The evidence-based practice (EBP) process results from integration of existing research, clinical expertise, and patient preferences aimed at customizing care and promoting effective care decision-making (Cullen et al., 2020). As such, the use of effective frameworks or models for change in the EBP allows change implementers to use appropriate models to guide the process to attain the expected outcomes. These models are critical in ensuring that all stakeholders accept changes so that there is minimal or no resistance (Amit-Aharon et al., 2020). Nurses as the core implementers of change require enough knowledge and participation to comprehend different components of the proposed change aimed at reducing falls among adult-hospitalized patients in medical-surgical unit through the use of TIPS toolkit as a bundled care approach. The purpose of this paper is to select and describe an evidence-based practice framework or model for change in implementing the mentioned intervention in clinical settings to reduce falls and their adverse effects.
Selected Model or Framework for Change
Organizations implementing EBP change interventions should adopt models that best fit their situations, align with the quality improvement goals and address priority clinical issues as well as guide a systematic and evaluative approach to enhancing collaboration in practice change (Melnyk et al., 2022). The selected model for this change process is the Iowa evidence-based practice to promote quality care (IEBPPQC). The Iowa model is appropriate for this project because it continues to be reviewed to better address sustainability of the EBP, enhance inter-professional change implementation and patient-centered care for clinicians and advanced practice registered nurses (APRNs), guiding them through a team-based and multiple process.
Stages of the Iowa EBP Model
The Iowa model is one of the most popular approaches in addressing and implementing changes to improve quality and patient outcomes. The model has seven essential stages or steps. These include identification of a problem-based trigger or knowledge-focused issue that generate the need for change in practice, determining if the issue is a priority for the healthcare organization, and analyzing the interest of the organizational team and stakeholders which entails searching for, appraising, and synthesizing literature associated with the issue (DeNisco, 2019). The fourth stage is to evaluate the availability and merit of evidence which implies understanding the level of evidence and its quality. The fifth step in the Iowa model is to pilot practice change based on the credibility and reliability of the available evidence. The pilot change intervention aims at assessing the level of impact that such practice will have on the organization, patients, and other stakeholders.
The sixth step is to evaluate the results of the pilot practice intervention to ascertain if the organization should or should not implement the practice change. The seventh step is to disseminate the change across the department if it is feasible and can result in significant benefits to the different stakeholders. After introducing the change, it is essential for stakeholders to continue monitoring, evaluating and analyzing the results while making necessary alterations to attain the expected outcomes.
Application of Each Stage of the Iowa Model
The Iowa EBP model is easy to use for the current issue of preventing and reducing falls among hospitalized adults in medical-surgical unit. The initial step in this case is to identify the need for change. The use of TIPS toolkit means that the stakeholders, especially nurses have identified falls as a trigger problem that reduces the quality of care because of its adverse effects on patients. Secondly, reducing and prevention of falls is a healthcare organization priority. The Centers for Medicare and Medicaid Services (CMS) considers patient falls as never events and does not compensate organizations for expenses and costs associated with the issue (DeNisco, 2019). As such, reducing and preventing falls is a priority for the organization to improve the quality of care it offers to patients and enhancing their overall safety.
The change team’s topic of interest on falls’ prevention through the TIPS toolkit is essential for the organization. In this case, team comprises of different stakeholders interested in developing, evaluating and implementing changes to improve patient safety because of their increased susceptibility to falls due to their condition. The EBP team in this case, comprises of different players, from physicians to nurses and physiotherapists as well as quality assurance experts to ensure that the proposed EBP intervention attains its set goals based on the PICOT framework. The next step for th
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