Iowa model of evidence-based practice


I selected the Iowa model of evidence-based practice.  Titler and colleagues initially developed the Iowa model of evidence-based practice in 1994 to provides direction

for the development of evidence-based practice in clinical agency were triggers that can be problem-focused evolving from risk management data, process improvement data,

benchmarking data, financial data, clinical problems, knowledge-focused such as new research findings, change in national agencies or organizational standards and guidelines,

an expanded philosophy of care, or questions from institutional standards committee initiate the change; and the focus should always be to make the change based on the best

available evidence (Grove, 2015, p. 483). 

This model should be effective for implementing EBP in any area of practice as long as triggers are evaluated and prioritized based on the needs of the practice to prompt a

focused action from the organization, an action that is guided by the most appropriate evidence-based research practice available. Once the trigger is prioritized, a group is

formed to search for the best evidence to manage the issue and evaluate all factors such as cost, the strength of the evidence, and the impact of such evidence on the triggers.

This group will assemble relevant research and related literature, critique and synthesize the research for use in practice and if there is sufficient research base, it will proceed

and make changes as deemed necessary as the research progresses. Once the research is completed, results are evaluated and decision is made to make the changes as approved

at the organizational level.

Barriers to this implementation can be the lack of research evidence available on the effectiveness of measures to address the particular trigger; the transfer of evidence-

based research to a particular trigger might not produce expected results based on other factors independent from studies that produced the evidence in use. For example, 

patients’ multiple chronic illnesses can affect their response to treatments, not all patients respond the same way to a particular treatment, regardless of the strength of the

evidence. Other barriers include the cost of implementation related to training staff. Effective EBP implementation at the practitioner and organizational levels within a health

care setting is essential to provide safe, effective and patient-centered care; nurses play a pivotal role to sustain the use of EBPs in clinical setting, and the contextual quality

of an organization that facilitate successful implementation should involve an organizational culture that is value-oriented and learning-oriented and receptive to change, and

a transformational leadership style determined by the leadership and practice of management (El-Mallakh at al., 2013, p. 42).


Grove, S. K., & Burns, N. (2017). The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (8th ed.). St. Louis, Mo: Elsevier Sanders. 483

El-Mallakh, P., Howard, P. B., Rayens, M. K., Roque, A. & Adkins, S. (2013). Organizational fidelity to a medication management evidence-based practice in the treatment of

schizophrenia. Journal of Psychosocial Nursing & Mental Health Services, 51(11), 35-44

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