From the Guidelines
The Johns Hopkins Evidence-Based Practice (EBP) Model is the most effective approach to clinical decision-making, as it integrates the best available scientific evidence with clinical expertise and patient preferences, as evident from the comprehensive review of the effectiveness of CME report generated by The Johns Hopkins Evidence-based Practice Center 1. The model's three-step approach, consisting of Practice, Evidence, and Translation (PET), provides a systematic framework for clinicians to identify clinical questions, search and evaluate relevant research evidence, and translate it into practice.
- The Practice phase involves identifying a clinical question using the PICO format (Patient/Problem, Intervention, Comparison, Outcome), which helps to focus the search for evidence.
- The Evidence phase involves searching for, evaluating, and synthesizing relevant research evidence, rating it using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale, which categorizes evidence from Level I (strongest) to Level V (weakest) 1.
- The Translation phase involves determining applicability to practice, developing an action plan, implementing changes, evaluating outcomes, and disseminating findings, ensuring that practice changes are sustainable and patient-centered. This model is particularly effective because it provides clear, practical tools for clinicians to evaluate evidence quality and strength of recommendations, making it accessible for healthcare professionals regardless of research experience, as seen in the American College of Chest Physicians evidence-based educational guidelines 1.
From the Research
Overview of Evidence-Based Practice Models
- The John Hopkins evidence-based practice model is one of the models used in healthcare settings to improve patient outcomes and healthcare system return on investment 2.
- A scoping review of evidence-based practice models and frameworks in healthcare settings found that many models and frameworks are well-developed and widely used, but the inclusion of patient values and preferences needs to be better integrated into these models 3.
Key Components of Evidence-Based Practice Models
- The key components of evidence-based practice models include asking the question, acquiring the best evidence, appraising the evidence, applying the findings to clinical practice, and evaluating the outcomes of change, along with patient values and preferences and clinical skills 3.
- The John Hopkins Nursing Evidence-Based Practice Model is one of the models that includes these key components, and it is used for education and training, nurse residency programs, and EBP and research fellowships 2.
Implementation of Evidence-Based Practice Models
- The implementation of evidence-based practice models can improve patient outcomes and healthcare system return on investment, but it requires coordinated and consistent use of established nomenclature and methods to evaluate EBP and patient outcomes 4.
- Nurse practitioners play a crucial role in implementing evidence-based practice into routine care, but they face barriers such as lack of time, lack of EBP competence, and inadequate resources 5.
- Supportive collaborative relationships and having professional confidence are identified as facilitators of evidence-based practice implementation 5.
Use of Evidence-Based Practice Models in Healthcare Settings
- Over 90% of nursing research leaders reported that their hospital uses an evidence-based practice model, and the most frequently reported models include the Iowa Model of Evidence-Based Practice, Johns Hopkins Nursing Evidence-Based Practice Model, and Advancing Research and Clinical Practice Through Close Collaboration Model 2.
- Evidence-based practice models are used most frequently for education and training, nurse residency programs, and EBP and research fellowships, and findings are implemented through policy and procedure committee processes, shared governance structures, and EBP processes 2.