A model for change to evidence-based practice.
OBJECTIVE
To describe a model that guides nurses and other healthcare professionals through a systematic process for the change to evidence-based practice. The tremendous increases in clinical research and accessibility to research findings have prepared the way for the paradigm shift from traditional and intuition-driven practice to evidence-based practice. Although several models have emerged to guide practitioners in research utilization, practitioners continue to have difficulty synthesizing empirical and contextual evidence and integrating evidence-based changes into practice.


METHODS
The model is based on theoretical and research literature related to evidence-based practice, research utilization, standardized language, and change theory. In this model, practitioners are guided through the entire process of developing and integrating an evidence-based practice change. The model supports evidence-based practice changes derived from a combination of quantitative and qualitative data, clinical expertise, and contextual evidence.


METHODS
The model was developed using sources identified on searches of Medline, CINAHL, and systematic reviews available on the Internet. Review topics were focused on evidence-based medicine and nursing, research utilization, and change process. Other sources included clinical expertise and quality-improvement information.


CONCLUSIONS
Practitioners need skills and resources to appraise, synthesize, and diffuse the best evidence into practice. Patient outcomes must reflect discipline-specific and interdisciplinary accountabilities. Collaboration between researchers and practitioners within and among disciplines will enhance the diffusion of evidence-based practice innovations.
Rosswurm
M A
MA
West Virginia University School of Nursing, Charleston Division, USA. mrosswur@wvu.edu
Larrabee
J H
JH
D019985:Benchmarking; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006801:Humans; D007400:Interprofessional Relations; D016294:Models, Nursing; D009732:Nursing Care / Q000458:organization & administration*; D015399:Nursing Research / Q000458:organization & administration*; D009740:Nursing Staff / Q000523:psychology; D009742:Nursing Theory; D009936:Organizational Innovation; D012107:Research Design; D012108:Research Personnel / Q000523:psychology