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Appendix A: The IOWA Model Revised: Evidence-Based Practice to Promote Excellence in Health Care

THE IOWA MODEL REVISED: EVIDENCE-BASED PRACTICE TO PROMOTE EXCELLENCE IN HEALTH CARE

Iowa Model Collaborative. (2017). Iowa Model of Evidence-Based Practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. doi:10.1111/wvh.12223

A flowchart represents the Iowa model of evidence-based practice: revisions and validation. The flowchart includes 15 steps. Step 1: Identify Triggering Issues/Opportunities: Clinical or patient identified issue, Organization, state, or national initiative, Data/new evidence, Accrediting agency requirements/regulations, and Philosophy of care. Step 2: State the Question or Purpose. Step 3: Is this topic a priority. If no, it leads to step 4: Consider another issue/opportunity. If yes, it leads to step 5: form a team. Step 6: Assemble, Appraise, and Synthesize Body of Evidence: Conduct a systematic search and Weigh quality, quantity, consistency, and risk. Step 7: Is there sufficient evidence? If no, it leads to step 8: Conduct research. If yes, it leads to step 9: Design and Pilot the Practice Change: Engage patients and verify preferences, Consider resources, constraints, and approval, Develop localized protocol, Create an evaluation plan, Collect baseline data, Develop an implementation plan, Prepare clinicians and materials, Promote adoption, and Collect and report post-pilot data. Step 10: Is change appropriate for adoption in practice? If no, it leads to step 11: consider alternatives. If yes, it leads to step 12: Integrate and Sustain the Practice Change: Identify and engage key personnel, Hardwire change into the system, Monitor key indicators through quality improvement, and Reinfuse as needed. Step 13: Disseminate Results. Step 11 leads to step 14: redesign. Step 11 also leads to step 15: reassemble. Step 14 leads to step 9. Step 15 leads to step 6. Step 8 leads to step 15. Step 11 leads to steps 4 and 1. Step 4 leads to step 1.
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