Chays-Amania Audrey, Schwingrouber Jocelyn, Melnyk Bernadette Mazurek, Haller Pierre Henri, Soler Julie, Colson Sébastien
Aix-Marseille Université, Faculté Des Sciences Médicales et Paramédicales, Nursing School, CEReSS, Marseille, France.
The Ohio State University, Columbus, Ohio, USA.
Worldviews Evid Based Nurs. 2025 Jun;22(3):e70050. doi: 10.1111/wvn.70050.
Evidence-based practice (EBP) should be implemented in clinical settings and practiced by registered nurses as it improves healthcare quality, safety, costs, and patient outcomes. For this to occur, nurses need to be skilled and acculturated. An EBP culture needs to be developed and sustained, both in initial academic programs and in clinical settings. Implementation models already exist and are being used, but outcomes are not consistently measured.
The aim of this scoping review was to gather and map the use of EBP implementation models as well as their implementation strategies and outcomes.
The methodology for the JBI Scoping Reviews was applied. The databases queried were PubMed, CINAHL, EMBASE, EMCARE, AMED, BNI, HMIC, PsycInfo. Inclusion criteria were as follows: Any primary study that describes the implementation of EBP in nursing, clinical, or academic settings. Studies using the following EBP implementation models were included: the ARCC Model, ARCC-E Model, IOWA Model, Stetler Model, Johns Hopkins Nursing EBP Model, ACE Star Model as well as PARIHS and i-PARIHS. They must have used Proctor's taxonomy for implementation outcomes as well as described implementation strategies according to the ERIC classification. Data extraction was performed by four independent reviewers in February 2024. There was no language or date limitation. Three independent reviewers performed an initial selection on titles and abstracts. Reading of the full texts was carried out by two independent reviewers using the JBI SUMARI.
A total of 2244 articles were retrieved. After removing duplicates and applying the inclusion criteria, 26 articles were reviewed, and data extracted. The most used implementation model was the PARiHS or i-PARiHS model followed by the IOWA model, the ARCC model combined with the JHNEBP model and the Stetler model. Nearly all studies used the implementation strategy domain "Use evaluative and iterative strategies" of ERIC classification. Overall, the selected studies used between 1 and 2 outcomes from Proctor's eight available.
The underuse of existing taxonomies (Proctor, ERIC) prevents an exhaustive mapping of the use of implementation models. The vocabulary used is too vague, and the implementation strategies are sometimes poorly described. An effort needs to be made to report on all work done to transfer the results to other settings and thus improve health care practices.
循证实践（EBP）应在临床环境中实施，并由注册护士践行，因为它能提高医疗质量、安全性、成本以及患者预后。要实现这一点，护士需要具备技能并适应这种文化。需要在初始学术项目和临床环境中培养并维持一种循证实践文化。现已有实施模型并正在使用，但结果并未得到一致的衡量。
本范围综述的目的是收集并梳理循证实践实施模型的使用情况及其实施策略和结果。
采用了JBI范围综述的方法。所查询的数据库有PubMed、CINAHL、EMBASE、EMCARE、AMED、BNI、HMIC、PsycInfo。纳入标准如下：任何描述在护理、临床或学术环境中实施循证实践的原始研究。纳入使用以下循证实践实施模型的研究：ARCC模型、ARCC - E模型、爱荷华模型、斯特特勒模型、约翰霍普金斯护理循证实践模型、ACE星型模型以及PARIHS和i - PARIHS。它们必须使用普罗克特的分类法来衡量实施结果，并根据教育资源信息中心（ERIC）的分类描述实施策略。2024年2月由四名独立评审员进行数据提取。没有语言或日期限制。三名独立评审员对标题和摘要进行初步筛选。两名独立评审员使用JBI SUMARI阅读全文。
共检索到2244篇文章。在去除重复项并应用纳入标准后，对26篇文章进行了综述并提取了数据。使用最多的实施模型是PARiHS或i - PARiHS模型，其次是爱荷华模型、ARCC模型与约翰霍普金斯护理循证实践模型的组合以及斯特特勒模型。几乎所有研究都使用了教育资源信息中心分类中的实施策略领域“使用评估和迭代策略”。总体而言，所选研究从普罗克特的八个可用结果中使用了1至2个。
现有分类法（普罗克特、教育资源信息中心）使用不足，妨碍了对实施模型使用情况的详尽梳理。所使用的词汇过于模糊，实施策略有时描述不佳。需要努力报告为将结果转移到其他环境并从而改善医疗实践所做的所有工作。
