Change facilitation requires forethought and intentional planning and execution if a well-supported, sustainable change is going to be made on a larger scale – especially in healthcare. Evidence-base practice models may include theoretical models grouped into evidence-based practice/research utilization and knowledge transformation processes, strategic organizational change theory or knowledge exchange and synthesis for application and inquiry (Melnyk & Fineout-Overholt, 2019).
However, it is becoming more widely acknowledged that a formalized approach must be considered to successfully implement these evidence-based models. NUR 590 Topic 3 DQ 2 Review the different models and frameworks that can be used to facilitate change
Eight different models have been identified as key drivers for evidence-based integration and change management. These include: 1. The Stetler Model of Evidence-Based Practice, 2. The Iowa Model of Evidence-Based Practice, 3. The Model for Evidence-Based Practice Change, 4. The Advancing Research and Clinical practice through close Collaboration (ARCC) model for implementation and sustainability of EBP, 6. The Clinical Scholar Model, 7. The Johns Hopkins Nursing Evidence-Based Practice Model, and 8. The Stevens Star Model of Knowledge Transformation (Melnyk & Fineout-Overholt, 2019).
Upon comparing the Stetler Model and Johns Hopkins Model, the Stetler Model has been regularly revised, and involves integrating evidence-base practice information into practical, sustainable day to day standards for patient care. With critical thinking and utilization of both internal and external evidence to support practice change, the Stetler Model hinges on five phases, and multiple steps to identify and support use of evidence, determined by critical thinking (Melnyk & Fineout-Overholt, 2019).
A “toolkit” of sorts has been developed to implement consensus guidelines and evidence-base practice change. Upon comparison, the Johns Hopkins Model supports its use by bedside registered nurses with aim to implement research results in an evidence-based practice format. The key objective is to make it easy for direct caregivers to make change at a grass-roots level, while positively impacting patient outcomes in a meaningful way. NUR 590 Topic 3 DQ 2 Review the different models and frameworks that can be used to facilitate change
A problem-solving approach to address clinical questions, the 18-step process allows for non-randomized control trial designed evaluations and quality improvement initiatives to take place(Melnyk & Fineout-Overholt, 2019).. With mindfulness that registered nurses encounter challenges that require a fix “tomorrow”, with potential use of nonresearch evidence by use of four pathways.
For my PICOT with aim to reduce occurrence of CLABSIs in patients with a central line, I believe either model could be used to implement meaningful change. However, the Stetler model is better suited for a randomized control trial approach, which is the method I believe to be best suited to gain the most sound, valid and reliable results. By way of using critical thinking and various types of evidence (internal AND external), the Stetler model allows for easy implementation of evidence gathered by way of a toolkit and use of consensus guidelines and policy change.