Nursing is among the top careers for job growth, with an estimated 7% increase in the nursing workforce by 2029. As new students train to enter or advance in the profession, advanced practice RNs (APRNs) must mentor and empower them to integrate evidence-based practice (EBP) into their care.

EBP Mentorship Benefits Students and APRNs Alike

Mentorship is a process where an experienced nurse guides a novice nurse to influence and facilitate personal and professional growth. Mentorship may apply to various levels of nursing students, including undergraduate and graduate nursing students. Students often share innovative ideas and bring new energy to a practice issue.

Although mentorship can be informal too, a formalized approach focuses on helping the novice nurse achieve a specific project or goal, such as an EBP project. Some of those projects tackle quality improvements for patient care or other improvements in clinical practice issues. I recently mentored a DNP student through a clinical project for an organizational leadership course, and we both found the experience rewarding and beneficial for the clinical setting.

Use EBP Frameworks to Guide Change

As we discussed potential ideas for projects, we used the Iowa Model for EBP change as a framework to guide to the clinical practice change. The Iowa Model has been used in practice since 1994, but it was revised in 2017 to include multiple levels of evidence, expanded piloting, implementation, and sustained change.

We began by identifying a trigger, or opportunity. The trigger can be a clinical or patient-identified issue, an organizational or national initiative, new data or evidence, accrediting agency requirements, or a philosophy of care. We chose a project brought to us by an interprofessional colleague, who reported that a recent accreditation visit sparked questions about therapeutic phlebotomy order, equipment, and procedures. This was an opportunity to review our policy, equipment, procedures, and nursing competencies.

The next step was to ask a clinical question or state a purpose for the project, and one way to do that is through the PICOT question formula. Because the topic was considered a priority, we then formed a team. We assembled, appraised, and reviewed the current evidence and deemed it sufficient to move forward with a pilot project. The Infusion Nurses Society Standards and literature from the past five years provided supportive evidence.

When designing the pilot, the student observed and discussed the project with several staff nurses. We also considered the resources, barriers, and approval we needed. The student and I decided they would focus on consent implementation and nursing competency. After consulting with various team members, including blood bank staff, compliance officers, legal team, health information management, and hematology physicians, we developed a consent form based on a current template.

During a staff retreat at the completion of the semester and project, the student presented the new consent and procedure and the nurses completed simulated competency assessments. Together, the student and nurses brainstormed ideas and adopted the educational materials. We are now ready to integrate the practice change, disseminate our results, and sustain the practice change. See the sidebar to follow along on the model steps and project milestones.

Additional mentorship resources are often available through professional organizations like ONS. By joining ONS (with a free membership for prelicensed students), nurses can access free and discounted continuing nursing education, networking opportunities through local chapters and ONS communities, and career development information.

Applying the Iowa Model to Therapeutic Phlebotomy Practice Change

Iowa Model