NR 451 Week 1 Discussion

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 Evidence-Based Practice (EBP)

Current Models and Frameworks of EBP

The development of nursing models and evidence-based practice (EBP) frameworks began gaining momentum in the late 1950s and 1960s, as nurse theorists and researchers sought structured approaches to improve clinical decision-making and patient outcomes (American Nurses Association [ANA], 2015). These frameworks are essential because they provide clear guidelines that support the integration of scientific knowledge into everyday practice. According to Chamberlain College of Nursing (2018), models tailored to nursing contexts allow practitioners to implement evidence systematically and effectively.

Stevens (2013) highlights that at least 47 different EBP models exist, each offering unique approaches for guiding nursing practice. Among them, the ACE Star Model of Knowledge Transformation stands out as an interdisciplinary framework designed to translate research into improved practice outcomes. This model demonstrates five sequential stages, ranging from identifying a clinical problem or new evidence to assessing results after the intervention has been applied (Schaffer, Sandau, & Diedrick, 2013).

Another widely adopted model is the Johns Hopkins Nursing Evidence-Based Practice Model, which emphasizes teamwork in translating research into practice. It follows a three-step process:

1. Developing a clinical question,

2. Gathering and evaluating relevant evidence,

3. Converting evidence into practice recommendations (Dearholt & Dang, 2012).

Both models highlight the importance of systematic frameworks that empower nurses to make informed decisions, ultimately elevating the quality of patient care.

Evidence Strength and Its Impact on Practice

The strength and reliability of evidence are fundamental in shaping safe and effective nursing interventions. High-quality evidence provides nurses with confidence that their clinical decisions will positively impact patient health. Systematic reviews, which compile and critically assess findings across multiple studies, are especially valuable because they provide comprehensive insights into effective interventions (Stevens, 2013).

The ANA (2015) emphasizes that while positive patient outcomes are the ultimate goal, the structured process of EBP helps clinicians ask meaningful, testable, and patient-centered questions. These steps lead to practice guidelines that are both reliable and adaptable. Importantly, patient safety is directly connected to the quality of evidence guiding practice. As new technologies, health policies, and patient needs evolve, nursing must continuously adapt by integrating updated evidence into care delivery.

Integrating EBP with Patient and Family Preferences

Delivering truly patient-centered care requires balancing scientific evidence with the unique preferences, values, and cultural backgrounds of patients and families. This integration is a key competency emphasized in baccalaureate nursing education. Nurses must be able to incorporate EBP into their decision-making while respecting patient autonomy.

Although systematic reviews and guidelines provide strong recommendations for practice, patient preferences sometimes differ. For example, religious beliefs, cultural traditions, or personal experiences may influence patients’ willingness to accept certain interventions. Nurses must acknowledge and respect factors such as spirituality, health values, and cultural identity when designing care plans. In doing so, they ensure that care is both evidence-informed and aligned with the patient’s personal context.

Nurse’s Responsibilities in Discrepancies Between EBP and Patient Preferences

A critical nursing responsibility is managing situations when evidence-based recommendations differ from patient or family preferences. In such cases, nurses should educate patients and families about the evidence behind recommended interventions, presenting the information in clear, understandable terms (Smirnoff, 2013). Education enables patients to make informed choices while maintaining autonomy.

The nurse should also validate concerns raised by patients and encourage them to ask questions or express uncertainties. Active listening ensures patients feel respected in the decision-making process. Shared decision-making, which includes weighing the benefits and limitations of treatments, is essential for aligning medical recommendations with the patient’s values and goals. While EBP forms the foundation for safe and effective care, final decisions should reflect what the patient considers acceptable.

Table: Comparison of Key Evidence-Based Practice Models

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD.

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.

NR 451 Week 1 Discussion

Smirnoff, L. (2013). Incorporating patient and family preferences into evidence-based medicine. BMC Medical Informatics and Decision Making, 13(Suppl 3), 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