Evidence-Based Practice Models
EBP is nothing new to nurses. Florence Nightingale, through her use of
meticulous record keeping and data analysis, was able to demonstrate that
mortality rates decreased when sanitary methods were improved (Riddle,
2006). By using the data she had gathered, Nightingale developed interventions
that, when applied to medical and surgical patients, reduced mortality rates
caused by unsanitary conditions. In general, the term EBP describes a model
of care whereby nurses, using current evidence or research knowledge, make
decisions using clinical expertise and patient preferences to guide patient care
(Melnyk & Fineout-Overholt, 2015). The University of Minnesota (n.d.) has
on its website the following definition of evidence-based care: “Evidence-Based
Practice is the thoughtful integration of the best available evidence coupled
with clinical expertise.”
Clinical practice based on evidence would seem to be an important goal for
nurses, yet many nurses acknowledge that they do not incorporate research
findings into their practices (Malik, McKenna, & Plummer, 2016; Warren et al.,
2016). Why this is so has been explored by many researchers (Hommelstad &
Ruland, 2004; Pettengill, Gillies, & Clark, 1994; Retsas, 2000; Rutledge, Greene,
Mooney, Nail, & Ropka, 1998; Sitzia, 2001) and is a topic that remains under
continued examination (French, 2002).
Several models have emerged and serve as the foundation for evidence-based
nursing practice. Some models are the conduct and utilization of research in
nursing (CURN) project, the Stetler model, and the Iowa model for EBP to
promote quality care.CURN
The CURN project was one of the earliest attempts to increase the use of re-
search in practice by registered nurses (RNs). It was a 5-year project awarded
to the Michigan Nurses’ Association by the Division of Nursing in the 1970s
and focused on helping nurses transition research findings into their practice
settings (Polit & Beck, 2016). An outcome of the CURN project was a real-
ization that practicing nurses would use research only if it had been widely
disseminated and was relevant to their practice (Horsely, Crane, & Bingle,
1978). The CURN project moved nursing practice from customs, opinions,
and authority to searching for the best research available and integrating the
evidence with a nurse’s clinical expertise, patient preferences, and existing
resources (Polit & Beck, 2016).
To appreciate the importance of the CURN project, consider that in the
1970s nurses engaged in practice behaviors solely because “we’ve always doneKEY TERMS
conduct and
utilization of
research in nursing
(CURN): Early
study conducted
about how nurses
transition research
findings into
practice
Stetler model:
Step-by-step
instructions for
integrating research
into practice
Iowa model for EBP
to promote quality
care: A systematic
method explaining
how organizations
change practice426 CHAPTER 16 Transitioning Evidence to Practice