In this discussion post, the committee’s approach presented in the video will be evaluated according to the Iowa Model, and additional steps will be offered for the improvement of evidence-based policies. Evidence-based practice (EBP) committees are often established by healthcare agencies to ensure patient safety and promote quality care through implementing and sustaining EBP change in clinical procedures (Cullen et al., 2017). The committees responsible for the implementation of EBP changes require effective leadership and communication. The Iowa Model of EBP provides a direction for healthcare facilities and helps nurses to expand their EBP practice (Gray et al., 2017). In the video, the nurse manager discusses the issue of the increase in the number of homebound patients developing pressure areas (Laureate Education, Inc., 2016). Therefore, the committee needs to apply an evidence-based approach to develop the policy and procedures addressing the problem of pressure ulcers and improving the quality of care and patient safety.
The first step in the Iowa EBP Model is the identification of problem-focused or knowledge-focused triggers, which emphasize the need to make changes in clinical practice. The healthcare agency followed this step and defined a problem-focused trigger associated with the increase in pressure ulcers in homebound patients. The trigger was considered a priority for the agency, so the management moved to the next step of the model. Karen, the nurse manager, formed a team to conduct, synthesize, and evaluate research for its implementation in evidence-based clinical practice (Gray et al., 2017). Jan, the nurse manager from the wound care center, prepared a flip chart dedicated to the prevention of pressure ulcers. Danielle, a certified wound care nurse, argued that only industry standards, such as national guidelines from wound care associations, could have been considered while developing the solution to the problem. Rick, a staff nurse, suggested that a literature search should have been done to expand the knowledge and review the existing guidelines. Since the research base was not sufficient, the committee did not proceed to the next steps, including searching for other types of evidence, piloting and establishing the change in practice, and disseminating the results.
However, the aforementioned steps are essential for the development of evidence-based policies and can benefit the project in several meaningful ways. Examining other types of evidence, such as case reports, expert opinion, scientific principles, or theories, would allow the agency to standardize the practice via a strong knowledge base (Laureate Education, Inc., 2009). The measure might decrease variation in patient outcomes, improve the confidence of nurses, and optimize the use of resources. Moreover, nursing is a constantly evolving discipline, so the research of different types of evidence provides up-to-date knowledge and appropriate EBP guidelines. Piloting the change in practice is another crucial step in the Iowa EBP model. It involves the engagement of patients and the verification of their preferences, which help to design effective evaluation and implementation plans (Cullen et al., 2017). Establishing the change is also important, as it creates awareness, accumulates knowledge, promotes action and integration. Finally, disseminating the results is the key step in the model, which requires the agency to share the results of the project among its employees and with other organizations. The step would allow the agency to improve nursing knowledge and promote the EBP approach in different areas of clinical practice.
References
Cullen, L., Hanrahan, K., Farrington, M., DeBerg, J., Tucker, S., & Kleiber, C. (2017). Evidence-based practice in action: Comprehensive strategies, tools, and tips from the University of Iowa hospitals and clinics. Sigma Theta Tau International.
Gray, J. R., Grove S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Elsevier.
Laureate Education, Inc. (Producer). (2016). EvidEvidence-basedctice committee 1 [Video]. Author.
Laureate Education, Inc. (Producer). (2009). Research and scholarship for evidence-based practice: Synthesizing the research [Video]. Author.