Types of Nursing Models and Frameworks of Evidence-Based Practice (EBP)

Current Models and Frameworks in Use

The medical field is continuously evolving, making it crucial for nurses to stay up-to-date with the latest research, as it significantly impacts patient care. Evidence-Based Practice (EBP) is the application of the best available evidence, derived from rigorous research, in making decisions about patient care (Chamberlain College of Nursing [CCN], 2017). Nurses play a pivotal role in both EBP and the delivery of high-quality care.

One prominent model is the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model. This model is a robust problem-solving approach tailored for clinical decision-making and includes user-friendly tools to assist both individual and group use. The model follows a three-step process known as PET: Practice question, Evidence, and Translation.

Integrating EBP with Patient and Family Preferences

The health and well-being of patients should always be the top priority for nurses, who strive to provide the best care possible while respecting patients' preferences. However, conflicts may arise when patient or family preferences do not align with current EBP recommendations. In such cases, it is essential for nurses to find a balance, ensuring that patients receive both the care they desire and the care that is in their best interest based on the latest evidence.

Nurses' Role in EBP and Patient-Centered Care

When there is a discrepancy between EBP and the preferences of patients and their families, nurses have the responsibility to educate them about the evidence and associated outcomes. Nurses should then aim to provide care that best fits the patient’s values and needs. As healthcare moves towards patient-centered care, it is vital to implement shared decision-making processes that are “respectful of and responsive to individual patient preferences, needs, and values,” ensuring that these values guide all clinical decisions (Applying Evidence for Patient-Centered Care).

Importance of Choosing the Right Model

With numerous models and frameworks available, selecting the right one can be overwhelming for nurses. For example, the ACE Star Model of Knowledge Transformation is closely aligned with the nursing process, consisting of five stages: knowledge discovery, evidence summary, translation into practice recommendations, integration into practice, and evaluation. This model merges old and new concepts to create a framework that organizes EBP effectively.

Nurses' Responsibility When EBP and Preferences Do Not Match

In situations where EBP does not align with patient and family preferences, the nurse’s role is to educate and provide evidence-based options that align as closely as possible with the patient’s beliefs. This approach ensures that care remains holistic and patient-centered.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.

Chamberlain College of Nursing. (2017). Establishing Differences in Research, Evidenced-Based Practice, and Quality Improvement Projects [Online lecture]. Retrieved from nursingonline.chamberlain.edu

Nilsen, P. (2015). Making sense of implementation theories, models, and frameworks. Implementation Science. doi: 10.1186/s13012-015-0242-0

Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html