Evidence-Based Practice for Nurses

well research is applied to practice. In the fourth phase it
was decided that practice should be based on the knowledge
that patients respond best to HF discharge advice when
they are hospitalized because of symptoms related to HF
and when they indicate they are ready to make changes.
Practice was altered to have nurses assess patient readi-
ness to make changes and immediately provide written
and verbal HF management information. The success of
this practice change can be evaluated by comparing how
often patients are given HF management information with how many of them
are being readmitted for symptoms of HF.

The Iowa Model

The Iowa model for EBP to promote quality care is a systematic method that
explains how organizations change practice (see Figure 16-2). Originally a
research utilization model, it has been updated recently to include more
emphasis on EBP and renamed the Iowa model of evidence-based practice
to promote quality care (Titler et al., 2001). In this model nurses consider the
following questions: Is the topic a priority for the organization? Is there a
sufficient research base? Is change appropriate for adoption for practice? By
considering these questions, nurses address many of the same issues as in the
Stetler model (2001), such as the need to gather relevant research, identify
outcomes to be achieved, apply the research to practice, and evaluate the
application of the research to practice.

Barriers to Connecting Research

and Practice

By understanding barriers to creating EBP, nurses are better able to anticipate
potential problems when initiating research activities in clinical practice.
Several studies have examined barriers to applying research to practice and
have found organizational culture, nurses’ belief systems related to practice,
and research-related barriers as some of the reasons why integration of
research findings is difficult for practicing nurses at the point of care (Malik,
McKenna, & Plummer, 2016; Warren et al., 2016).

Organizational Culture

That health care is practiced in a rapidly changing, highly complex environ-
ment is no surprise to nurses. Nurses are constantly challenged to provide
patients with high-quality, safe care with limited resources. How success-
ful nurses are at delivering high-quality patient care can depend on how

FYI

By understanding barriers to creating EBP,

nurses are better able to anticipate potential

problems when initiating research activities in

clinical practice. Barriers to applying research

to practice include organizational culture,

nurses’ belief systems related to practice,

and research-related barriers.

KEY TERM

barriers: Factors

that limit or prevent

change

16.1 Evidence-Based Practice Models to Overcome Barriers 431