practice for an institution. That is why I like the JBIM...

I also think that the model's creator was very interested in the perspective of the individual nurse and diverse cultures of practices and settings, and did not confine her perspective to a single worldview. However, even when reviewing qualitative studies, it is important to do so with rigor, which is why the Stetler Model is so useful, given that it provides a systematic method of evaluating research quality. Preparation, validation, comparative evaluation and decision-making, translation and application followed by evaluation are easy, simple, and clear steps to validate research. This method is helpful for nurses who need to quickly sift through research results. Having a step-by-step method is also vital to developing the types of critical thinking skills that are so necessary for all nurses to have as part of their technical toolkits.
Q3. I do agree with your assessment regarding the utility of the ARCC method -- it can be easy to focus on individuals too much and to forget about the need to alter the organizational structures to support the change. Within every organization there will be change supporters and naysayers -- the critical thing is to create an institution to support change overall and to create standard operating procedures so that an evidence-based practice culture is second nature.

One organizational problem that nurses do frequently encounter is a lack of necessary resources and an under-appreciation of the administration for the need for such resources. Administrators can often be 'pennywise but pound-foolish' which results in underestimating the financial drain in the long-term of not investing in education in the short-term. Taking time out of the workday to educate nurses can result in better patient outcomes overall. The goal is fluency in evidence-based practice. Simply because a nurse has an advanced degree does not mean she cannot benefit from additional training, particularly because nurses are…