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Iowa Model

The Iowa Model of Evidence-Based Practice to Promote Quality Care provides a framework for nurses to make decisions about day to day practices that affect patient care outcomes.

The Iowa Model begins by encouraging staff nurses to identify practice questions, triggered either through identification of a problem or through new knowledge. The practice question aligned with organizational priorities is best positioned for allocation of supporting resources.

Once the topic is deemed a priority for the organization, a team is formed to develop, implement, and evaluate the practice change. The team is ideally comprised of stakeholders in the practice change, and may include the staff nurse(s) that identified the practice question, unit managers and advanced practice nurses, and interdisciplinary colleagues.

Initially, the team selects, reviews, critiques, and synthesizes available research evidence. If the research evidence is not sufficient, the team can recommend using lower levels of evidence or conducting more research. If the evidence is sufficient, a practice change is initiated. The team pilots the practice change to determine the feasibility and effectiveness. If the pilot results in positive outcomes, roll-out and integration of the practice is facilitated through leadership support, education, and continuous monitoring of outcomes. Sharing project reports within and outside of the organization through presentations and publications supports the growth of an evidence-based practice (EBP) culture in the organization, expands nursing knowledge and encourages EBP changes in other organizations.

The Iowa Model includes several feedback loops, reflecting analysis, evaluation, and modification based on that evaluation of both process and outcomes. These are critical to individualizing the evidence to your practice setting.

Original Citation of Iowa Model:

Titler, M.G., Kleiber, C., Steelman, V., Rakel, B.A., Budreau, G., Everett, L.Q... Goode, T. (2001). The Iowa model of evidence-based practice to promote quality care. Critical Care Nursing Clinics of North America, 13, 497-509.

To download the Iowa Model, click here.

To obtain permission to use the Iowa Model, please complete this form and return it to Dr. Marita Titler at

View a video about the Iowa Model that was created by Siti Zubaidah and her children, from Singapore.