NUR 590 Benchmark – Evidence-Based Practice Proposal Project: Framework/Model for Change Evidence-Based Practice Proposal Project: Framework/Model for Change

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The Selected Framework/Model for Change and its Relevance

The appropriate framework/model for the proposed project is the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model. Friberg and Creasia (2023) mentioned that the JHNEBP model was created in 2002 to address gaps in evidence utilization in nursing. The model has three essential components that guide change leaders in EBP implementation: practice question, evidence, and translation (Dusin et al., 2023). The JHNEBP model is relevant to the project since it provides a step-wise approach to evidence translation (Appendix A). Its other dominant feature is the interrelationships between scientific inquiry, practice, and learning, enabling nurses to improve patient outcomes as they improve their knowledge. Importantly, the model is team-based, and the proposed project requires such an approach for successful implementation.

The Stages in the Change Framework/Model

The first step (practice question) has much to do with identifying the EBP question guided by the clinical problem. Within nursing, this question is in problem/population, intervention, comparison, outcome, and time (PICOT) format (McClinton, 2022). The evidence phase involves searching, appraising, and rating the strength of the evidence. This search is mainly in scientific journal articles from the leading nursing databases. The appraisal ensures they meet the desired qualities, particularly credibility, relevance, and purpose. The third phase, translation, involves implementing and evaluating the proposed change through an action plan (Dusin et al., 2023; Friberg & Creasia, 2023). After evaluating the outcomes, change leaders should share findings with the stakeholders.

Applying the Framework/Model in the Proposed Implementation

Applying the JHNEBP model implies following the steps of the practice question, evidence, and translation (PET). The proposed intervention is a two-weekly tailored physical exercise training program to improve functional fitness and independent living among older adults with type 2 diabetes. Following the PICOT format, the practice question is: in older adults with type 2 diabetes (P), does a twice-weekly tailored physical exercise training program (I), compared to no exercise interventions (C), improve functional fitness and independent living (O) in 8 weeks (T)?

Scientific evidence to support the intervention should be searched, appraised, and rated as the model recommends. Similarly, evidence (particularly levels 1 and 2) exploring the effectiveness of the tailored physical exercise training program in improving functional fitness will be appraised before being translated into practice (project implementation). Such evidence includes Zarco et al. (2021) and Kirwan et al. (2021) peer-reviewed articles exploring participants’ experiences and impacts of exercise programs on functional fitness and independence among older adults with type 2 diabetes. The findings will also be shared with stakeholders as the model recommends.

JHNEBP Conceptual Framework

The concept map (Appendix A) illustrates the basic steps (PET) of the JHNEBP model. It will be applied to the project to guide the phased translation of evidence into practice. As such, it will be a reference tool to ensure that the essential steps are followed and key activities are accomplished. Above all, it will be used during project evaluation to determine the project’s success and ensure its findings have been shared with the stakeholders.

Conclusion

EBP projects require a systematic implementation to ensure evidence is translated appropriately and outcomes can be evaluated. As a result, EBP frameworks/models are crucial to facilitate this organized implementation. The JHNEBP model is relevant to the current project due to its step-wise (PET) approach. Evidence will be sourced from credible sources and appraised to ensure the intervention improves outcomes as envisioned.

References

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1, 1-9. https://doi.org/10.1186/s43058-020-00070-0

Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks