Week 1: Types of Nursing Models and Frameworks of EBP 2 2 unread replies. 2 2 replies. What are some of the models and frameworks of EBP currently in use? How does the strength of the evidence determine translation into practice? Why is it important to integrate both evidence-based practice and patient and family preferences? What is the nurse’s responsibility when EBP and patient and family practice do not match?
There are several models and frameworks of evidence-based practice (EBP) currently in use in the field of nursing. These models and frameworks provide a systematic approach to integrating the best available evidence with clinical expertise and patient preferences to guide nursing practice.
One commonly used model is the Iowa Model of EBP. This model consists of five stages: (1) problem identification, (2) evidence search and appraisal, (3) translation into practice, (4) implementation, and (5) evaluation. The Iowa Model emphasizes the importance of collaboration between researchers, clinicians, and administrators in the implementation of EBP.
Another popular model is the John Hopkins Nursing Evidence-Based Practice Model. This model incorporates six steps: (1) cultivating a spirit of inquiry, (2) asking clinical questions, (3) searching for and collecting evidence, (4) critically appraising the evidence, (5) integrating the evidence with clinical expertise and patient values, and (6) evaluating the outcomes of the practice change. The John Hopkins Model places emphasis on the role of the nurse as a critical thinker and lifelong learner.
In addition to these models, there are also several frameworks that guide the implementation of EBP. One such framework is the Promoting Action on Research Implementation in Health Services (PARIHS) framework. The PARIHS framework highlights three key elements that influence successful implementation of EBP: evidence, context, and facilitation. It emphasizes the importance of tailoring the evidence-based intervention to fit the specific context and providing appropriate support for its implementation.
The strength of the evidence plays a crucial role in determining its translation into practice. In EBP, evidence is often graded based on its quality and strength. High-quality evidence, such as systematic reviews and meta-analyses of randomized controlled trials, is given more weight in guiding practice than lower-quality evidence, such as expert opinion or case studies.
The strength of the evidence determines the level of confidence that can be placed in its findings. Strong evidence that supports a particular practice guideline or intervention is more likely to lead to changes in practice, as it provides a solid foundation of scientific evidence. On the other hand, weak or conflicting evidence may require further research or evaluation before it can be confidently implemented in practice.
It is essential to integrate both evidence-based practice and patient and family preferences because it promotes patient-centered care. EBP provides a scientific foundation for nursing practice, ensuring that interventions are based on the best available evidence. However, patient and family preferences must also be taken into account as they play a significant role in decision-making and treatment outcomes.
By combining evidence-based practice with patient and family preferences, nurses can provide care that is tailored to the individual needs and values of each patient. This approach promotes shared decision-making, enhances patient satisfaction, and improves health outcomes.
When EBP and patient and family preferences do not match, the nurse has a responsibility to engage in shared decision-making and communication with the patient and family. The nurse should discuss the available evidence, present the pros and cons of different options, and help the patient and family make an informed decision based on their values and preferences.
In cases where there is a significant discrepancy between EBP and patient and family preferences, ethical considerations must be taken into account. The principle of beneficence, which emphasizes promoting the best interests of the patient, may require the nurse to prioritize and follow evidence-based practice.
However, the principle of respect for autonomy also plays a crucial role in decision-making. If the patient has the capacity to make decisions, their preferences should be respected even if they do not align with current evidence-based guidelines. In such cases, the nurse should document the discussions and decisions made, ensuring that the patient has received adequate information and understanding of the potential risks and benefits of their choices.
In conclusion, there are various models and frameworks used in evidence-based practice in nursing. These models provide a systematic approach to integrating evidence, clinical expertise, and patient preferences into nursing practice. The strength of the evidence determines its translation into practice, with higher-quality evidence carrying more weight. It is crucial to integrate both evidence-based practice and patient and family preferences to promote patient-centered care. When EBP and patient and family preferences do not match, nurses have a responsibility to engage in shared decision-making and consider ethical principles such as beneficence and respect for autonomy.