Research Models

Evidence-Based Practice Models

The importance of research is to implement change, whether it’s with staff, the hospital system, or patient care…the main purpose is to have more effective outcomes. Here are a few models that serve different purposes and can make a huge difference:

ACE Star Model of Knowledge Transformation®: a model for understanding the cycles, nature, and characteristics of knowledge that are utilized in various aspects of evidence-based practice (EBP). The Star Model organizes both old and new concepts of improving care into a whole and provides a framework with which to organize EBP processes and approaches. –UT Health San Antonio. Additional Information:

  • Evidence-Based Practice in the United States: Challenges, Progress, and Future Directions; New competencies were identified using the ACE Star Model of Knowledge Transformation ©. –pdf download
  • The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas by Dr. Stevens, the creator of the Star Model –American Nurse Assoc

Advancing Research & Clinical Practice through Close Collaboration (ARCC) model: first conceptualized in 1999 by Melnyk as a mentorship framework to assist advanced practice nurses in implementing EBP. Melnyk and Fineout-Overholt (2002) have further developed the model, which now serves as a guide to advance system-wide implementation and sustainability of EBP. –PubMed. Additional Information:

  • A Test of the ARCC© Model Improves Implementation of Evidence‐Based Practice, Healthcare Culture, and Patient Outcomes by Sigma
  • Detailed in the popular EBP text by the model’s authors, Evidence-Based Practice in Nursing & Healthcare.
  • Wallen, G. R., Mitchell, S. A., Melnyk, B., Fineout-Overholt, E., Miller-Davis, C., Yates, J., & Hastings, C. (2010). Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship program. Journal of advanced nursing, 66(12), 2761–2771. doi:10.1111/j.1365-2648.2010.05442.x (Implementing ARCC PDF Download)

The Clinical Scholar Model: an effective framework for investigating and implementing evidence-based practice (EBP) changes by direct care providers. The model guides one in identifying problems and issues, key stakeholders, and the need for practice changes. It provides a framework to critique and synthesize external and internal evidence. –PubMed. Additional Information:

Iowa Model: focuses on organization and collaboration incorporating conduct and use of research, along with other types of evidence (Titler et al, 2001). Since its origin in 1994, it has been continually referenced in nursing journal articles and extensively used in clinical research programs (LoBiondo-Wood and Haber, 2006). This model allows us to focus on knowledge and problem-focused triggers, leading staff to question current nursing practices and whether care can be improved through the use of current research findings (Titler, 2006). –Research Gate. Additional Information:

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model: a powerful problem-solving approach to clinical decision-making and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. –Hopkins Medicine. Additional Information:

Model for Evidence-Based Practice Change (formerly Rosswurm & Larrabee Model): guides nurses and other healthcare professionals through a systematic process for the change to evidence‐based practice. –Sigma & A model for change to evidence-based practice –PubMed

Stetler Model of Research Utilization: helps practitioners assess how research findings and other relevant evidence can be applied in practice. This model examines how to use evidence to create formal change within organizations, as well as how individual practitioners can use research on an informal basis as part of critical thinking and reflective practice. The Stetler model provides a way to think about the relationship between research use and evidence-informed practice. It is also useful for groups of practitioners given the task of developing common standards, tools, policies, etc. -NCCMT Additional Information:

PARIHS (Promoting Action on Research Implementation in Health Services) Framework: a model that continues to develop, incorporating elements and sub-elements, including research, clinical experience, patient experience, local information, culture, and leadership. Additional Information:

  • A Guide for applying a revised version of the PARIHS framework for implementation –PubMed
  • A detailed summary by NCCMT
  • Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges by Implementation Science

Major Weaknesses of Nursing Models (in General)

  • Confusion or increased stress: if nursing units are struggling with a lack of staff, then advocating for more changes and improving patient care may cause more difficulties.
  • Lack of resources/support (poor finances, lack of supplies, and cooperation from staff/managers).
  • Time Consuming: staff needs to be trained for these model implementations and you must factor the time to train the “educators” to train the staff…

More Information:

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