Importance of Evidence-Based Models
Healthcare practices are constantly being improved to provide patients with the best services and care for the population’s health. Improvement efforts are based on reviewing, translating, and implementing studies (Dusin et al., 2023). However, evidence-based practice (EBP) is quite complex in implementation, and therefore several models and frameworks have been developed to guide the introduction of changes (Dusin et al., 2023).
Evidence-based models (EBM) support the management of the improvement process, as they help to identify such aspects as potential barriers, stakeholders, resources, and other necessary elements (Dusin et al., 2023). The current paper considers the Johns Hopkins Nursing Evidence-Based Practice (JHEBP) Model and its application to the quality improvement project. The report includes an overview of the model and its elements, a clinical practice question for the project, and a discussion of the application of the model.
Description of the Model
EBP involves integrating the best evidence and research findings into the practice of health care professionals, and EBMs guide the process. The JHEBP supports the statement on the importance of applying research to the work of healthcare institutions. The model includes a three-step approach to implementing change, which includes elements such as “practice question, evidence, and translation,” also called the PET process (The Johns Hopkins University, n.d., para. 3). The identified components can be described as follows:
- A practical question describes the patient population, the coming intervention, comparison with current situations, and outcome (PICO) (The Johns Hopkins University, n.d.). The development of the question helps narrow the intervention’s focus and take more accurate measures to solve the problem.
- The evidence stage suggests that experts seek a solution to the highlighted problem in relevant and recent research (The Johns Hopkins University, n.d.). It is essential to find reliable sources and assess the quality of the evidence presented in them.
- The translation step involves synthesizing evidence derived from research and turning it into recommendations for practice (The Johns Hopkins University, n.d.). This phase may also involve the development of an action plan to improve practice, change implementation, and subsequent assessment(Dusin et al., 2023).
The presented JHEBP has significant advantages that support its wide application and highlight its benefits. In particular, it is noted that the model has a set of tools that significantly help implement EBP (Dusin et al., 2023; The Johns Hopkins University, n.d.). For example, instruments include a guide to creating a PICO question, a guide to assessing evidence, intervention planning tools, and similar elements (The Johns Hopkins University, n.d.).
Moreover, evaluating implemented changes and reflection can push employees to make new workflow changes, supporting continuous healthcare improvement. At the same time, although the steps of the model are pretty simple, they require some level of knowledge and skills from the specialists applying it, namely, competency to assess the quality of evidence (Dusin et al., 2023). Given the model’s advantages, it is expected to benefit the improvement project being developed significantly.
Clinical Practice Question
The developing project for improving practice quality focuses on bedside rounding procedures, specifically enhancing patient interaction and documentation. As a result, the project aims to achieve improved patient satisfaction, better practice quality, and enhanced patient health outcomes. A key measure is to deepen patient communication and engage them in interactions with providers during bedside rounding procedures. Based on the goals and perspective of the study, it identifies the following elements for the development of the clinical PICOT question:
- Patient population (P): Individuals remaining in the hospital in the emergency room.
- Intervention (I): Deepening patient communication and supporting documentation accuracy.
- Comparison (C): Current patient satisfaction with services, hospital error rates, and patient outcomes before intervention.
- Outcomes (O): Improved patient health and satisfaction indicators and reduced errors.
- Time (T): Four to six weeks.
The presented elements form the following PICO question: Is optimizing the attitude towards ER patients during bedside rounding to increase their engagement and documentation correctness effective when implemented within four to six weeks?
Practice Application
The described project includes several aspects where the application of the presented EBM will be helpful. In particular, in EBP, it is essential to ensure that employees select the best evidence from studies to inform their patient care (Skela-Savič et al., 2020). The second stage of the JHEBP model aims to find the best evidence. Moreover, the model includes tools that help assess the reliability of evidence and is, therefore, the best option for application (Dusin et al., 2023). The choice of the best evidence implies that the intervention will be able to achieve its goals of increasing patient satisfaction and enhancing their health, and effectively improving the quality of the services provided.
Another example that proves that JHEBP is helpful for the selected project is support for patient preferences. According to Dusin et al. (2023), tools developed within the Johns Hopkins model allow specialists to integrate the wishes of patients and their families into the care process. This feature aligns with the project’s goals and will support efforts to enhance interaction with patients. Realizing that providers respect their wishes and introduce appropriate measures, patients and their families will be ready to develop trusting relationships. Such circumstances will have a beneficial effect on health outcomes and patient satisfaction.
References
Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. BMJ Open, 13(5), 1-9.
Skela-Savič, B., Gotlib, J., Panczyk, M., Patelarou, A. E., Bole, U., Ramos-Morcillo, A. J., Finotto, S., Mecugni, D., Jarosova, D., Patelarou, E., Dolezel, J., & Ruzafa-Martínez, M. (2020). Teaching evidence-based practice (EBP) in nursing curricula in six European countries—A descriptive study. Nurse Education Today, 94, 1-8.
The Johns Hopkins University. (n.d.). Evidence-based practice.