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There has never been a time in history when the need for evidence-based practice (EBP) in the clinical arena has been greater to guide patient, clinician, and health-system decisions. Building on the seminal work of the Iowa Model (Titler et al., 1994), Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From the University of Iowa Hospitals and Clinics delivers exactly what nurses and leaders have told me they need for EBP success. Supporting EBP within healthcare settings requires 1) a process that is clear, logical, and usable in practice settings; 2) tools and examples to support each step of the process; 3) links to available resources; and 4) mentors.
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This book starts with an introduction of a clear, logical EBP process framed by the Iowa Model—which many of us are familiar with or have used in the past. The process originates with identifying problem triggers and then moves through the steps of formulating actionable questions, determining if the topic is a priority, and forming a team. The process of acquiring and appraising the evidence follows, which then forms the basis for the practice recommendation. Next, the authors describe how to design and pilot the practice change before implementing and evaluating. Change, sustainability, and dissemination strategies are also included. Contemporary issues are raised, such as engaging patients in decisions related to patient-centered practices.
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Tools and examples to guide the EBP process aligned with each step are very important to foster the work of EBP teams. Not only are tools prevalent in supporting the EBP process, they are also provided for implementing recommendations to practice. Examples are particularly helpful for nurses who are new to the EBP process to help them understand what the final product will look like. The chapters are replete with pertinent and timely examples (e.g., oral mucositis and management of pain after surgery) that include policy, procedures, templates, communication strategies, slides, and flow diagrams.
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Available resources that allow teams or settings to access and tailor their processes to meet the needs of their own organizational context are also imperative. Links are provided for EBP guidelines; search databases (e.g., PubMed); evidence assessment instruments for critical appraisal of research, guidelines, and systematic reviews; and tools for rating evidence. The approach to available resources is nonprescriptive, so readers can choose the resources that best meet their needs.
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Experienced mentors are essential to teach and support the EBP process, verify professional development outcomes of teams (knowledge, skills, and attitudes), and foster a supportive infrastructure for the process and evidence translation. Mentors in clinical practice or academia can use the book to teach the process and will find benefit in the tips and tools.
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Nurses and leaders in clinical environments need EBP models with clinical usability and utility for their setting. Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From the University of Iowa Hospitals and Clinics provides a systematic process with the tools, examples, and links to resources that both novice and experienced teams in clinical and academic settings need.
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–Robin P. Newhouse, PhD, RN, NEA-BC, FAAN
Dean and Distinguished Professor
Indiana University School of Nursing
Deputy Chair, University Clinical Affairs Cabinet
Associate Vice President for Academic Affairs, IU Health