NR439 Evidence Based Practice

1. Rogers’ diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models presented such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based intervention in clinical practice.

 

2. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model.

Chosen Model: The Iowa Model of Evidence-Based Practice (EBP)

Chosen Organization: Harris Health System

Chosen Topic: School Based Intervention in Asthma Prevention

Evidence-based Practice (EBP) improves the quality of patient care and assist in controlling the escalating healthcare costs. Iowa Model is an evidence based research model that assists the nurses and the other healthcare professionals to translate the research findings into clinical practice and thereby improving the overall health outcome (Brown, 2014).

                                                                                             

                                                   Figure: the Iowa model of evidence based practice to promote quality care

                                                                                          (Source: Brown, 2014)

The first step of the model is to identify a problem that can be resolved via EBP. Then the problem is specifically selected from the risk management data or identification of the patient’s problem. In this study, the asthmatic problems that are associated with the schoolchildren are selected for the EBP on the basis of the identification of the clinical problems (Sleath et al., 2014).  The next step is determination step where the chronicity of the problem is determined based on its occurrence. The problems, which have higher cost, are given higher priority. Like in this case, the anti-inflammatory medications that are used to treat asthma are too costly for the poor and minority families (Blaakman, Cohen, Fagnano & Halterman, 2014). Once the priority has been determined, the next step deals with proper evaluation and implementation of the EBP change. The composition of the team will be framed according to the need of the problem. The team must also consist of stakeholders residing outside the healthcare or nursing unit. In this study, the team has been framed with the registered nurses along with the schoolteachers who reside outside the bracket of the healthcare professionals. 

After the formation of the team, the next step is collection of relevant research paper related to the desired theme of practice change.  This step is also a crucial, cannot be avoided in any occasion, and involves framing of a good question via the application of PICOT method. The results generated from the PICOT method will be useful in conducting the literature search. In this case study, the PICOT question is, Does effective school-based interventions, in comparison to present practices, decrease the rate of frequent visits by the paediatric population presenting with asthma to the healthcare clinic by more than 10% within six months?

After gathering of the available literatures, critically analysis of the article follows in order to determine the relevancy of the study and the intervention. Not every article published with the relevant keywords has the desired outcome or qualifies with the required scientific merit. In this case, the selection of the articles are based on certain inclusion and exclusion criterion.

 

Source: Created by author

After the critical evaluation of the articles, the team where the majority must be nursing professionals must sit together. They must discuss and then come to a conclusion regarding whether there are relevant research articles selected for the study has significant information and matches all the criteria of the research. If the criterions are meet then the pilot practice must be initiated. However, if adequate research studies are absent then initiatives must be taken for actual research study. Here the adequate data are gathered from the research articles, which lead to the successful implementation of the plan. Next step is the implementation of the plan into the pilot practice change. If the intervention is found to be successful then it must be applies to the selected organization. So the appropriate information is utilized to control asthma in school-based interventions. 

References

Blaakman, S. W., Cohen, A., Fagnano, M., &Halterman, J. S. (2014). Asthma medication adherence among urban teens: A qualitative analysis of barriers, facilitators and experiences with school-based care. Journal of Asthma, 51(5), 522-529.

Brown, C. G. (2014). The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing. Clinical journal of oncology nursing, 18(2).

Sleath, B., Carpenter, D. M., Beard, A., Gillette, C., Williams, D., Tudor, G., & Ayala, G. X. (2014).Child and caregiver-reported problems in using asthma medications and question?asking during pediatric asthma visits. International Journal of Pharmacy Practice, 22(1), 69-75.