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Nursing Research Center

EBP Step-by-Step

Below is a list of key steps to consider when planning and conducting an EBP project.  Helpful resources (such as worksheets and published articles) have been included to provide further explanation and support. Huntington Health utilizes the IOWA Model for conducting EBP projects. More information about the IOWA model can be found here. 

Cullen, L. & Hanrahan, K. & Farrington, M. & DeBerg, J. & Tucker, S. & Kleiber, C. (2018). Evidence-Based Practice in Action (1st ed.). Sigma Theta Tau International. https://www.r2library.com/Resource/Title/1940446937 

Step 1: Define the Question

When performing research, begin by formulating clinical question. Develop a clinical research question using PICO. Using a structured framework will help you to formulate a concise and focused research question so that you can build a more effective search as well.

PICO is an acronym for:

    Patient/Population/Problem

  • What are the specific characteristics of the patient or problem of interest? How would you describe your problem?

    Intervention

  • What do you plan to do for the patient or problem you are considering? Are there any therapies or prognostic factors that might affect this patient or population?

    Comparison

  • If relevant, is there any alternative to your intervention, such as a different drug or therapy (or is there a placebo, no intervention, routine care, etc.)? 

    Outcome

  • What are the effects? What are you hoping to measure or achieve with your intervention?

Step 2: Organizational Priority

Step 3: Form a Team

Form a team of colleagues that share an interest in creating the change.

Step 4: Search the Literature

Utilize library resources or perform your own literature search. If you have a well-formulated question and variables, you don't need to search yourself, you can ask a librarian for help. Email: library@huntingtonhealth.org

Step 5: Critique & Synthesize the Evidence

Understanding the levels of evidence presented in each study design will help you to find the strongest evidence to support your research. Each ascending tier corresponds to a stronger study design in aspects such as rigor, reliability, and reduction of bias.

 

levels of evidence pyramid

Adapted from: Duke University Medical Center Library

Step 6: Determine if Sufficient Evidence Exists

  • If No, then go back and review other topics/evidence or conduct research.
  • If Yes, then pilot the evidence-based change in your practice.

Step 7: Pilot the Change

Use EBP guidelines based on your research to design your practice change. Develop an action plan with a timeframe and state your measurable outcome.

Step 8: Is Change Appropriate for Adoption in Practice?

Were the results of the pilot positive? Is it feasible to implement as a permanent practice change?
Ask yourself: Will nurses be able to handle any extra workload? Do the benefits gained from the project justify the costs?

Step 9: Implement & Monitor

  • If you answered No to those questions, then continue to look for evidence-based methods to improve practice and gain knowledge. 
  • If you answered Yes, then expand the pilot and institute the change into practice.

To maintain change remember to periodically assess the desired outcomes (determined in step 1) and make sure those affected understand and follow the implemented practice change.

Step 10: Disseminate

Share your work and results with other professionals! See the section on Abstracts, Posters & Publishing for information and resources on how to disseminate your research.

 

IOWA Model

IOWA is the evidence-based model adopted by Huntington to assist practitioners in using evidence in their practice.

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