Learning Objective #1: Incorporate the Iowa Model of Evidence-Based Practice as a framework to achieve practice that is based on best available evidence

Learning Objective #2: Use the Iowa Model of Evidence-Based Practice to select the best approach to addressing clinical practice problems

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Nursing practice based on the best available evidence has become the expected standard in healthcare. Nurses are challenged to develop evidence based clinical practice guidelines (CPGs) but may lack the skills needed to accomplish this. The Iowa Model of Evidence-Based Practice to Promote Quality Care was selected as the framework to guide the development of evidence based practice. With triggers starting the process, nurses have used the Iowa Model to conduct original research and use existing research to change practice. A problem focused trigger lead to the development of two original research studies that compared the use of the forearm (FA) to the upper arm (UA) for non-invasive, blood pressure (NIBP) measurement. In contrast, a knowledge focused trigger guided a research utilization (RU) project that incorporated guided imagery (GI) into the CPG for the care of patients undergoing cardiac catheterization. Findings from the two BP studies demonstrated that FA and UA NIBP measurements were not interchangeable. Data from these studies will be used to develop evidence based CPG for NIBP measurement. The RU project, incorporating GI into the CPG for the care of patients scheduled for cardiac catheterization, generated evaluation data from patients selecting GI and from patients who did not select GI. Data analysis revealed high levels of satisfaction with the GI program and low levels of anxiety after the procedure when compared to levels prior the procedure. Based on these findings, GI is being piloted in two intensive care units and a step-down unit and the hospital-wide implementation of an evidence based CPG for GI is anticipated. The Iowa Model has provided a logical and practical approach to the challenge nurses face regarding the development of evidence based practice. It has been used successfully in this institution to identify and address practice problems, and develop evidence based CPGs.