Kathleen C. Buckwalter

The Iowa Model of Evidence-Based Practice to Promote Quality Care

The UIHC Department of Nursing is nationally known for its work on use of research to improve patient care. This reputation is attributable to staff members who continue to question how can we improve practice? or what does the latest evidence tell us about this patient problem? and to administrators who support, value, and reward EBP. The revisions made in the original Iowa Model are based on suggestions from staff at UIHC and other practitioners across the country who have implemented the model. We value their feedback and have set forth this revised model for evaluation and adoption by others.

The caring partnership: Staff and families of persons institutionalized with Alzheimer's disease

This article has set forth a strategy to increase family/staff cooperation in the care of persons institutionalized with AD. The FIC program was developed as an outgrowth of research that demonstrated family member dissatisfaction with their roles. It is specifically designed to provide a partnership role with staff for families whose relatives with AD are institutionalized. Hypothesized outcomes include the reduction of stress in caregiving, increased satisfaction in role and improved patient cognitive and functional outcomes. Testing of the FIC is currently underway.

Nasogastric and nasointestinal feeding tube placement: an integrative review of research

The authors present a review of the research on various methods for determining placement of nasogastric and nasointestinal feeding tubes. They also discuss research on associated risk factors, complications specific to critical care patient populations, and techniques for postpyloric placement. They present research consensus, recommendations for practice, and implementation strategies.

Review of exemplar programs for adults with early-stage Alzheimer's disease

In response to the need to develop evidence-based best practices interventions and services for individuals in the early stages of Alzheimers disease (AD), the authors conducted an interdisciplinary literature review of exemplar programs, defined as those including multimodal or unimodal interventions; shown to be appropriate for individuals in the early stages of AD; demonstrating promise to support, maintain, and improve independent functioning; and shown to have positive effects for a variety of outcomes, including quality of life. This article examines evidence from five kinds of programs: (a) multimodal interventions, (b) programs developed by the Southwest Florida Interdisciplinary Center for Positive Aging, (c) sleep enhancement interventions, (d) managed care programs, and (e) technology-based interventions. Evidence from the review suggests that a number of programs can support functioning and improve quality of life for adults living with the early stages of memory loss. The article concludes with recommendations to advance a national research agenda in this area.

Iowa Model of Evidence‐Based Practice: Revisions and Validation

Background nThe Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g., emergence of implementation science, emphasis on patient engagement) prompted the re-evaluation, revision, and validation of the model. n nMethods nA systematic multi-step process was used capturing information from the literature and user feedback via an electronic survey and live work groups. The Iowa Model Collaborative critically assessed and synthesized information and recommendations before revising the model. n nResults nSurvey participants (n = 431) had requested access to the Model between years 2001 and 2013. Eighty-eight percent (n = 379) of participants reported using the Iowa Model and identified the most problematic steps as: topic priority, critique, pilot, and institute change. Users provided 587 comments with rich contextual rationale and insightful suggestions. The revised model was then evaluated by participants (n = 299) of the 22nd National EBP Conference in 2015. They validated the model as a practical tool for the EBP process across diverse settings. Specific changes in the model are discussed. n nConclusion nThis user driven revision differs from other frameworks in that it links practice changes within the system. Major model changes are expansion of piloting, implementation, patient engagement, and sustaining change. n nLinking Evidence to Action nThe Iowa Model-Revised remains an application-oriented guide for the EBP process. Intended users are point of care clinicians who ask questions and seek a systematic, EBP approach to promote excellence in health care.BACKGROUNDnThe Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g., emergence of implementation science, emphasis on patient engagement) prompted the re-evaluation, revision, and validation of the model.nnnMETHODSnA systematic multi-step process was used capturing information from the literature and user feedback via an electronic survey and live work groups. The Iowa Model Collaborative critically assessed and synthesized information and recommendations before revising the model.nnnRESULTSnSurvey participants (n = 431) had requested access to the Model between years 2001 and 2013. Eighty-eight percent (n = 379) of participants reported using the Iowa Model and identified the most problematic steps as: topic priority, critique, pilot, and institute change. Users provided 587 comments with rich contextual rationale and insightful suggestions. The revised model was then evaluated by participants (n = 299) of the 22nd National EBP Conference in 2015. They validated the model as a practical tool for the EBP process across diverse settings. Specific changes in the model are discussed.nnnCONCLUSIONnThis user driven revision differs from other frameworks in that it links practice changes within the system. Major model changes are expansion of piloting, implementation, patient engagement, and sustaining change.nnnLINKING EVIDENCE TO ACTIONnThe Iowa Model-Revised remains an application-oriented guide for the EBP process. Intended users are point of care clinicians who ask questions and seek a systematic, EBP approach to promote excellence in health care.

Psychiatric and Geriatric Nurses Together at the Table: Evaluation of a Combined Conference

Older adults who exhibit behavioral symptoms, particularly aggression, are increasingly being admitted from long-term care settings to psychiatric units for evaluation and treatment. Posthospitalization “success” is often limited, suggesting that improved understanding and communication between nurses who work in nursing homes and those who work in hospital inpatient units may be needed. With use of a video about older adults and aggression as a basis for education, discussion, and interaction, geriatric/long-term care and psychiatric nurses participated in a day-long program. The conference was designed to bring the two groups together to focus on common problems and solutions, sharing information, and networking. Quantitative evaluation, including 15 items that rated the relevance, usefulness, and overall quality of the program and teaching approaches, and qualitative evaluation in the form of narrative comments about the program’s most and least useful aspects, support the value of the approach.