Evidence-based practice occupies a progressively more prominent place in the healthcare system improvement despite various barriers on individual and organizational levels. Becoming evidence-based practitioners is highly beneficial for clinicians and their patients and should be encouraged (Melnyk & Fineout-Overholt, 2019). Furthermore, the existing barriers are not insurmountable as an array of models and conceptual frameworks were developed to improve the healthcare system based on reliable scientific data. Such frameworks function as guidelines that employ contemporary research to refine or create new patient care practices, allowing health care professionals to integrate the best and most reliable evidence in their professional activities.
As EBP gained more scholarly attention, a variety of models or conceptual frameworks were originated to facilitate EBP adoption into health care facilities. Among the models, the Stetler Model of Research Utilization, ARCC Model, PARIHS framework, Clinical Scholar Model, Stevens Star Model of Knowledge Transformation, and Iowa Model seem to be the most widely-recognized ones (Melnyk & Fineout-Overholt, 2019). Each of the models provides clinicians with the theoretical basis for modifying their clinical and administrative practice to improve patient outcomes, enhance the quality of care, and reduce costs. The enlisted models are designed to facilitate the adaptation of empirical findings into practice on the basis of specific steps or phases. Although all models have their positive sides, the Iowa model represents a particular interest due to its pragmatism and in-depth systematic approach.
The Iowa Model appears to be widely utilized in the current healthcare system to achieve improvement and promote a higher quality of care since it effectively facilitates and systemizes the implementation of research findings into practice. The model is used as a pragmatic guide to healthcare professionals’ decision-making in their administrative and clinical activities (Melnyk & Fineout-Overholt, 2019). Firstly, the Iowa Model prompts clinicians to detect a practical problem from which research questions are derived. Secondly, the priority of the problem is established; if it is high, then a team is formed, and evidence is collected, synthesized, and analyzed. Depending on whether the evidence is sufficient, a research or pilot study is conducted. Consequently, a pilot study is supposed to help alter clinical procedures. Lastly, pilot study findings are assessed and potentially adopted in practice, creating a change (Melnyk & Fineout-Overholt, 2019). Feedback loops at each step of this multiphase model seem to be its primary advantage. Overall, the model can be used to optimize clinical and administrative practice.
The model under consideration appears to be efficient in facilitating change in various studies. For instance, Robinson (2016) applied the Iowa Model as a theoretical foundation in a project designed to improve the perioperative hand-off communication. The researcher selected this model specifically due to its capacity to facilitate organizational change (Robinson, 2016). The need for constant patient information communication during the perioperative period was the problem that triggered the need to alter existing practice. Consequently, an interdisciplinary team was organized to restructure the perioperative communication process based on the evidence extracted from an extensive literature review. The processes that the team used to restructure perioperative communication wholly align with the Iowa Model. The model is used from the outset to identify a triggering issue until the final step when it is applied to evaluate the practice change data (Robinson, 2016). Hence, in the research study, the Iowa Model served as a cornerstone for identifying a problem, analyzing it, and implementing change into clinical practice to resolve it.
The Iowa Model is also employed as a conceptual framework in a study designed to promote patient safety by tailoring clinical alarms for an emergency department’s needs in Honolulu, Hawaii. Particularly, such a phenomenon as the alarm fatigue in emergency departments became the focus of improvement project that Fujita and Choi (2019) undertook and described in their article. Sensory desensitization has dangerous implications for clinicians working in emergency departments since it entails a higher likelihood of missing an alarm. The Iowa Model was applied to identify knowledge-focused triggers regarding alarm fatigue in emergency departments and, consequently, implement the necessary research-based changes to reduce alarm fatigue (Fujita and Choi, 2019). Another aspect of the model, such as the formation of a team, was also included in the study, as nursing and emergency department specialists provided input into implementing the clinical alarm-related change. Fujita and Choi (2019) finalized their research by piloting the modification in practice, an essential step in the model. It appears that in this study, the Iowa Model is used to a significant extent, incorporating the model’s major steps.
In conclusion, EBP conceptual frameworks are beneficial for clinicians since they provide health care workers with a systematic approach to implementing change. The Iowa Model is of particular interest as it seems to be one of the most widely recognized and adopted. By using the two overviewed articles as examples, the model’s fundamental role in improving clinical and administrative practice is established. Although to slightly different extents, the Iowa Model is employed in the studies to guide the search and resolution of problems that potentially diminish care quality.
References
Fujita, L. Y., & Choi, S. Y. (2019). Customizing physiologic alarms in the emergency department: A regression discontinuity, quality improvement study. Journal of Emergency Nursing, 1-13. Web.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
Robinson, N. L. (2016). Promoting patient safety with perioperative hand-off communication. Journal of PeriAnesthesia Nursing, 31(3), 245–253. Web.