Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

 

 

 

Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

 

 

 

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Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

For the appropriate implementation of evidence-based practice intervention, certain change models or frameworks have been proven to be effective in guiding the implementation process (Camargo et al., 2018). For my evidence-based project proposal, I will utilize the Iowa model of change to guide the incorporation of effective evidence-based fall prevention interventions in medical-surgical wards. The purpose of this paper is to illustrate the stepwise application of the Iowa model in implementing the proposed evidence-based practice intervention.

The Iowa Model

            The Iowa model of change was developed in the 1990s to serve as a guide for nurses in the utilization of study findings to come up with EBP interventions aimed at promoting the safety and quality of care provided at the University of Iowa Hospitals and Clinics (Cullen et al., 2022). This model serves as a pathway in promoting effective implementation of EBP, by first identifying a problem, then utilizing research finding to come up with the most applicable potential solutions, and finally implementing the new intervention. The change model also plays a significant role in helping clinicians draw their focus on knowledge and problem-focused triggers when questioning if the use of research can help identify problems in current practice and solve the problems effectively. For my project proposal, the Iowa model will play a significant role in helping clinicians identify the impact of falls in medical-surgical wards and come up with the most effective EBP intervention to help reduce fall incidences and promote patient outcomes (Tucker et al., 2019). The model will also provide a stepwise guide to promote the effective implementation of my proposed EBP intervention in clinical practice.

Steps of the IOWA model for Evidence-Based Practice

            With the adoption of the Iowa model, the first step in promoting EBP is identifying a trigger precipitating the need for an EBP change. The trigger can be either problem focuses or knowledge-based. The following step involves evaluation of the priority of the identified change trigger or problem for the practice or organization (Tucker et al., 2021). Once the significance of the identified problem has been considered a priority, the following step involves selecting a team of professionals who will be involved in the development, implementation, and evaluation of the EBP change. In the next step, the change leader will come up with an outline that will help guide the research aimed at identifying the most effective solution. The research findings or study outcome are synthesized and analyzed in the fifth step, to decide on which EBP is going to be implemented to solve the problem. The selected team members analyze and confirm that the selected EBP is the most applicable and effective in solving the problem. Once the team members have agreed on a given EBP, the implementation process can then begin. Once the EBP has been implemented, the last step involves evaluation of the entire implementation process and outcome in clinical practice to identify strengths and areas of weakness which must be addressed to optimize the outcome.

Application of the Iowa Model

            For my project proposal, the application of the Iowa model helped in identifying a problem-focused trigger for change in the first step, which is increasing incidences of falls in the medical-surgical ward and how it negatively impacts patient outcomes (Haskell, 2022). In the second step, it was confirmed that this is a priority problem that requires immediate attention by identifying the most effective EBP to solve the problem entirely. The third step involved coming up with a team of professionals to guide the EBP comprising of the nurse leader, registered nurses, and physicians among other clinicians. The team carried out extensive research on the most effective way to reduce the incidences of falls in hospitals. It was discovered that Fall Tailoring Interventions for Patient Safety (TIPS) have proven to be effective in reducing incidences of falls in the medical-surgical wards (Tzeng et al., 2021). Further analysis of this intervention was conducted in the following step to ensure that there is substantial evidence supporting its use in clinical practice. Once the intervention was agreed upon, an implementation plan was developed to promote the incorporation of Fall Tailoring Interventions for Patient Safety (TIPS) into practice. Once the EBP has been implemented, the evaluation process will follow to identify areas of weakness that need to be addressed.

Conclusion

Evidence-based practice has helped introduce new interventions into clinical practice promoting the safety and quality of care provided. For this project, the Iowa model was used to guide the implementation of EBP in reducing the incidences of falls in the medical-surgical ward. The proposed EBP is the use of Fall Tailoring Interventions for Patient Safety (TIPS).

 

 

References

Camargo, F. C., Iwamoto, H. H., Galvão, C. M., Monteiro, D. A. T., Goulart, M. B., & Garcia, L. A. A. (2018). Models for the implementation of evidence-based practice in hospital based nursing: A narrative review1. Texto & Contexto-Enfermagem, 26.

Cullen, L., Hanrahan, K., Edmonds, S. W., Reisinger, H. S., & Wagner, M. (2022). Iowa Implementation for Sustainability Framework. Implementation Science, 17(1), 1-20. https://doi.org/10.1186/s13012-021-01157-5

Haskell, D. (2022). Implementing an Evidence-Based Fall Prevention Plan to Address Unintentional Hospital Falls on a Medical/Surgical Unit.

Tucker, S., McNett, M., Mazurek Melnyk, B., Hanrahan, K., Hunter, S. C., Kim, B., … & Kitson, A. (2021). Implementation Science: Application of Evidence‐Based Practice Models to Improve Healthcare Quality. Worldviews on Evidence‐Based Nursing, 18(2), 76-84.

Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., … & Cullen, L. (2019). Patient, nurse, and organizational factors that influence evidence‐based fall prevention for hospitalized oncology patients: An exploratory study. Worldviews on Evidence‐Based Nursing, 16(2), 111-120.

Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C. (2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality, Publish Ahead of Print.

Appendix

Conceptual Map: Application of Iowa Model for EBP