Stetler's Model of Research Utilization

EBP Nursing Models

• EBP models assist nurses in implementing evidence-based practices in specific settings.

Common Steps in EBP Models

• Identification of a clinical problem or potential problem
• Gathering of best evidence
• Critical appraisal and evaluation of evidence
• Implementation of the practice change
• Evaluation of practice change outcomes

Stetler's Model of Research Utilization

• Helps practitioners assess how research findings and other relevant evidence can be applied in practice.

• Examines how to use evidence to create formal change within organizations and individual practice.

• Designed to promote and facilitate critical thinking about the application of research findings in practice.

• 5 sequential phases:

  Preparation

  • Define the purpose and outcomes of the project
  • Search, sort, and select sources of research evidence
  • Consider external and internal factors that influence potential application
  • Affirm priority of the perceived problem

  Validation

  • Conduct a critique of each source of evidence focusing on its soundness for potential application in practice

  Comparative Evaluation and Decision-Making

  • Synthesize findings and determine the desirability and feasibility of applying findings from sources to clinical practice
  • Consider fit to setting, feasibility, and current practice

  Translation/ Application

  • Confirm how the findings will be used
  • Formulate the operational details of the project and implement them

  Evaluation

  • Evaluate the application from a multitude of perspectives

Iowa Model of EBP

• Developed in the 1990s to promote quality care through Research Utilization (RU)

• Provides guidance for nurses in making decisions about practice

• Begins with a trigger to explore possible changes to practice:

  Knowledge-Focused Trigger

  • Emerges from awareness of innovative research findings (e.g. new research, new guideline published)

  Problem-Focused Trigger

  • Rooted in a clinical or organizational problem (e.g. risk management data, financial data, QI data)

• 3 critical decision points:

  1st Decision Point

  • Decide whether the problem is a sufficient priority for the organization
  • If yes, form a team; if no, consider other triggers (EBP topics/areas)

  2nd Decision Point

  • Decide whether there is a sufficient research base
  • If yes, formulate the EBP guideline, collect baseline data, conduct a pilot test, evaluate the process and outcomes, and modify the plan as indicated
  • If no, base practice change on other types of evidence

  3rd Decision Point

  • Decide whether the change is appropriate for adoption in practice
  • If yes, implement the change, evaluate process and outcomes, and disseminate results to other settings
  • If no, proceed to seek another trigger and evaluate service quality

The Johns Hopkins Nursing EBP Model

• Resulted from the collaborative work of leaders in nursing education and practice at Johns Hopkins Hospital and the Johns Hopkins University School of Nursing