In research from Chiwaula et al. (2021), researchers observed that most nursing care decisions and actions are not evidence-based but derived from work experiences, direction from experts, education, and clinical practices rather than scientific origins. This lack of evidence-based practices (EBP) compromises nurses’ ability to improve care to be effective, safe, and efficient. There is a lack of strategies to translate EBP into nursing practice, which inhibits nursing care quality from improving from ineffective or risky practices. In this particular study, the Iowa model was used because it is a problem-solving approach that focuses on organizing the processes that support the implementation of EBP. The five steps of the model include: identifying the problem(s), selecting, critiquing, and combining relevant research, designing, planning, and piloting change into practice, and integrating and sustaining change.
In my opinion, a change agent is a person that takes on the responsibility of transforming the status quo to improve their practice regardless of others’ views. Throughout my nursing career, I’ve witnessed policies and procedures still used that were outdated and irrelevant in today’s modern medicine. As things in the medical field are ever-evolving, so should our practice as nurses. The best way to integrate evidence-based change is through models such as the Iowa Model, as described above. Models such as this ensure a smooth transition into new practices and a lasting effect on policies. For example, nurses in my PCICU unit changed PICC line dressings on an as-needed basis because that is how it had always been done. The process of changing the dressing was not focused on the outcome desired, which was decreasing central line-associated bloodstream infections. The change agent involved with altering this policy to reflect current EBP discovered that changing the dressings weekly lowered the patient’s infection risk. When nurses begin focusing on outcomes rather than just processes, we put the patient’s best interest in priority over customs.
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