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Personally, I found this model easy to understand. Also, a with a similar PICOT question used this model with success.
Implementation of a practice change can be difficult. I was pleased when I found the White and Spruce (2015) article, as it provided many implementation strategies to build support among key stakeholders and the organizational system.
What I enjoyed most about this project, is that I learned one of the many ways clinicians can lead the way in implementation of best practice, and continue to decrease the gap between research and practice.
McCommons, R., Wheeler, M., & Houston, S. (2016). Colonoscopy Comfort: An Evidence-Based Practice Project. Gastroenterology Nursing: The Official Journal Of The Society Of Gastroenterology Nurses And Associates, 39(3), 212-215. doi:10.1097/SGA.0000000000000213
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice. (3rd ed.). Philidelphia, PA: Wolters Kluwer
White, Shawna, and Lisa Spruce. 2015. "Perioperative Nursing Leaders Implement Clinical Practice Guidelines Using the Iowa Model of Evidence-Based Practice 1.3." AORN Journal 102, no. 1: 50-59. CINAHL with Full Text, EBSCOhost (accessed July 11, 2017).
Data may demonstrate an opportunity for improvement....
Data sources: risk management, benchmarking, financial, risk management
Or it could simply stem from the identification of a clinical problem.
(Melnyk &neout-Overholt, 2015)
(Melnyk & Fineout-Overholt, 2015).
1. Develop Clinical Question: from problem or knowledge focused triggers.
Study developed from knowledge focused trigger, leading to the questioning of current practice standards :
Emerging literature demonstrating that carbon dioxide insufflation decreases postoperative flatus and discomfort (McCommons et al., 2016).
Evaluate the existing evidence for the practice change.
(Melnyk & Fineout-Overholt, 2015).
"In the general adult population undergoing colonoscopy, how does carbon dioxide (CO2) insufflation affect postoperative pain when compared to air insufflation?" (McCommons et al., 2016, p. 313).
My Question: In patients undergoing a screening colonoscopy, what is the effect of the use of CO2 versus room air for insufflation on post-operative pain and patient satisfaction?
This article gives a detailed example on how to use the Iowa model as a framework for a pilot study on surgical site infections.
I would apply the Iowa Model to my research question in a similar fashion to the McCommons et al., (2016) study. Application of this framework would facilitate generation of data to validate a recent practice change on my unit from the use of room air to CO2 for insufflation.
Ex: My team members would include: the endoscopy department chair, unit manager, unit education committee, surgical services director, recovery room nurses, and patients
Taking an organizational approach, and involving interdisciplinary stakeholders will theoretically build wider support for the practice change. This will be helpful in building support for the change on a larger scale, since there are no existing practice guidelines specifically on the use of CO2 for insufflation during colonoscopy in the United States.
Based on Iowa Model's Implementation Guide
(McCommons et al., 2016)
Ex: report to senior leaders
Ex: staff meeting
Ex: pocket guides
Ex: change champion