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Clinical Scholar Model
One nursing model that can guide evidence-based practice change in practice is the Clinical Scholar Model. The Clinical Scholar Model aims to improve the implementation of evidence-based practice by educating providers and facilitating mentorships between new nurses and seasoned researchers (Dang et al., 2019). Part of the model includes a workshop that can be used within organizations to promote and guide research among staff (English, 2016). Implementing the Clinical Scholar Model workshops will help create an environment of innovation among healthcare providers. Dang et al. (2019) suggests that doctoral prepared nursing students are great candidates to serve as mentors for new nurses who may engage in clinical practice more often. The model’s idea is that the curiosity of bedside nurses to change clinical practices, coupled with the guidance of mentors will help provide success in the completion of new research projects. The Clinical Scholar Model and workshops provide a roadmap for researchers and nurses to follow throughout the course of an evidence-based research project (Dang et al, 2019). English (2016) describes a plan explaining how this model and workshop could be applied to a healthcare organization.
One type of information technology that can be used with this method is electronic medical records (EMR). Electronic medical records hold a lot of information that could be used to identify gaps in care and provide ideas for quality improvement projects. These systems also have built in safeguards to protect patient identifying data. Jedwab et al. (2019) states that reviewing specific data in EMRs such as falls, hospital acquired infections and deep vein thrombosis has led to reduced rates of these occurrences. Bedside nurses and their mentors can use EMRs with the Clinical Scholar Model to come up with necessary changes that could be implemented in practice.
Dang, D., Melnyk, B. M., Fineout-Overholt, E., Yost, J., Cullen, L., Cvach, M., Larabee, J. H., Rycroft-Malone, J., Schultz, A. A., Stetler, C. B., & Stevens K. R. (2019). Models to guide implementation and sustainability of evidence-based practice. In B. M. Melnyk & E. Fineout-Overholt (Eds.), Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed., pp. 378-427). Wolters Kluwer.
English, R. (2016). Evidence-based teaching tactics for frontline staff using the clinical nurse scholar model. Journal for Nurse Practitioners, 12(1), e1-e5. https://doi.org/10.1016/j.nurpra.2015.08.033 (Links to an external site.)
Jedwab, R. M., Chalmers, C., Dobroff, N., & Redley, B. (2019). Measuring nursing benefits of an electronic medical record system: A scoping review. Collegian, 26(5), 562-582. https://doi.org/10.1016/j.colegn.2019.01.003
The Advancing Research and Clinical practice through close Collaboration (ARCC) Model can guide an evidence-based practice (EBP) change in practice. Melnyk et al. (2017) conducted a study to look at how the ARCC Model can influence views of EBP implementation and how it affects patient outcomes. After a year of using the ARCC Model views of EBP improved and EBP was utilized more. Interventions that used evidence-based practice enhanced patient outcomes as well. It creates an environment of innovation because the ARCC Model evaluates the strengths and weaknesses to evidence-based practice so it can be improved.
The ARCC Model can be used to get nurses and other healthcare workers to better utilize the electronic medical record (EMR) technology. The ARCC Model will identify the barriers that are preventing healthcare workers from using EMR and eliminate them. Once the barriers are removed, healthcare workers will be more inclined to use electronic medical records and that will ultimately improve patient outcomes. One reason healthcare workers can be resistant to using electronic medical records is because they do not see the benefits of them. Pettit et al. (2019) proves that medication errors are decreased in patients receiving antiretroviral therapy with electronic medical record modifications. Showing this study and others and the benefits of electronic medical records can remove the resistance to utilizing EMRs. The barriers will be diminished and healthcare workers will implement EBP regarding electronic medical records and patients will eventually benefit.
Melnyk, B. M, Fineout, O. E., Giggleman, M., & Choy, K. (2017). A test of the ARCC Model improves implementation of evidence-based practice, healthcare culture, and patient outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9. https://doi-org.ezproxylocal.library.nova.edu/10.1111/wvn.12188 (Links to an external site.)
Pettit, N. N., Han, Z., Choksi, A., Voas-Marszowski, D., & Pisano, J. (2019). Reducing medication errors involving antiretroviral therapy with targeted electronic medical record modifications. AIDS Care, 31(7), 893–896. https://doi-org.ezproxylocal.library.nova.edu/10.1080/09540121.2019.1566512
Iowa Model for Evidence-Based Practice Change
An example of a nursing model that can be used to guide EBP change in practice is the Iowa Model, which aims to improve patient care through a systematic, step by step process, that also attempts to appraise intended change and use of EBP in practice (Mudderman et al., 2020). The model consists of a series of 7 steps with three points of evaluation: 1) addressing the issue of interest and whether or not it is a priority, 2) stating the question or purpose of change implementation, 3) designating a team, 4) assembling, appraising, and synthesizing evidence and determining whether or not it is sufficient, 5) initiating practice change and deciding whether or not it is appropriate to adopt in practice, 6) fully integrating the change, and 7) evaluating the results of the change (Mudderman et al., 2020). In this way, practitioners are able to analyze the change process at designated points in time in order to determine feasibility. It takes the daunting task of trying to introduce new ideas in practice and makes it less intimidating, encouraging practitioners to be more open and mindful of areas that need improving. The model can also inspire more unified collaboration among practitioners by promoting awareness of pertinent issues, creating an environment of inquiry, and through collective garnering of evidence in order to help support practice change (Huether et al., 2016).
Certain remote patient monitoring (RPM) technologies can be used with the Iowa Model in order effectively manage and protect sensitive data. Since the technology is relatively new, it is important to make sure that any information transferred is secure. This technology can be important in communicating of patient data to the health care provider in order to determine the efficacy of a proposed intervention or change. Utilizing these types of information technology can help health care professionals deliver high quality patient care in today’s rapidly advancing world by simplifying communication efforts and keeping information secure (Ye et al., 2019).
Huether, K., Abbott, L., Cullen, L., Cullen, L., & Gaarde, A. (2016, June). Energy Through Motion©: An evidence-based exercise program to reduce cancer-related fatigue and improve quality of life. Clinical Journal of Oncology Nursing, 20(3), E60-E70. https://doi.org/10.1188/16.CJON.E60-E70
Mudderman, J., Nelson-Brantley, H. V., Wilson-Sands, C. L., Brahn, P., & Graves, K. L. (2020, May). The effect of an evidence-based practice education and mentoring program and increasing knowledge, practice, and attitudes toward evidence-based practice in a rural critical access hospital. Journal of Nursing Administration, 50(5), 281-286. https://doi.org/10.1097/NNA.0000000000000884
Ye, Q., Deng, Z., Chen, Y., Liao, J., & Li, G. (2019, May). Using electronic health records data to evaluate the impact of information technology on improving health equity: Evidence from China. Journal of Medical Systems, 43(6), 1-9. https://doi.org/10.1007/s10916-019-1322-5
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