Nursing - RN to BSN

IOWA Model of Evidence-Based Practice

IOWA Model was developed at the University of Iowa Hospitals and Clinics in 1990s to serve as a guide for nurses to use research findings to help improve patient care. The model was developed as a pathway or method to EBP - a method to guide the steps to help identify issues, research solutions and implement changes. It is an application-oriented guide for the EBP process.   

Steps of the IOWA model for Evidence Based Practice

1. Identify the trigger where an EBP change is warranted. This can be either a knowledge-focus trigger or a problem-focus trigger*.

2. Determine if the problem at hand is a priority for the organization, practice, department, or unit.

3. Form a team that will develop, evaluate, and implement the EBP change. The team should be made up of representatives both in and out of the nursing unit. This allows for interdisciplinary stakeholders in the team for better evaluation and implementation of the change.

4. Gather and analyze the research related to the desired practice change. This includes formulating a good research question using the PICO(T) method and conducting a literature search looking for related research studies.

5. Critique and synthesize the research discovered during the literature search. This includes reviewing the research to determine if the change is scientifically sound.

6. STOP and DECIDE if there is sufficient research to implement a practice change:

   • NO -  Review the research and: 

     • Determine if there is a need and resources available to conduct actual a research study.  If so, conduct the study and then go back to Step 5.

     • Review and base practice on other types of evidence: Case Reports, Expert Opinions, Scientific Principles, and Theory and then move to Step 7.

   • Yes - Move to Step 7.

7. Implement Change into a Pilot Program. DO NOT conduct a full practice change. Rather, change one or two smaller areas/units first for evaluation.

8. Evaluate results. Is the change feasible and does it result in improved outcomes? Is the change appropriate for full adoption within the department/practice/organization?

   • NO -  Continue to evaluate the care and new research to be able to revisit the issue in the future with new information.

   • YES - Introduce the change across the department/unit/practice/organization.  After the introduction of the change, continue to observe, evaluate, and analyze the results.  As technology and research changes, this could be an issue that will once again need to evaluated.

*Knowledge-focus trigger is a trigger that arises from a change in research, national agencies or organizational standards & guidelines, philosophies of care or information for Institutional Standards Committee.  Problem-focus trigger is a trigger that comes from risk management data, financial data or identification of a clinical problem. 

Brown, C. G. (2014). The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing. Clinical Journal Of Oncology Nursing, 18(2), 157-159. doi:10.1188/14.CJON.157-159