GIBBS REFLECTIVE CYCLE

INTRODUCING EVIDENCE INTO NURSING PRACTICE:

USING THE IOWA MODEL
(Catriona M. Doody, Owen Doody)

Description:
Evidence-based practice has gained increasing popularity since its introduction in the
latter part of the twentieth century, aspiring to be a dominant theme of practice, policy,
management and education within health services across the world (Rycroft-Malone et al, 2004;
Ryan et al, 2006). Nurses are urged to use up-to-date research evidence to deliver the best
possible care (Haynes et al, 1996; Barnsteiner and Prevost, 2002; LoBiondo- Wood and Haber,
2006). The Iowa model focuses on organization and collaboration incorporating conduct anduse
of research, along with other types of evidence (Titler et al, 2001). Since its origin in 1994, it has
been continually referenced in nursing journal articles and extensively used in clinical research
programmes (LoBiondo- Wood and Haber, 2006). This model allows us to focus on knowledge
and problem-focused triggers, leading staff to question current nursing practices and whether
care can be improved through the use of current research findings (Titler, 2006). In using the
Iowa model, there are seven steps to follow namely; selection of a topic, forming a team, evience
retrieval, grading the evidence, developing evidenced based practice standards, implementing
evidenced based practice, evaluation.
Feelings:
There are many was how will a hospital will deal with the changes for the improvement
of healthcare services given among their client. As I have encountered in the nursing service
department there are some decisions which does not have further investigation to resolve some of
the issue and some points were not be discussed thoroughly in the team. And because of these
concerns I am eager to adopt this article to know the very impotance of evidenced based nursing
practice in the clinical setting.
Evaluation:
Upon reviewing the article I have found that it is important to undergo a rigorous studies
and investigation in concerns that arise in the hospital especially in the nursing care. Immediate
resolution without further investigation and understanding with the situation makes the process
weaker and the end point is the goal to achieve the solution is not properly met. Immediate
implementation of corresponding actions regarding hospital problems without further
investigation may lead to chaos in example. To answer the problem in the fast turnover among
hospital nurses. One action which has taken was to shorten the process of probationary and
training duration. Due to this I have observe that the newly hired nurses become weaker in terms
of their clinical practice because of limited time of exposure. They become more dependent
among the senior staff and they are having problems in their duties.

Analysis:
Further investigation may help the institution to resolve this issue is through the usage of
the IOWA model in the nursing practice using the IOWA model in the nursing practice to
determine the work turnover among nurses and how to resolve them. Action taken previously of
the institution creates a problem in the staffing distribution as well as the working environment
and relationship among new nurses, workload of the senior staff. Since staffing was affected
there was a domino effect staff from different area becomes floater and they were pulled out to
augment other unit from the hospital to assist area which have number of newly hired nurses.
Due to theses observation I was able to ask randomly some of the staff about the culture and
surprisingly all the answer has a resemblance with one another. Some of them answers that they
are used to it and they doesnt have any choice. The worst and the last thing for them if they are
really tired is to resign from their work.
Conclusion:
As I read the article entitled Introducing evidence into nursing practice: using IOWA
model by Doody. I have realize the importance of research and evidence based nursing practice
in the clinical setting. EBP is important in resolving conflict in the clinical set up and according
to the article the process which has to be followed is very systematic making all points
considered thus further analysis and investigation will be rendered as a result a credible solution
to each problem will be established. Seven steps were address to apply the IOWA principle
selecting the problem which should be address should be weight down on the urgency and its
importance in the institution prioritization is much important at this point. In the clinical setting
one of which is the patient safety because we are handling people. Dealing lives is such an
important matter to keep them well and recovered from health problem. Formulation of a team is
responsible for the development, implementation and evaluation. In our situation since the
problem is on staffing pattern and staff weakness I have identified that the team responsible is
the nursing service however it is greatly encourage that those people who are interested with the
concern may be included in the team. Such as head nurses because they are managers as well.
Evidence retrieval are gathering evidences including paper works, observations and staff outputs
in the clinical setting are evidences which can be used during the investigation. Brain storming is
important in gathering and validating evidences communication with each member of the team is
very important at these point in time. Determining the reason and factors which make the staff go
out from the company, working environment etc. Grading the evidence, weighing the
importance of the gathered data from the staff identifying the reliability and validity of each
statement of the staff. Developing EBP standard, since the process of analysis and investigating
already arise now is the time that the team will again open the floor for suggestions and
recommendation for the improvement and to answer such problems in the clinical setting. All
possible suggestion were taken as part of the possible resolution for the problem including these
is the usage of SWOT analysis to identify its applicability in the institution. Implementation of
EBP, once standards policies and procedure has been set the facility should implement the

resolution to answer such problem and lastly, Evaluation to check if the program really work and
aswers the problem which is the abrupt turnover of the nursing personnel.
Action Plan:
If this process will be taken by the institution thorough investigation
will be rendered making more better and attainable solution to resolve the
problem in the work turnover among nurses. Factors that are determinants of
fast work turnover among nurses will be specifically identified. Specific
actions pertaining to such problems will be answered thus creating a
harmonious environment among all the staff not only among nursing
personnel but also among all heath care practitioners in the hospital.
Empowering people is very important in strengthening the capacity of the
facility and the empowerment start of the key people which is the manager
who will serve as a guide among the staff motivational personnel to help the
workers boost their morale in their own working areas. Management team
should be trained to how to handle people and how to practice good
communication practices among the staff so that all information will be
delivered properly and words of appreciation and commendation will be
establish, positive outlook in the working environment should be the
ambiance to lessen the stress and burnout among staff of the hospital
regardless on the nursing service or in the administration.