Response to Letter 2: John Hopkins EBP Model To Letter 2- I agree that the John Hopkins EBP model is one of the best for implementation of EBP in all medical settings. The two research evidence classifications, promoted by the John Hopkins Nursing Evidence-Based Practice Model (JHNEBP), are: research or non-research (Dearholt & Dang, 2012). Practice, Evidence and Translation (PET) are the three phase relationship components (with 18 steps) that link critical thinking and the judicial process of applying evidence into an active process. The application in initially designing the JHNEBP was to include bedside nurses and they were the first testers in the implementation of the pilot process in 2002 (Melnyk & Fineout-Overholt, 2011).
The JHNEBP model is a combination of research and non-research encompassing nursing practice, education and the research fields. In utilizing PET, the practice question is designed so as to provide an answer from results. In evidence, research finds the answers by analyzing specific proof (data). The translation of the findings provides the method of implementing the infrastructure into a pilot application for further testing and refining (Melnyk & Fineout-Overholt, 2011).
As you would know, there are seven tools utilized during the PET18 steps, applied within the process. and they are: Question Development, Evidence Rating Scale, Research Evidence Appraisal, Non-research Evidence Appraisal, Individual Evidence Summary, Overall Evidence Summation and Project Management (Melnyk & Fineout-Overholt, 2011, p. 270).
In the 18 step PET process, the first five steps occur in the Practice Question development phase, whereby a question is identified, the practice scope is defined, leadership and responsibility is assigned, a team is developed and the project conference scheduled. In the Evidence phase, internal and external research occurs, critical appraisal is made on findings, evidence is summarized including a rate of strength, and recommendations are made. In the third phase, Translation, recommendations are set into a plan of action, the changes are implemented, outcomes are evaluated, preliminary reports are made to the decision makers, support is obtained for implementation by a step-by-step process and, finally, the findings are communicated (Melnyk & Fineout-Overholt, 2011; Dearholt & Dang, 2012).
In some situations, when research is limited in regards to a particular issue, nurses will need to review and evaluate other resources such as trade journals, peer expertise recommendations, professional organizations, regulations and guidelines in order to come up with an answer. This is the basis of non-research which does not provide scientific data as would be found in research studies (Dearholt & Dang, 2012). Whether it is research or non-research, the results are then combined with the patient assessments and interviews, in order to discover the best final medical solution for a patient. This is particularly true as many patients must now take a more active participation in helping themselves attain or regain a healthy lifestyle again.
You and I both agree that this is a very effective model because it encompasses so many processes within its infrastructure, essential for success in EBP innovation and application.
Resources
Dearholt, S. L., & Dang, D. (eds.) (2012). Johns Hopkins nursing evidence – based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare (2nd ed.). Baltimore, MD: Wolters Kluwer Health.
Appendix I-
John Hopkins Model
(Fig. 1, Dearholt & Dang, 2012)
Appendix 2-
The PET Model in Application of 18 Steps
(Fig. 2, Melnyk & Fineout-Overholt, 2011, p. 271)
