Capstone Implementation Change Model

Capstone Implementation Change Model

Of significance to the implementation plan of any evidence-based practice (EBP) project is the use of a change model that will offer guidance to the institutionalization. Examples of the theoretical frameworks commonly utilized in EBP projects include but not limited to the ARCC model, Roger’s diffusion of innovation, Iowa model, Duck’s change curve model, Stetler’s utilization model,and transtheoretical model of health behavior change (Nilsen, 2015). In essence, this section focuses on the Iowa model of EBP, which will guide the implementation of a project targeting to inculcate transformational leadership behaviors for improvement of nursing retention. Central to the analysis is the systematic scrutiny of the 6steps of Iowa model.

Identification of Practice Question

At the heart of this step is the encouragement of healthcare professionals to identify clinical practice questions that can undergo the EBP process. The practice questions often originate from problem-focused and knowledge-centered triggers (Schaffer, Sandau, &Diedrick, 2013). In relation to this step of the Iowa model, the project pioneers will seek to encourage the current organizational staff to question the established processes of the organization.

Determination of Whether or not the Topic is an Organizational Priority

According to Grove, Burns, and Gray, (2014) not every practice question can form the basis of undertaking an EBP process. As such, there is need for determining issues of highest priority if the organization support is not to be in question.An issue considered as pressing will ordinarily command support from the organization’s stakeholders. In this case, the PICOT question adopted meets this criterion and thus considered for undergoing the EBP process.

Formation of a Team for Search, Critique, and Synthesize of Available Evidence

Following the determination of the topic’s priority status and organizational commitment to the resolution of the identified, there is a need to develop teams.The team will search, appraise and synthesize the readily available literature addressing the formulated clinical question (Melnyk, &Fineout-Overholt, 2015).

Determination of the Sufficiency of the Evidence

During this stage, the team will seek to assess the adequacy of the evidence gathered. Such a determination is of the essence since it enables the team to identify high quality research that supports the implementation of the practice change. Notwithstanding, the absence of high-quality evidence will inform either the team’s reliance on lower level of evidence or intention to conduct a research seeking to better available evidence (Schmidt, & Brown, 2014).

Pilot the Recommended Practice Change

Upon the ascertainment of the adequacy of the evidence, the project developers have to roll out the practice change as a pilot study to establish its feasibility and efficacy of the EBP project. Melnyk, andFineout-Overholt,(2015) are of the opinion that such a roll out is necessary since it enables the project champions to identify issues that might affect the success of the EBP project once rolled out in the whole of the organization.

Evaluate Pilot Success

Evaluation of the pilot success forms the last step of the Iowa model that enables one to determine the need for disseminating the results as well as implementation of the change into practice (Schaffer, Sandau, &Diedrick, 2013). The evaluative data used in the pilot is vital for determining the success of the practice change. Upon establishment of the efficacy of the practice change in the pilot, dissemination of the findings and organization-wide implementation of the EBP will ensue simultaneously.


Grove, S. K., Burns, N., & Gray, J. (2014). Understanding nursing research: Building an evidence-based practice.Elsevier Health Sciences.

Melnyk, B. M., &Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams et Wilkins

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science10(1), 53.

Schaffer, M. A., Sandau, K. E., &Diedrick, L. (2013). Evidence‐based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing69(5), 1197-1209.

Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses.Jones & Bartlett Publishers.




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