Evidence-based practice (EBP) results from the integration of available research, clinical expertise, and patient preferences to individualize care and promote effective care decision-making. Oncology nurses are perfectly positioned to be adopters and promoters of EBP, resulting in practice change for improved quality and safety.
The impact of EBP on nursing and patient outcomes is clearly evident. Many organizations have developed competency-based, nurse-led EBP programs that are redesigning care delivery to increase the effectiveness and efficiency of interventions while reducing costs and safety risks. For EBP integration to be successful and sustainable, a culture of EBP readiness must exist through ongoing leadership support, EBP resource availability, and adoption of an EBP implementation framework.
In recent years, nurse scientists have developed several EBP models to help demystify the process of translating research into clinical practice. Although the models include varying levels of detail, they share the following basic phases of the EBP process.
• Ask: Identify a clinical problem.
• Attain: Review relevant literature.
• Appraise: Critically appraise evidence.
• Apply: Evaluate the need for practice change and potential implementation.
• Assess: Evaluate outcomes.
Organizations must adopt the EBP model that best fits their context of care, aligns with improvement goals, addresses priority clinical problems, and guides a systematic and evaluative approach to collaborative practice change.
Common EBP Models
The Iowa Model for Evidence-Based Practice to Promote Quality Care has been revised to better address sustainability of EBP, interprofessional change implementation, and patient-centric care for clinicians at all levels of practice, guiding them through a team-based, multiphase 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 interprofessional team formation; evidence review, critique, and synthesis; change implementation through piloting; ongoing evaluation; and outcomes dissemination.