The Johns Hopkins Nursing Evidence-Based Practice Model: The Clinical Scholar Model

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Evidence base practice has had a huge impact on nursing practice. Evidence based practice has influenced the way and what is being taught to nurses and future nurse, nursing clinical practice itself, and so much more. The two most significant factors that evidence based practice effect within the nursing practice is the patient’s quality of healthcare and the cost to provide this care. According to Stevens, she defines quality healthcare as, “Degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (pg 2, 2013). My interpretation of the previous definition, is that healthcare is the goal for every patient and it’s the responsibility of the health services (including their workers such as nurses) to reach this goal.

Slutsky, J. (2005). Using evidence-based guidelines: Tools for improving practice. In B. F.-O. Melnyk, Evidence-based practice in nursing & healthcare. A guide to best practice (pp. 221-236). Philadelphia, PA: Lippincott, Williams & Wilkins.

Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.

Models that fall under this thematic area aim to enhance patient care and outcomes through appraisal of evidence. Most use a step-by-step approach of identifying a healthcare issue, seeking out appropriate evidence, evaluating that evidence, and then applying it to the issue at hand to improve healthcare outcomes.7 These models also take into consideration the appropriateness of certain types of evidence and, if lacking, provide a process for obtaining new and relevant information.7 Methods for transforming this evidence into practice, such as a new practice standard, are also emphasized in these

As the nursing field grows, evidence-based practice is becoming more pragmatic. This is because people want to know the when, why, and how of diseases processes. Increasing knowledge on evidence-based practice has shown to improve health outcomes. Research translation models are utilized heavily in nursing to help transform findings into practice (Polit & Beck, 2012). Some models are more clinician oriented, while others are institution oriented. There are various models that are utilized by different entities. For the purpose of this paper, the Stetler Model of Research Utilization will be researched and discussed.

I chose the Iowa model for implementing evidence based practice. This model was chosen because of the design of the model, as it follows a scientific approach. This model requires a question to be generated form either a problem or new knowledge, organization of relevance of the subject matter, development of a team to

The John Hopkins Nursing Evidence Based Practice Model (JHNEBP) has three phases that describe the practice question, evidence and translation (PET) for determining the practice problem finding evidence that supports change in current practice and than translating the new information into practice (Newhouse, Dearholt, Poe, Pugh, & White, 2012). The first phase, practice question, is developed used to develop an answerable evidence-based practice question that derived from the PICO mnemonic (Newhouse et al., 2012). The second phase of is conducting the research and finding the evidence to be used in implementation for change of practice. The PET process finds the evidence, makes an appraisal of the findings and provides recommendations for change in practice (Newhouse et al., 2012). The final phase is to determine if the information obtained in research is appropriate for implementing change in the current practice. The PET process within the JHNEBP Model can be used as a means for finding evidence, evaluating and synthesizing the information from the research and evaluating

The institutions make use of network-connected information systems that facilitates for efficient exchange of the information in the entire enterprise. Evidence-based practice has been common in the nursing education, science as well as practice (O’Sullivan & Benham-Hutchins, 2011). The nurses must aspire to achieve improvements in evidence-based quality as well as transformation in health care so that they can effectively redesign care to be safe, efficient as well as effective (O’Sullivan & Benham-Hutchins, 2011). Nurses must also respond to the launch initiatives which can potentially maximize the treasured contributions from the nurses, and hence deliver the EBP promises (O’Sullivan & Benham-Hutchins,

Evidenced-based practice is the process of implementing clinical trials that involve clinical expertise, scientific evidence, and perspectives of those involved in the overall care of patients. It heavily depends on the research that goes into the development of new medical practices. It helps determine safe and effective ways to approach treatments and surgical procedures. The process of evidence-base practice is a multifaceted approach that takes time and research. Nursing research is used to enforce the rationale behind the evidenced based process.

Technological advances and genetic discoveries have increased the average individual’s life span. Today’s nurses regularly care for an aging population with a higher incidence of chronic illnesses. People are now living longer and the population is becoming more diverse creating a host of new challenges for nurses. The American Association of Colleges of Nursing has created nine essentials that may be incorporated into any university curriculum to prepare nurses to provide high quality patient care. The third essential discusses the importance of scholarship for evidence-based practice. The term scholarship differs from evidence-based practice. Scholarship involves asking thought provoking questions that may have the potential to better patient outcomes, researching these questions or the topic of interest, collaborating with the healthcare team to successfully incorporate interventions, and continually performing evaluations. Evidence-based practice is vital to quality patient outcomes, may take as long as seventeen years or more to integrate into the hospital setting, is based on numerous scientific research studies, and is best fostered through scholarship. Scholarship

A model is a representation of concepts which are used to help people know, understand or simulate a subject matter. Moreover, a model is used to create the various hypothesis which can be tested in the laboratory or utilized for explaining a case study. The goal of this assignment is to explore three models of evidence-based practice (EBP) that interest the authors and give a summary. Although several models used in research, this paper will highlight three specific models and provide a summary, strengths, weaknesses and a model that can be implemented in a particular practice.

(“Nursing Programs Conceptual Model,” 2016). I utilize this role by incorporating the model element Evidence-Based Practice. This model focuses on determining the best Evidence-Based Practices to implement, in order to deliver the optimal healthcare to my patients. The model element Professional/Legal/Ethical is applied within my profession daily, by maintaining a reflective mindset when performing interventions or interacting with patients.

The facility my change project has potential impact upon is a teaching hospital which is known for promoting, supporting, and encouraging clinical research and implementing latest evidence-based practice. Erlanger serves as the region's only academic teaching hospital and strives to employ healthcare professionals who are knowledgeable in the latest skill, technique, and evidence based practice (EBP) (Erlanger Health System, 2017). This serves as both a strength and opportunity for the facility. A major strength for the hospital is the support that is has for research and implementation of all change processes. In 2013 the Institute for Clinical Research (EICR), was developed to solidify unity of two objectives, providing patients’ access

Each is essential to embedding research into practice. The model is depicted in Figure (3-3). This organizational model relies on a formal relationship between a university medical center and a college of nursing to provide resources needed to successfully implement and sustain EBP. The strength of the Colorado Model resides in the specific identification of both research and nonresearch as sources of evidence (Goode,