Application of the Iowa Model, an Evidence-Based Practice Model, When Initiating Clinical Project Pilots to Evaluate How Self-Care Techniques Affect Simulated Nursing Performance


The delivery of evidence-based practice (EBP) care is adaptable in health care settings when taught to licensed nursing professionals and prelicensure nursing students. Nursing professionals who are taught the Iowa Model of Evidence-Based Practice, an EBP model that is used as a framework for the development of pilot projects, gain an understanding that the historical or traditional approaches to clinical care, when not correlated with current nursing practice interventions, may potentially place patients at risk of harm. Hence, health care delivery is compromised.

The Iowa Model of Evidence-Based Practice is specific to clinical nursing practice. Developed to be used within clinical health organizations, Marita G. Titler and colleagues identified two types of triggers that were necessary for change to occur within EBP reflecting best clinical practices. The two triggers were problem-focused triggers and knowledge-focused triggers.

Problem-focused triggers are those data that impact the functionality of health care organizations and can include clinical problems (e.g., an increase in episodes of ventilator pneumonia within the surgical intensive care unit), benchmarking data, risk management data, financial data, and process improvement data. The second trigger, knowledge-focused triggers, examines organizations’ philosophies of care, new research or other literature, national agencies or organizational standards and guidelines. The decision to implement exploration into identified problem-focused and knowledge-focused triggers using the Iowa Model of Evidence-Based Practice is made by the person(s) or parties (project manager(s)) identifying a gap in knowledge or problem area(s) within the organization. The Iowa Model of Evidence-Based Practice can then be implemented as a theoretical framework into the design for clinical problem resolution, after problem identification, and when researched evidence within the review of current literature supports the finding(s) as a priority for the organization. Stakeholders within the organization that support the change(es) must be secured by the person(s) (project manager(s)) initiating the change, so that when change occurs status post clinical interventions and data collection, practice change has the support of the stakeholders. It is then that integration of the new practice change can occur and be maintained.

This case study used the Iowa Model of Evidence-Based Practice to initiate a clinical practice change. The case study was an actual EBP clinical pilot project that I conducted that explored the intervention of self-care techniques (e.g., aromatherapy, sleep hygiene, healthy eating, positive affirmations, and exercise) for final-year nursing students (senior-level nursing students) in the reduction of stress, anxiety, and distraction for the prevention of medication errors and increase of patient safety awareness within the clinical environment.

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