Eric's rough idea of: Historical evolution of EBP, Dr Titler's model.

Question 1

Describe the historical evolution of evidence based practice…(This is just my (Eric’s) understanding of the history, not a word for word account)

Answer 1

Historically, Florence Nightingale used “Research Utilization,” to change nursing practice in hopes of bringing down high mortality rates among patients. From there however, the difference between conducting research and using research for practice change started to form a gap. In the 70’s, 80’s, & 90’s nurses were taught to use “Research Utilization,” which means they did a lot of research projects that encompassed dissemination of scientific knowledge, critique of studies, synthesis of applicability of findings for practice, development and institution of research-based practice guidelines, & evaluation of changes. At the same time, doctors were focused on EBP (evidence based practice). The difference between “Research Utilization” and EBP seems to be that EBP uses randomized controlled trials. EBP and RU are not interchangeable terms. Adopting the definition of EBP as the conscientious and judicious use of “best evidence,” to guide delivery of health care services, RU is a subset of EBP— a process and product encompassed within EBP. Importantly, RU is the application of findings from studies that use qualitative and quantitative methods and is not limited to the use of findings from randomized studies. The Iowa Model serves as a guide for Nurses and other healthcare providers to use research findings “research utilization,” for improvement of patient care. There is a big difference between the medical model and the nursing model. The nursing model does not lend itself well to randomized controlled trials, hence the reason for guidance brought forth by the Titler (Iowa) model of research.

Question 2

Describe the Titler Model of Evidence Based Practice…(This is just my (Eric’s) understanding of Titler’s model, not a word for word account)

Answer 2

1: something triggers a need for research. Either a problem triggers it or knowledge of a problem triggers it.
2. Then you do relevant research.
3. Then you Critique and evaluate the research, you’re reading for validity (am I reading bullshit research or is this legit research).
4. If it’s legit, is there a sufficient research base to do this experiment…IE do I have enough research to cover my ass from a lawsuit if shit goes sideways?
- If no, do some more research and talk to other experts until you do have enough research to proceed.
- If yes, is the research base sufficiently developed to guide practice?
5. Is this change appropriate for the unit?
6. if so, change the practice.