The Iowa Model: A Catalyst for Evidence-Based Practice Collaborations to Near and Far

In the early 1990s, a team of nurses from the University of Iowa Hospitals and Clinics and University of Iowa (UI) College of Nursing (CON) developed a model for using research findings to promote quality care in health care settings (Titler et al., 1994). In 2001, authors revised the model to include the use of other types of evidence, and more specific information about pilot testing and implementing the practice change (Titler et al., 2001). The Iowa Model of Evidence-Based Practice (EBP) to Promote Quality Care (Iowa Model) provides direction for use of a systematic and scholarly process leading to safe, high quality health care. In 2014, a mixed-method descriptive survey of users’ experiences with the Iowa Model in a variety of settings was conducted to investigate what revisions were needed (Iowa Model Collaborative, 2017). The Revised Iowa Model continues to outline an application oriented EBP process and shifts the primary focus from use of research to use of all existing evidence for making the best clinical decisions. It also emphasizes implementation and sustainability steps for achieving best healthcare outcomes. In 2018, EBP in Action: Comprehensive Strategies, Tools and Tips from University of Iowa Hospitals and Clinics, a how-to text that follows the Iowa Model, was published (Cullen et al., 2018).

Nurses frequently report the Iowa Model outlines an intuitive route that makes the EBP process easy to navigate. The Iowa Model is highly respected and widely used by interdisciplinary teams working in complex settings (Bougard, Laupola, Parker-Dias, Creekmore, & Stangland, 2016; Brown, 2014; Cuevas et al., 2018; Kowal, 2010; White & Spruce, 2015). Since 2001 there have been nearly 5,000 requests to use the Iowa Model. Requests have come from all 50 US states and 41 other countries. Over 650 publications have cited the Iowa Model. The most recent revision was downloaded > 3,000 times in first six months, making it a top ten article for the journal.

The Iowa Model has been a catalyst for EBP collaborations locally, nationally and globally. Locally, the Iowa Model is used as the EBP process model in our 800 bed Academic Medical Center. It is used in a variety of development programs including: preceptor workshops and staff orientation, new graduate and experienced Nurse Residency Programs, EBP Change Champion Program, Staff Nurse EBP Internship, Clinical Leadership Development Academy, Executive Leadership Academy, and an advanced EBP competencies program. The Iowa Model recently became the primary EBP process model for students at the UI College of Nursing.

In 2018, the 25^th National Evidence-Based Practice conference had over 300 participants from 29 US states and 1 from abroad. Many are drawn in by the Iowa Model and report EBP work using it. Across the US, the Iowa Model has been a catalyst for more than 10 keynote and podium presentations and 15 EBP workshops in the past five years. Formal and informal partnerships continue to be developed with academic and clinical settings to either use the Iowa Model or provide assistance with the EBP process.

Globally, collaborations were formed to translate the Iowa Model into four languages (German, Japanese, Korean and Portuguese). Recently, the Iowa Model has been a catalyst for visiting scholars from Japan and South Korea. In spring semester 2019, a visiting scholar from Australia will collaborate with our team and faculty at the College of Nursing. Products of that collaboration, including a mixed-methods research study on the Iowa Model experience, will be presented.

In summary, the Iowa Model has been a catalyst for EBP collaboration near and far. Improved operational and healthcare outcomes have been demonstrated (Bougard et al., 2016; Brown, 2014; Cuevas et al., 2018; Kowal, 2010; White & Spruce, 2015), although given the reach and ripple effect, the full impact is difficult to measure.