1. Conceptual models, simplified (‐> is a process step indicated in the model).
Authors | Brief description |
Horsley 1978 | Identify clinical problem ‐> Find and appraise research evidence ‐> Evaluate relevance of evidence for local context ‐> Design practice innovation and devise implementation plan ‐> Clinical trial (evaluation) of the innovation ‐> Review evidence from evaluation ‐> If innovation is positive then devise plan to extend and disseminate to other areas |
Funk 1989 | Find and appraise literature ‐> Effective communication ‐> Effective facilitation of utilisation |
Goode 1992 | Organisational commitment ‐> Change agents ‐> Planned change process ‐> Outcome (research‐based practice) |
Burrows 1995 | Review current practice ‐> Motivation to change ‐> Identify relevant evidence and appraise ‐> Implement in practice |
Kitson 1996 | Evidence ‐> Context ‐> Successful implementation ‐>Facilitation |
Jack 1997 | Facilitation/education ‐> Quality assurance/audit ‐> Conducting research ‐> Guidelines ‐> Evidence‐based practice ‐> Dissemination |
Rosswurm 1999 | The Rosswurm and Larrabee Model: assess needs of stakeholders ‐> Build relationships and make connection between nursing intervention and outcome ‐> Synthesise the gathered evidence ‐> Plan for the evidence‐based change in practice ‐> Implement the plan and evaluate the implementation ‐> Maintain the change |
Stetler 2001 | The Stetler Model (replaces the previous Stetler Model (Stetler 1994)) Preparation (gather evidence, look for confounding influences) ‐> Validation (appraise and synthesise evidence) ‐> Comparative evaluation/Decision‐making (determine the ability of evidence to answer the question) ‐>Translation/application (if there is sufficient evidence, implement it either formally or informally) ‐> Evaluation (evaluate whether evidence implementation sufficiently addressed the given issue) |
Melnyk 2002 | The ARCC Model (Advancing Research and Clinical Practice through Close Collaboration): the central concept in the ARCC model is that of an evidence‐based practice (EBP) mentor, an advanced nurse with in‐depth EBP and clinical knowledge and skills who provides mentorship in EBP and facilitates improvement in clinical care and patient outcomes through EBP implementation and outcomes management projects. Promoting EBP among both advanced practice and staff nurses locally and nationally ‐> Establishing a cadre of EBP mentors to facilitate EBP in healthcare organisations ‐> Disseminating and facilitating use of the best evidence from well‐designed studies to advance an evidence‐based approach to clinical care ‐> Conducting an annual EBP conference ‐> Conducting studies to evaluate the effectiveness of the ARCC model on the process and outcomes of clinical care and ‐> Conducting studies to evaluate the effectiveness of the EBP implementation strategies |
Titler 2002 | The Iowa model (Titler 2002) replaces the previous model (Titler 1994): Generate the question from either a problem or new knowledge ‐> Determine relevance to organisational priorities ‐> Develop a team to gather and appraise evidence ‐> Determine if the evidence answers the question ‐> If there is sufficient evidence, pilot the change in practice ‐> If there is insufficient evidence, generate evidence through research ‐> If change is initiated based on the evidence, deem appropriateness of change to practice |
Di Censo 2005 | Asking the question ‐> Compiling the evidence ‐> Planning a change ‐> Integrating skills and experience |
Schultz 2005 | The Clinical Scholar Model: this model reinforces the intellectual process of EBP, building a cadre of mentors who foster an environment in which staff nurses are encouraged to continuously ask questions. Clinical scholars are bedside clinicians who challenge nurses practices through inquiry, observation, analysis and synthesis of internal data and published evidence, application of synthesised evidence, and evaluation of subsequent outcomes. Clinical scholars serve as role models in the ownership of their clinical practice. Inherent in the model is the final step, dissemination of findings from the projects and research accomplished by the clinic scholar team to team members and the healthcare public. Intrinsic to the model are collaboration, consultation and mentorship by a nurse scientist through every step of the educational and application processes. |