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Chapter 13
Models to Guide Implementation and Sustainability of Evidence-Based Practice
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Components That Need to Be Considered in the Clinical Decision-Making Model of EBPPatient preferences and behaviorsClinical state, setting, and circumstances Availability of healthcare resources High-quality research evidence
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Copyright © 2015 Wolters Kluwer • All Rights Reserved
Factors That Are Impacted by the Practitioner’s Clinical ExpertiseQuality of the initial assessment of the client’s clinical state and circumstancesProblem formulationDecision about whether the best evidence and availability of healthcare resources support a new approachExploration of patient preferencesDelivery of the clinical interventionEvaluation of the outcome for that particular patient
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Commonalities Found in Models Used for Implementation of EBPIdentifying a problem that needs addressingIdentifying stakeholders or change agents who will help make the change happen in practice Identifying a practice change shown to be effective through high-quality research that is designed to address the problemIdentifying and, if possible, addressing the potential barriers to the practice change
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Commonalities Found in Models Used for Implementation of EBP—(cont.)Using effective strategies to disseminate information about the practice change to those implementing itImplementing the practice changeEvaluating the impact of the practice change on structure, process, and outcome measuresIdentifying activities that will help sustain the change in practice
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Copyright © 2015 Wolters Kluwer • All Rights Reserved
Commonly Used Models That Facilitate Integration of Evidence Into PracticeThe Stetler Model of Evidence-Based PracticeThe Iowa Model of Evidence-Based Practice to promote quality careThe Model for Evidence-Based Practice ChangeThe Advancing Research and Clinical practice through close Collaboration (ARCC) model for implementation and sustainability of EBP
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Commonly Used Models That Facilitate Integration of Evidence Into Practice— (cont.)The Promoting Action on Research Implementation in Health Services (PARIHS) frameworkThe Clinical Scholar modelThe Johns Hopkins Nursing Evidence-Based Practice modelThe ACE Star Model of Knowledge Transformation
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Fives Phases of the Stetler Model of EBPPreparation: Identifying the purpose, context, and sources of evidence Validation: Assessing the credibility of the evidence and its statistical and clinical significanceComparative evaluation/decision making: Synthesizing evidence and making decisions/recommendations for useTranslation/app.