Key steps

1. KEY STEPS IN EBP..
1.FIRST STEP : - asking a searchable and ansrable questions. It's of two
types of questions
1. Background questions
2. foreground questions
Background questions:- According to Sackett and Colleagues(2000)
background questions are asked for general information about a clinical
issues e.g what , where, when, why et
FOREGROUND QUESTIONS:- foreground questions are those that can be
answered from scientific evidences about diagnosing, treating, and
assisting patient's with understanding their Prognosis.
2.SECOND STEP:- Assembling and evaualting the evidence, once the
clinical practice question has been selected, the next step is to search
and assemble research evidence on the topic.
3.THIRED STEP :- Criticallyv Appraising the article, it determines
implementation potential of an innovation in a particular setting.

2. CONTD..
FOURTH STEP:- integrating the evidence with one's clinical
expertise, if the implementation criteria are met, the team will
develop an evaluation plan, collecting base line data relating to
those outcomes to develop a counterfactual against which
outcomes would be assessed., , developing EBP guidelines, training
the relevant staff in the use of new guidelines .
FIFTH STEP:- Evaluating the change, The last step in EBP is
evaluation of the pilot project in terms of both process and
outcomes a variety of design can be used in evaluation but most
Rigroius being an experimental design.

3. MODELS AND THORIES OF EBP
• WHY IS EVIDENCE BASED PRACTICE MODELS NEEDED..
• It is needed to translate research findings into practice.
• To provide framework for understanding.
• To ensure that the latest and best practices are quickely and
appropriately incorporated into patient’s care.
• Improve overall care for the patient

4. MODELS OF EVIDENCE BASED
PRACTICE
• Sterler Model
• Lova Model
• Rossworm and Larabee Model
• D. Censo Model
• John hopkins nursing EBP Model
• Centre for Advanced nursing practice model
• Evidence based multidisciplinary practice model.

5. STETLER MODEL
Meaning of evidence based practice in stetler model..
Evidence is defined as information or facts that are obtained
systematically. Evidence and comes from two different sources,
EXTERNAL source INTERNAL source
EXTERNAL EVIDENCE: - comes from opinions of experts.
INTERNAL Source:- comes from systematically obtained facts or
information.
STETLER model was designed with the assumptions that research
utilization could be undertaken not only by organizations but by
individual clinicians and managers.
It was a model designed to promote and facilitate critical thinking
about the application of research findings in practice.

6. STETLER Model was developed as practitioner oriented
model in 1994. Revised in 2001 without change in its focus
on critical thinking. Raised awareness about importance of
applying research findings in nursing practice.

7. CONTID
• The current stetler models involves five(5) phases.
• PREPARATION PHASE
• VALIDATION PHASE
• COMPARATIVE EVALUATION AND DECISION
MAKING PHASE
• TRANSLATION/ APPLICATION PHASE
• EVALUATION PHASE

8. PREPARATION PHASE
In this phase, the model defines the understanding purpose
and outcomes the project, search, sort and select sources of
research evidence. She considers external factors that can
influence potential application and internal factors that can
diminish objectivity and affirm the priority of perceived
problems. It identify a priority need.
. Organize work.
. Initiate the research systematically.
. Review the content in which research utilization would occur.

9. .
VALIDATION PHASE- In this process, it involves a utilization of
focused critiqye of each source of evidence, focusing in
particular on whether it is sufficiently source for potential
application in practice
• Validation critique each study systematically.
• Choose and summarize the collected research that relates
to the identified need.

10. COMPARATIVE EVALUATION AND DECISION MAKING:- This phase
involves a synthesis of findings and application oof criteria,
that taken together, are used to determine the desirability and
feasibility of applying findings from validated source to nursing
practice. The end result of the comparative evaluation is to
make a decision about using the study findings.

11. TRANSLATIONAL PHASE/ APPLICATION PHASE-this involves the
activities to conform how findings will be used,e.g formal or
informal and spell out the operational details of the
applicational and implemenating them.
it converts findingd ,planning,their application ,putting the plan
to use and then implementing use within and evidence based
practice.

12. EVALUATION:- In this final phase the application is
evaluated. Informal use of innovation versus formal
use would lead to different evaluative strategies.
It evaluates the plan I terms of goal.
Obtains evidence.
Uses alternate evidence to achieve goals.

13. LOVA MODEL..
• Successfully implemented since 1994
internationaly
• Infuses research into practice to improve quality of care
• It incorporates the use of research and other forms of
evidence.
• Infrastructure to support research use might involve
every level of the organization.
• Evidence based practice is linked to quality assurance.
• Staff are given recognition for research work.
• Clinicians are given timw and resources for research
work.

14. ROSSWORM AND LARABEE MODEL..
• Developed by Rossworm and Larabee in 1999.
• It is based on theoretical and research literature.
• It begins with the assessment of need and integration of evidence
based protocol.
• STAGES OF ROSSWORM AND LARABEE MODEL.
1. Asses the need of stalkholders
2. Build bridges and make connection
3. Synthesis of evidence and determine relevancy
4. Plan the practice change
5. Implement and evaluate the practice change
6. Integrate and maintain practice change

15. D.CENSO'S MODEL
• COMPONENTS:-
• Patients preferances and actions will be dominant
element in their decision making.
• Patients clinical state and circumstances should be
considered.
• Resources are considered before making decision.
• Clinical expertise integrates the other model
components.