(^174) Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines, Third Edition
Box 8.1 Differentiating EBP, Quality Improvement, and Research (continued)
disseminated outside the organization in the form of lessons learned, but they
are not generalizable beyond the organization. In certain situations, however,
the goal of the activity is to not only improve care but also generalize knowledge
for research purposes. In these cases, it is important to determine whether the
regulations that relate to protection of human subjects apply (U.S. Department of
Health and Human Services, 2016a, 2016b). http://www.hhs.gov/ohrp/regulations-
and-policy/guidance/faq/Quality-Improvement-Activities/index.html
http://www.hhs.gov/ohrp/regulations-and-policy/decision-charts/index.html
QI Example: Review medical records to assess whether guideline-based smoking
cessation counseling is used for patients with heart failure in a specific unit or
organization. Compliance with the smoking cessation standard is measured as
present or absent for patients and is reported for improvement purposes and
public information.
Research
Research generates new knowledge and is “a systematic investigation, including
research development, testing, and evaluation, designed to develop or contribute
to generalizable knowledge” (U.S. Department of Health and Human Services,
2009, 45 CFR 46.102[d]). Research activities are intended to be generalized or
applied outside an organization and require compliance with Office for Human
Research Protections (OHRP) regulations and, sometimes, the Food and Drug
Administration (FDA).
Research Examples: A randomized cluster design is used to test whether a quality
collaborative improves the quality of smoking cessation counseling for people
admitted to the hospital with heart failure who smoke (Newhouse et al., 2013).Create an Action Plan for Translation
Creating an action plan provides manageable steps to implement change and as-
signs responsibility for carrying the project forward. The EBP team develops spe-
cific change strategies to introduce, promote, and evaluate the practice change. It
can be helpful to formulate the plan in a template that includes a timeline with
progress columns (see Appendix I).
The action plan includes:
■■ Development of (or a change to) a protocol, guideline, critical path, sys-
tem, or process related to the EBP question