Models for Facilitating Change to Evidence-Based Practice in Nursing

Facilitating Change to Evidence-Based Practice in Nursing: The Iowa and Stetler Models The Iowa Model of Evidence-Based Practice Developed by Marita Titler to promote quality healthcare, the Iowa Model is a source of guidance for nurses and clinicians when making decisions that have an impact on patient outcomes. It infuses research into practice by using a multidisciplinary team approach to address a number of topics that are clinically important (Melryk and Overholt, 2011). This model is represented as an algorithm that has well-defined feedback loops as well as decision points.

The very first decision has got to do with whether a particular problem is a priority to an organization and the second decision considers how adequate the evidence is to change practice. After the conduction of a pilot of change, on the basis of the available evidence, subsequent decisions are made on whether to adopt it or not, which is followed by frequent evaluations (Schaffer, Sandau and Diedrick, 2013).

The Stetler Model of Evidence-Based Practice The Stetler Model of Evidence-Based Practice (EBP) enables practitioners assess how research findings can be applied in practice. It helps nurses use evidence to make formal changes in organizations and enhances reflective practice and critical thinking (Melryk and Overholt, 2011). The model integrates evidence informed practice and research use, which enhances the application of a specific research. Using this model, research use is categorized into instrumental, conceptual and symbolic use. It has six phases.

The said phases include: preparation, validation, comparative evaluation, decision making, translation and application and evaluation (Melryk and Overholt, 2011). A comparison of the Iowa and Stetler methods In the designing and implementing of an EBP project, the Stetler Model relies on the perspectives of individual clinicians while the main focus of the Iowa model is on institutional EBP efforts (Melryk and Overholt, 2011). Education components are not specified by the Iowa model, which makes it difficult for nurses to interpret research.

The Stetler Model has evaluation tools that make guideline development easier, which makes it easier for staff nurses to use. It provides an understandable guide for implementation and makes use of practitioner expertise and evidence. Although the Iowa model incorporates decision points and feedback loops, most nurses do not prefer it over the Stetler model. In terms of simplicity, the Iowa model can be termed as simple as it only involves making direct decisions as opposed to the Stetler Model, which has six phases.

However, the Stetler method is applicable to both individual patients and systems, as it uses operational definitions and change strategies that provide detailed guidance for practice change (Schaffer, Sandau and Diedrick, 2013). The strengths and limitations of the two models and their applicability One of the key disadvantages to the Iowa model is that it makes it difficult for nurses to interpret results and also makes it particularly hard to implement changes in their practice.

The fact that it does not specifically give a detailed flow of enlightening staff on the practice change is also detrimental (Schaffer, Sandau and Diedrick, 2013). Multiple reports have demonstrated successful application of this model in a wide range of scenarios. The model also takes into consideration input from the whole organizational system and ropes in nurses at every turn. The Stetler model is prone to interpretation mistakes and experimental information from different professionals has to be treated with caution.

Its main advantage, however, is that it takes characteristics of individual users into account and uses comprehensive guides for implementation. The Stetler model is applicable to both individuals and organizations. It makes available critical guidance as well as expertise for EBP practitioners with the relevant experience in diverse settings. The Iowa model is also useful in a variety of settings, but it is best suited for acute care in large organizations. Which model is more appropriate? The Iowa Model is the most appropriate for our organization.

The model comes in handy in multiple settings and will make implementation for practice change easier. According to Schaffer, Sandau and Diedrick (2013), a good application of the Iowa Model would be in the implementation of a critical care.