THE IOWA MODEL OF
EVIDENCE-BASED
PRACTICE TO PROMOTE
QUALITY CARE
Jill Collins, Jerilyn Rodgers,
Sandy Siebert & Julie Unruh
**please refer to page 252 for presentation**
The Iowa Model of Evidence-Based
Practice to Promote Quality Care
• Provides guidance for nurses and other
clinicians in making decisions about dayto-day practices that affect patient
outcomes.
• Based on the problem-solving steps in the
scientific process and is widely recognized
for its applicability and ease of use by
multi-disciplinary healthcare teams.
USING THE IOWA MODEL
• Begins by encouraging clinicians to
identify practice questions or “triggers”
either through identification of a clinical
problem or from new knowledge. These
triggers often come from questioning
current practice.
• There are 2 types of triggers: Problem
Focused Triggers and Knowledge
Focused Triggers
TRIGGERS
Problem Focused
• Risk Management Data
• Process Improvement
Data
• Internal/External
Benchmarking Data
• Financial Data
• Identification of Clinical
Problem
Knowledge Focused
• New research or other
literature
• National Agencies or
Organizational Standards
and Guidelines
• Philosophies of Care
• Questions from
Institutional Standards
Committee
USING THE IOWA MODEL
• Once the trigger has been identified, one
should assess the priority of the topic for the
organization. If it is not an organizational
priority then one should consider selecting
another trigger.
• If the trigger is a priority, a team should be
developed to develop, implement, and
evaluate the practice change. Should
include stakeholders involved in the current
practice.
USING THE IOWA MODEL
• Initially the team selects, reviews, critiques,
and synthesizes available research evidence.
If high-quality research evidence is not
available, or sufficient for determining
practice, the team may recommend using
lower levels of evidence, such as case
reports, expert opinion, scientific principles
and theory, or conduct research to improve
the evidence available for practice decisions.
• If the evidence is sufficient, a practice change
is piloted. The team then tries the change to
determine the feasibility and effectiveness of
the EBP change in clinical care.
USING THE IOWA MODEL:
PILOTING THE CHANGE IN
PRACTICE
• Select outcomes to be achieved
• Collect baseline data
• Design EBP guidelines
• Implement EBP on pilot units
• Evaluate process and outcomes
• Modify the practice guideline
USING THE IOWA MODEL
• Following the pilot, a determination is made
regarding appropriateness of adoption beyond
the pilot.
• Decision is made regarding adoption or
modification of the practice is based upon the
evaluative data from the pilot.
• If practice change is not appropriate, quality or
performance improvement monitoring is needed
to ensure high-quality patient care.
• Additional steps include watching for new
knowledge, collaborating with researchers in the
area, or conducting research to guide practice
decisions.
USING THE IOWA MODEL
• If the pilot results in positive outcomes, rollout
and integration of the practice are facilitated
through leadership support, education, and
continuous monitoring of outcomes.
• Dissemination of the results is important for
professional learning.
THANK YOU