NRS 490 Week 3 Essay Discussion
Methods for Evaluating Evidence
The fifth step of the process, outcome evaluation, attempts to interpret the results and evaluate the outcomes of the applied evidence (intervention). Outcome measures may be psycho social (quality of life, improved patient perception of care, reduction in depressive and anxiety symptoms), physiologic (improved health, reduced complications), or functional improvement. Evaluation of the process and the results may occur through peer assessment, audit, or even self reflection. Depending on the type of outcomes achieved, it may be possible to compare the outcomes of a study with similar outcomes on a local, regional, national, or international level.NRS 490 Week 3 Essay Discussion
The Iowa Model for Evidence-Based Practice to Promote Quality Care has been revised to better address sustainability of EBP, inter professional change implementation, and patient-eccentric care for clinicians at all levels of practice, guiding them through a team-based, multi phase process. The path initiates with a clinical “trigger” that identifies a clinical problem and includes decision points with evaluative feedback loops when recommending and implementing practice change. The model phases are inter professional team formation; evidence review, critique, and synthesis; change implementation through piloting; ongoing evaluation; and outcomes dissemination.
The Advancing Research and Clinical Practice Through Close Collaboration Model is for building resources and training mentors who play a central role in facilitating and sustaining EBP at the point-of-care and throughout the organization. The model has seven steps: cultivating a spirit of inquiry; asking a PICOT-formatted clinical question; collecting, critically appraising, and integrating the best evidence with clinical expertise and patient preferences; and evaluating and disseminating practice change outcomes.
The Johns Hopkins Nursing Evidence-Based Practice Model is clinician-focused, allowing rapid and appropriate application of current research and best practices. It simplifies the EBP process and cultivates a culture of care based on evidence. It has three overall steps: practice question, evidence, and translation. Its directive tools are intended for practicing clinicians working individually or in a group to address clinical inquiries.NRS 490 Week 3 Essay Discussion
The Promoting Action on Research Implementation in Health Services (PARIHS) Framework has been revised into the integrated or i-PARIHS framework. The framework refers to evidence-based change as practice innovation. It contends the core elements of successful implementation of practice innovation is dependent on the type of evidence available, context of the care setting, and how the process is facilitated. The framework emphasizes the importance of taking into consideration the perspectives of all recipients of the intended change.
Although these are just a few models for translating evidence into practice, each outlines and promotes the need for a systematic approach to evidence-based change. Each addresses the sustainability of EBP through organizational culture change, stakeholder engagement, comprehensive literature review and appraisal, barrier identification, impact evaluation, and outcomes dissemination. Regardless of the preferred model, the EBP process should tell the story of how a problem was recognized, addressed, and improved, and that story should be shared.NRS 490 Week 3 Essay Discussion