Name
Chamberlain University
NR-451: RN Capstone Course
Prof. Name
Date
Nursing models and frameworks of evidence-based practice (EBP) have been developed significantly since the late 1950s and 1960s. This development was spearheaded by nursing researchers and theorists aiming to create structured approaches for enhancing nursing practice (American Nurses Association [ANA], 2015). Nursing models are crucial as they provide guidance and a foundation for implementing changes in practice, specifically tailored to nursing contexts and settings (Chamberlain College of Nursing, 2018). Stevens (2013) identifies 47 prominent EBP models in the literature, offering a wide array of options for practitioners. Among these, the ACE Star Model of Knowledge Transformation is notable; it represents an interdisciplinary method for translating research into practice and achieving quality improvement (Schaffer, Sandau, & Diedrick, 2013). This model illustrates five sequential steps that range from identifying a problem or new knowledge to evaluating the outcomes after implementation.
Another significant model is the Johns Hopkins Nursing Evidence-Based Practice Model, which emphasizes translating research into practice through a collaborative team approach. This model comprises three main steps: formulating a clinical question, collecting relevant evidence, and translating that evidence into practice (Dearholt & Dang, 2012). These models underscore the importance of structured frameworks in nursing to enhance clinical decision-making and improve patient outcomes.
The strength of evidence is paramount in translating research into practice, as robust evidence is essential for optimizing patient outcomes. Systematic reviews provide a comprehensive evaluation of existing evidence, allowing for the integration of reliable data into clinical practice. Research serves as the most trustworthy source of knowledge regarding effective strategies that can influence a patient’s health status positively (Stevens, 2013). The ANA (2015) states that while outcomes are crucial, the EBP process itself offers a structured framework for clinicians and researchers to formulate relevant, patient-centered, and testable questions. This approach ultimately yields vital practice guidelines that enhance patient care. It is essential that research is derived from credible sources, as patient safety hinges on the delivery of care based on the best available evidence. Nursing practices should evolve continually, adapting to new evidence, technological advancements, and the unique challenges presented by patients.
Integrating evidence-based practice with patient and family preferences is critical in providing patient-centered care, a core competency of the baccalaureate nursing curriculum. Nurses must consider patient preferences alongside EBP when making clinical decisions. Systematic reviews empower nurses with evidence that supports effective interventions, yet implementing EBP can sometimes be challenging due to differing patient preferences. Factors such as religion, cultural beliefs, and personal experiences may create barriers to the adoption of evidence-based care. It is essential to acknowledge a patient’s spirituality, cultural background, decision-making processes, and health-related values when planning care that incorporates EBP.
When there is a discrepancy between evidence-based practice and patient or family preferences, the nurse’s responsibility is to educate the family about the evidence supporting recommended interventions, enabling them to make informed decisions regarding care. Nurses should validate any concerns raised by patients and families and provide clear explanations of available options. It is also crucial to encourage patients to articulate their understanding of the information provided (Smirnoff, 2013). Engaging patients in discussions about the advantages and disadvantages of treatments and relating them to their values is an important part of shared decision-making. While EBP forms the foundation of safe care, the ultimate decisions in care plans should reflect patient preferences.
American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD.
Chamberlain College of Nursing. (2018). NR439 Capstone Course. Lesson week 1. Downers Grove, IL: DeVry Education Group.
Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209.
Smirnoff, L. (2013). Incorporating patient and family preferences into evidence-based medicine. BMC Medical Informatics and Decision Making, 13(Suppl 3), S6.
Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), manuscript 4. https://doi.org/10.3912/OJIN.Vol18No02Man04
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