NR 451 Week 1 Discussion
Student Name
Chamberlain University
NR-451: RN Capstone Course
Prof. Name
Date
Week 1: Types of Nursing Models and Frameworks of EBP
What are some of the models and frameworks of EBP currently in use?
The development of nursing models began gaining momentum in the late 1950s and 1960s, when nursing theorists and researchers started formalizing conceptual structures to guide nursing practice (American Nurses Association [ANA], 2015, p. 17). These models are essential for directing practice changes, ensuring they are tailored for various clinical environments and patient care scenarios (Chamberlain College of Nursing, 2018).
Stevens (2013) identifies forty-seven prominent evidence-based practice (EBP) models in the literature, giving clinicians multiple approaches for integrating research into care. Two widely recognized models are:
NR-451: RN Capstone Course
| Model | Description | Key Features |
|---|---|---|
| ACE Star Model of Knowledge Transformation | Interdisciplinary framework for translating research into practice and enhancing quality outcomes (Schaffer, Sandau, & Diedrick, 2013). | Five-point star representing stages: (1) knowledge discovery, (2) evidence summary, (3) translation into practice recommendations, (4) integration into practice, and (5) evaluation of outcomes. |
| Johns Hopkins Nursing Evidence-Based Practice Model | Designed to facilitate the application of research into practice through a team-based process (Dearholt & Dang, 2012). | Three-step process: (1) developing a practice question, (2) gathering and evaluating evidence, and (3) translating findings into practice changes. |
Other models, such as the Iowa Model of Evidence-Based Practice to Promote Quality Care, emphasize identifying triggers for change, assessing priority, and implementing evidence-driven interventions (Titler et al., 2001).
How does the strength of the evidence determine translation into practice?
The reliability and rigor of evidence directly influence its adoption in clinical settings. High-quality evidence—such as that from systematic reviews, meta-analyses, and randomized controlled trials—provides the strongest basis for achieving optimal patient outcomes (Stevens, 2013). By synthesizing large bodies of research, these reviews enable practitioners to make informed decisions grounded in consistent and reproducible findings.
According to the ANA (2015), the EBP process offers a structured pathway for clinicians, educators, and researchers to generate patient-centered, clinically relevant, and testable questions. These questions lead to well-developed guidelines that improve patient safety and care quality. Without credible, up-to-date research, care decisions risk being based on outdated traditions rather than proven effectiveness. Considering the rapid evolution of medical science and patient needs, nursing practice must remain responsive to emerging evidence.
Why is it important to integrate both evidence-based practice and patient and family preferences?
Patient-centered care is one of the foundational competencies for baccalaureate-prepared nurses. While EBP offers a scientifically validated framework for clinical decisions, patient and family preferences ensure care remains personalized and respectful of individual values, cultural contexts, and spiritual beliefs.
Integrating these perspectives supports shared decision-making, strengthens trust, and increases adherence to treatment plans (Smirnoff, 2013). For example, cultural beliefs may influence a patient’s willingness to undergo certain procedures, while religious convictions might affect acceptance of specific medications. Awareness of these factors allows nurses to adapt evidence-based interventions in a way that honors patient autonomy without compromising safety.
What is the nurse’s responsibility when EBP and patient and family practice do not match?
When discrepancies arise between EBP recommendations and patient or family preferences, nurses play a vital role as educators, advocates, and facilitators of informed choice. This includes:
- Providing clear education – Explaining the scientific evidence supporting the intervention in an understandable manner.
- Validating concerns – Acknowledging emotional, cultural, or spiritual reasons for hesitancy.
- Offering options – Presenting alternative, evidence-supported choices where possible.
- Encouraging teach-back – Asking patients and families to restate the information to ensure understanding.
Smirnoff (2013) recommends engaging in open dialogue about the pros and cons of each option, relating them to the patient’s values, and promoting shared decision-making. Ultimately, while EBP forms the foundation of safe, effective care, the final plan must respect the patient’s informed choice.
References
American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
Chamberlain College of Nursing. (2018). NR439 Capstone course, lesson week 1. Downers Grove, IL: DeVry Education Group.
Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209. https://doi.org/10.1111/j.1365-2648.2012.06122.x
NR-451: RN Capstone Course
Smirnoff, L. (2013). Incorporating patient and family preferences into evidence-based medicine. BMC Medical Informatics and Decision Making, 13(Suppl 3), S6. https://doi.org/10.1186/1472-6947-13-S3-S6
Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), Manuscript 4. https://doi.org/10.3912/OJIN.Vol18No02Man04
Titler, M. G., Kleiber, C., Steelman, V., Rakel, B., Budreau, G., Everett, L. Q., Buckwalter, K. C., Tripp-Reimer, T., & Goode, C. J. (2001). The Iowa Model of Evidence-Based Practice to Promote Quality Care. Critical Care Nursing Clinics of North America, 13(4), 497–509.