| Learning Objective #1: Describe the four stages of intervention development according to this model | |||
| Learning Objective #2: Identify a patient problem area for which intervention development is indicated according to this model |
Background: Practicing nurses and nurse researchers often are confronted with a patient problem for which there is no clearly described, theoretically based and tested intervention to be used in order to achieve specific clinical outcomes. Then, it is necessary to develop and validate a new intervention. Few models are available to guide this process. Furthermore, existing models are not appropriate for complex interventions in which the experience of the client plays an important role in effectiveness.
Objective: The model used within the Division of Nursing Science in Utrecht to develop evidence-based interventions is described. First, the four stage model is explained. The stages are: Problem Definition, Accumulation of Building Blocks (for Intervention Design), Intervention Design and Intervention Validation. The decision to include one or more steps and the selected strategies depends on the nature of the problem that the intervention aims to alter, the nature of the intervention and the state of knowledge concerning the intervention and related subject areas. As the model is described, illustrations from our own studies are presented, for example: sexual teaching with cancer patients, patient and family coaching to prevent psychotic relapse in patients with schizophrenia and patient support and team coordination during weaning the ICU patient from a ventilator. The presentation concludes with a discussion of how this model facilitates accumulation of empirical evidence and theory building.
Conclusions: Evidence-based nursing practice is the use of empirical research findings to achieve a higher reliability in successfully achieving desired results. Such practice depends on more than the results of randomized controlled trials. Also indispensable is insight into the processes that are responsible for the results as well as understanding the limitations of an effective intervention. Use of qualitative research during development of interventions plays a vital role in complementing randomized controlled trials.
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