A model for change to evidence-based practice

Image J Nurs Sch. 1999;31(4):317-22. doi: 10.1111/j.1547-5069.1999.tb00510.x.


Purpose: To describe a model that guides nurses and other healthcare professionals through a systematic process for the change to evidence-based practice. The tremendous increases in clinical research and accessibility to research findings have prepared the way for the paradigm shift from traditional and intuition-driven practice to evidence-based practice. Although several models have emerged to guide practitioners in research utilization, practitioners continue to have difficulty synthesizing empirical and contextual evidence and integrating evidence-based changes into practice.

Organizing framework: The model is based on theoretical and research literature related to evidence-based practice, research utilization, standardized language, and change theory. In this model, practitioners are guided through the entire process of developing and integrating an evidence-based practice change. The model supports evidence-based practice changes derived from a combination of quantitative and qualitative data, clinical expertise, and contextual evidence.

Methods: The model was developed using sources identified on searches of Medline, CINAHL, and systematic reviews available on the Internet. Review topics were focused on evidence-based medicine and nursing, research utilization, and change process. Other sources included clinical expertise and quality-improvement information.

Conclusions: Practitioners need skills and resources to appraise, synthesize, and diffuse the best evidence into practice. Patient outcomes must reflect discipline-specific and interdisciplinary accountabilities. Collaboration between researchers and practitioners within and among disciplines will enhance the diffusion of evidence-based practice innovations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Benchmarking
  • Cooperative Behavior
  • Diffusion of Innovation*
  • Evidence-Based Medicine*
  • Humans
  • Interprofessional Relations
  • Models, Nursing*
  • Nursing Care / organization & administration*
  • Nursing Research / organization & administration*
  • Nursing Staff / psychology
  • Nursing Theory
  • Organizational Innovation
  • Research Design
  • Research Personnel / psychology