Evidence-Based Practice for Nurses

The second phase of the model is the validation phase.

In this phase, nurses analyze the evidence to determine

whether it is sufficient and credible to use in the practice

setting. You should be familiar with techniques, such as

creating a grid to summarize and weigh research articles,

that are important for successfully progressing through

this phase.

The third phase, also called the comparative evaluation/

decision making phase, is when nurses engage in label-

ing, condensing, organizing, and attributing meaning to all the assembled

evidence. Questions that could be considered during this phase are: Do you

have all the data needed to make a good decision? Is the evidence that you

have uncovered reliable? How strong is the evidence for any recommenda-

tions being made? For example, you may not want to make a practice change

if the only evidence came from a nonpeer-reviewed journal and was based

Phase II:

Validation

Phase III: Comparative

evaluation/decision making

Phase IV:

Translation/application

Phase V:

Evaluation

Phase I:

Preparation

Searsort, &ch,

sources ofselect

researevidencech

Performutilization-focused

critique & synopsis:

• Identify and, ifapplicable, record
  keyand qualif study details iers

influentialConsider

factors

Affirm priority STOP

settingFit of Feasibility(r,r,r,)

level & method ofA. Confirm type,

application, per detailsin phase II

B′. CONSIDER USE:

Evaluate as part of

routinepractice

Evaluate

Dynamically:

Identify goal for each

“use”

Obtain evidence re:

change process

and goal-related

progress, as well as

end result/outcomes

Use iterative evidence

to achieve goals

Informally: targeted practice Obtain

information; evFormally: Do formal details aluate

as in B; plan/implement a pilot “use”project, with

evaluation

Per results, accept and extend, with or without

modification, orif reject = STOP

Substan-tiating

evidence

StatUse of findings pere decision/s re:

strength of evidence:

A. Not use = STOP

B. USE NOW

B.′ Consider use

Currentpractice

Synthesize findings &evaluate per criteria

Reject

Accept

Define purpose &outcomes per

issue/catalyst

• Informally: Use in practice


• Fo evidence-based document/s;rmally: Identify/design
  pac as needed, develop kage for dissemination;
  evidence-based change plan, including
  evaluation

operational detailsB. USE: Review

FIGURE 16-1 Stetler Model of Research Utilization to Facilitate EBP

FYI

In today’s rapidly changing, highly complex

healthcare environment, patient outcomes

based on evidence provide the foundation

for safe, quality patient care. Several models

have emerged and serve as the foundation for

evidence-based nursing practice, including

the CURN project, the Stetler model, and the

Iowa model for EBP to promote quality care.

428 CHAPTER 16 Transitioning Evidence to Practice