The Iowa Model, a stalwart framework in the nursing field for enhancing patient care through evidence-based practice, has been revised, revitalizing its role in the ever-progressing healthcare landscape. The Journal of Pediatric Nursing has recently published an article discussing the updated model, underlining its significance and application in the context of modern healthcare needs.

DOI: 10.1016/j.pedn.2019.04.023

The Relevance of the Iowa Model in Today’s Healthcare

With healthcare evolving rapidly due to technological advancements, changing patient demographics, and emerging health challenges, the necessity for a responsive and effective nursing framework has never been greater. The Iowa Model has been one of the quintessential approaches to integrating research findings into clinical practice since its inception. This model has stood as a guide for nurses to address problems identified in clinical settings through a series of structured steps, promoting the implementation of the best available evidence into practice.

The revised Iowa Model maintains the integrity of the original structure but adapts to the enhanced complexity of current healthcare systems and the broader scope of evidence-based practice. This evolution is not only relevant but crucial in an era where precision medicine and personalized care have become focal points of discussion.

Key Features of the Revised Iowa Model

The revised Iowa Model, originally developed at the University of Iowa Hospitals and Clinics, retains its core principle of problem-focused triggers, which are derived from clinical practice issues or risk management data, and knowledge-focused triggers, which come about due to new research findings or other literature. However, several foundational enhancements stand out in the newly refined model:

1. A stronger emphasis on interprofessional collaboration, ensuring all relevant healthcare professionals are involved in the evidence-based practice process.
2. Greater incorporation of patient and family perspectives, which encompasses the needs, preferences, and values of those receiving care.
3. An expanded view of evidence, recognizing not only research evidence but also clinical expertise, patient preferences, and available resources.
4. Enhanced guidance for sustainability and dissemination of practice changes.

These adjustments mark a significant shift towards a more holistic and inclusive approach to nursing practice, aimed at improving outcomes and promoting patient-centered care.

The Practical Application of the Revised Iowa Model

In the Journal of Pediatric Nursing, authors Kirsten K Hanrahan, Cassandra C Fowler, and Ann Marie McCarthy provide a succinct overview of the Iowa Model Revised. Through their practice at the University of Iowa Stead Family Children’s Hospital and the College of Nursing, they attest to the model’s practical relevance.

For example, in postoperative care for pediatrics, applying the Iowa Model Revised can facilitate the systematic identification and implementation of the best pain management practices, enhancing recovery and parental satisfaction. It prompts the nursing team to collaboratively assess existing pain management protocols, review current literature for the best available evidence, and incorporate insights from patients’ families into care plans. Consequently, nurses can deliver care that not only aligns with the latest scientific evidence but also resonates with the individual needs of the children they serve.

Impact and Implications

Evidence-based nursing is a testament to the nursing profession’s commitment to continuous improvement and excellence in patient care. By revisiting and revising models like the Iowa Model, the discipline ensures that its methodologies remain effective, efficient, and above all, patient-centric.

The impact of such models extends beyond the realm of patient outcomes. They harbor the potential to influence policy at institutional levels, drive quality improvement initiatives, and shape the education and training of future nurses. By fostering an environment where research and practice coalesce, evidence-based models such as the Iowa Model Revised are instrumental in pushing the boundaries of what is possible in nursing care.

Next Steps and Further Research

While the Iowa Model Revised offers a robust framework for evidence-based practice, continuous evaluation and fine-tuning of its application are imperative. As healthcare continues to evolve, so too must the models and frameworks guiding clinical practice.

Further research could explore the long-term outcomes of applying the Iowa Model Revised in various clinical settings. Comparative studies examining pre- and post-implementation metrics can provide empirical data to support its efficacy and highlight areas for future refinement.


The Journal of Pediatric Nursing’s publication of the Iowa Model Revised marks a significant step for nursing practitioners and researchers alike. The model’s adaptation to contemporary healthcare challenges exemplifies the dynamic nature of evidence-based practice and underscores a collective committal to patient care excellence. As healthcare environments grow more complex, such approaches will be crucial in ensuring that patient care is both scientifically grounded and distinctly human-centered.


1. Hanrahan, K. K., Fowler, C. C., & McCarthy, A. M. (2019). Iowa Model Revised: Research and Evidence-based Practice Application. Journal of Pediatric Nursing, 48, 121-122.

2. Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q., … & Montgomery, L. A. (2001). The Iowa Model of Evidence-Based Practice to Promote Quality Care. Critical Care Nursing Clinics of North America, 13(4), 497-509.

3. Stevens, K. R. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. The Online Journal of Issues in Nursing, 18(2).

4. Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Philadelphia: Lippincott Williams & Wilkins.

5. DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence-Based Nursing: A Guide to Clinical Practice. Elsevier Health Sciences.


1. Iowa Model Revised
2. Evidence-Based Nursing Practice
3. Nursing Research Application
4. Patient-Centered Nursing Care
5. Clinical Practice Frameworks