The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing

Nurses understand that evidence-based practice (EBP) improves the quality of patient outcomes while controlling the cost of healthcare (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). But even in the year 2014, barriers and roadblocks exist to implementing EBP at the bedside or chair side. The Institute of Medicine estimated that it takes more than 17 years to implement a research finding into clinical practice (Institute of Medicine, 2001). Although research may exist that should be translated into practice, the time it takes to deliver these research-based interventions to patients takes too long. In their study of 1,054 RNs, Melnyk et al. (2012) discovered that although nurses value EBP, they required education, access to information, and time to implement EBP into daily practice. Nurses and other healthcare providers want their practice based in evidence, but they also acknowledge the barriers of lack of education and time to actually implement and use EBP.

EBP is a problem-solving approach to clinical decision making that integrates the best evidence from well-designed studies with a clinician's expertise along with patients' preferences and values (Melnyk et al., 2012). Numerous EBP models are available to help nurses organize and systematically track progress in implementing evidence into practice, including the Stetler Model of Research Utilization (Stetler, 2001), the Iowa Model of Evidence-Based Practice to Promote Quality Care (hereafter referred to as the Iowa Model) (Titler et al., 2001), and the Johns Hopkins Nursing Model (Newhouse, Dearholt, Poe, Pugh, & White, 2005). These models provide a step-by-step guide on how to take a clinical problem and match it with an intervention based on research to make an organizational or departmental change to practice. Using a model for EBP change also can assist nursing departments in better...