Selecting the correct evidence-based practice framework for a DNP capstone project is not a stylistic choice, it is a methodological decision that determines the structure of the proposal, the chapter headings of the literature review, and the language used to justify every phase of the project. Committees evaluate whether the framework is genuinely applied to the project (with each stage mapped to a specific project activity) or simply named and described in Chapter 2 without further integration. The five frameworks most commonly used in DNP capstone projects are the Iowa Model of Evidence-Based Practice, the Johns Hopkins Nursing Evidence-Based Practice Model, PARIHS, the ACE Star Model, and the Rosswurm and Larrabee Model.
Iowa Model of Evidence-Based Practice (2017 Revised Edition)
The Iowa Model is the most widely used EBP framework in DNP capstone projects and the most commonly required framework at programs that specify a particular model. The 2017 revised edition updated the original 1994 model with improved emphasis on implementation science, sustainability, and organisational system factors. The Iowa Model consists of seven phases:
(1) Identify triggering issues or opportunities (knowledge- or problem-focused triggers); (2) State the question or purpose; (3) Form a team; (4) Assemble, appraise, and synthesise body of evidence; (5) Design and pilot the practice change; (6) Integrate and sustain the practice change; (7) Disseminate results.
When to use the Iowa Model: The Iowa Model is best suited for EBP implementation projects, projects in which an evidence-based intervention is identified, evaluated in the literature, piloted, and then sustained within a clinical system. It works well for projects that involve a specific clinical change (implementing a screening protocol, adopting a care bundle) where the path from evidence to practice is the primary story. The Iowa Model is less well-suited for programme evaluation projects (where you are evaluating an existing programme rather than implementing a new one) or policy change projects (where the primary pathway is stakeholder and policy process, not evidence-to-practice translation).
How to cite: Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp-Reimer, T., & Tucker, S. (2017). Iowa model of evidence-based practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi.org/10.1111/wvn.12223
Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP)
The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) uses a three-phase PET process: Practice question, Evidence, and Translation. Within the Evidence phase, the JHNEBP provides its own evidence appraisal tools, the Johns Hopkins Evidence Level and Quality Guide, which rates research evidence (Level I: systematic review/meta-analysis; Level II: RCT; Level III: quasi-experimental; Level IV: non-experimental; Level V: expert opinion/organisational) and non-research evidence (Level VI: expert opinion consensus; Level VII: evidence from a single expert or organisational experience). The JHNEBP's appraisal tools are its primary strength and the primary reason students choose it, the evidence levelling system is straightforward to apply and generates the evidence synthesis table required for the DNP literature review chapter.
When to use the Johns Hopkins Model: Use JHNEBP when your programme specifies it, when you need a model with strong built-in evidence appraisal tools, or when your project involves a mixed evidence base (some research studies, some clinical practice guidelines, some expert opinion documents) that benefits from a tiered evidence levelling system. The JHNEBP is also well-suited for projects at hospital systems that have adopted the JHNEBP institutionally, some Magnet hospitals train their nursing staff in the JHNEBP, making it a natural fit for DNP projects at those sites.
How to cite: Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.
PARIHS Framework (Promoting Action on Research Implementation in Health Services)
The PARIHS framework (Rycroft-Malone et al., 2002) and its updated version i-PARIHS (Harvey & Kitson, 2015) differ from the Iowa Model and JHNEBP in an important way: PARIHS focuses on the factors that determine whether an evidence-based intervention will be successfully implemented in a specific context, rather than on the steps of identifying and synthesising evidence. PARIHS holds that successful implementation requires three elements: Evidence (strength and type of evidence for the intervention), Context (the organisational, cultural, and structural features of the implementation setting), and Facilitation (the processes and people that enable implementation). The i-PARIHS revision adds a fourth dimension, the Innovation itself (the specific characteristics of the practice change being implemented).
When to use PARIHS/i-PARIHS: PARIHS is best suited for DNP projects where the implementation context is complex, settings with known organisational culture challenges, physician-nursing hierarchy barriers, workflow integration barriers, or settings where similar EBP interventions have been attempted and failed. When the central question of the project is not "what is the evidence?" but "why has this evidence not been implemented here, and what will make it work in this specific setting?", PARIHS is the appropriate framework. It is particularly strong for nurse executive, organisational leadership, and system-level projects.
How to cite: Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: A facilitation guide. Routledge. For i-PARIHS: Harvey, G., & Kitson, A. (2016). PARIHS revisited: From heuristic to integrated framework for the successful implementation of knowledge into practice. Implementation Science, 11(1), Article 33. https://doi.org/10.1186/s13012-016-0398-2
ACE Star Model of Knowledge Transformation
The ACE Star Model (Stevens, 2004) describes five stages of knowledge transformation from primary research to point-of-care practice: Star Point 1 (Discovery Research (primary studies); Star Point 2) Evidence Summary (systematic reviews, meta-analyses); Star Point 3 (Translation to Guidelines (clinical practice guidelines); Star Point 4) Practice Integration (implementation in clinical settings); Star Point 5, Process/Outcome Evaluation (measuring whether the practice change achieved its intended outcomes). The ACE Star Model is conceptually elegant for DNP capstone projects because it maps directly to the DNP's mission: translating evidence (Star Points 1–3) into practice (Star Point 4) and evaluating the outcome (Star Point 5).
When to use the ACE Star Model: The ACE Star Model is best suited for EBP implementation projects where the literature review relies heavily on systematic reviews and meta-analyses (Star Points 1 and 2) and where the project involves adopting a clinical practice guideline (Star Point 3) rather than developing a novel intervention. It is less commonly required by specific programs than the Iowa Model but is well-recognised by committees familiar with implementation science.
Rosswurm and Larrabee Model
The Rosswurm and Larrabee Model (1999) is a six-step model for guiding EBP change: (1) Assess the need for change in practice; (2) Link the problem with interventions and outcomes; (3) Synthesise the best evidence; (4) Design a change in practice; (5) Implement and evaluate the change in practice; (6) Integrate and maintain the change in practice. The model is less commonly used in current DNP capstone projects than the Iowa Model or JHNEBP, but remains a valid choice, particularly in programs that have historical faculty familiarity with it. Its six steps map cleanly to a six-chapter proposal structure.
EBP Framework Selection Guide
Use this guide to select the correct framework for your project type:
EBP implementation (implementing a specific intervention supported by evidence): Iowa Model (2017) (first choice. ACE Star Model) strong alternative. JHNEBP, use when your site uses it or when you need built-in evidence appraisal tools.
Quality improvement (PDSA cycles, SPC monitoring, care bundle implementation): Iowa Model (applicable. Donabedian Structure-Process-Outcome Model) also used for QI framing (Structure = staffing/resources; Process = nursing interventions; Outcome = CAUTI rate, fall rate). Note: pure QI projects sometimes use QI-specific frameworks (IHI Model for Improvement) as the methodological framework rather than an EBP framework, committees accept either.
Programme evaluation: Kirkpatrick Model of Training Effectiveness (for educational programme evaluation). Logic Model (for programme inputs-activities-outputs-outcomes structure). CIPP Model (Context-Input-Process-Product). EBP frameworks are not typically the primary framework for programme evaluation projects, use a programme evaluation framework instead.
Policy change: Kingdon's Multiple Streams Model (problem stream, policy stream, political stream). Longest's Health Policy Cycle. Donabedian for policy impact evaluation. EBP frameworks are not the primary framework for policy change projects.
Projects with significant implementation barriers (context-dependent implementation): PARIHS or i-PARIHS, designed specifically for this scenario.
Which EBP framework does your committee expect, and have they indicated a preference?
Framework selection and application support covers choosing the correct framework for your project type, mapping each framework stage to your specific project activities, writing the framework chapter, and building the framework application table required by most DNP programmes. Share your project type, your clinical problem, and any framework your programme or committee has specified.
Common EBP Framework Application Errors in DNP Capstones
Describing rather than applying: Writing two pages describing the Iowa Model's seven phases without ever stating how each phase maps to this specific project. Fix: add a two-column table (Iowa Model Phase | This Project's Activity) in the framework chapter.
Selecting an EBP framework for a programme evaluation project: Using the Iowa Model for a Kirkpatrick-level 4 programme evaluation project. Fix: select the Kirkpatrick Model as the primary framework; the Iowa Model can serve as the secondary framework for the evidence review component if the programme evaluation includes an EBP literature review.
Citing the 1994 Iowa Model instead of the 2017 revision: The 2017 revision is the current version and should be cited. Using the 1994 version suggests the student found a secondary source rather than the primary citation.
See also: DNP literature review help · DNP capstone proposal help · Systematic vs scoping review
EBP Frameworks for DNP: Frequently Asked Questions
Does it matter which EBP framework I choose as long as I apply it correctly?
For most DNP programs, yes, correct application matters more than which framework is chosen, as long as the framework is appropriate for the project type. However, some programs (particularly those at Walden, GCU, and Capella) specify which frameworks are acceptable or preferred. Faculty committees also have individual preferences, if your committee chair has published using PARIHS, they may expect that framework or at least familiarity with it. Before finalising your framework choice, check your programme's capstone handbook and discuss your selection with your faculty chair before committing to a framework in Chapter 2.
Can I use a non-nursing theory (like Kotter's Change Model) as my DNP capstone framework?
Yes. Non-nursing frameworks are acceptable in DNP capstone projects when they are the best fit for the project type. Kotter's 8-Step Change Model is commonly used in nurse executive and organisational leadership projects. Donabedian's Structure-Process-Outcome Model (developed in healthcare, not nursing specifically) is widely accepted. The Logic Model is accepted for programme evaluation. The requirement is that the framework is applied explicitly to the project, not that it originated within nursing science. Some committees prefer a nursing framework as the primary framework with a change management model as a secondary framework for the implementation methodology.
Does the EBP framework need to appear in chapters other than Chapter 2?
Yes, this is the most commonly missed framework requirement. The framework must be referenced in Chapter 3 (Methodology), where each methodology decision is justified in relation to the framework stage it represents. It should reappear in Chapter 5 (Discussion), where the project findings are interpreted in relation to the framework's guidance for sustainability and dissemination. A framework that appears only in Chapter 2 and is never mentioned again is the primary reason DNP capstone manuscripts receive committee feedback requesting "greater integration of the theoretical framework throughout the manuscript."
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What is a DNP capstone project and how is it different from a PhD dissertation?
A DNP capstone project is a practice-focused doctoral scholarly project that applies evidence-based practice, quality improvement, or program evaluation methods to address a clinical problem. Unlike a PhD dissertation, which generates new knowledge through primary research, a DNP capstone translates existing evidence into practice change. It does not require original data collection in most cases and is evaluated on practice impact rather than research contribution.
Which DNP specialisation tracks do you support?
We support all 13 major DNP specialisation tracks: Family Nurse Practitioner (FNP), Adult-Gerontology Acute Care NP (AGACNP), Adult-Gerontology Primary Care NP (AGPCNP), Psychiatric-Mental Health NP (PMHNP), Pediatric NP (PNP), Neonatal NP (NNP), Women's Health NP (WHNP), Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Leader (CNL), Nurse Executive/Healthcare Leadership, Population Health, and Nursing Informatics.
Can you help with just one chapter of my DNP proposal or do I need the full project?
You can order help with any individual component: a single proposal chapter, just the PICOT question, just the IRB protocol, or just the data analysis section. You do not need to order the full project. Many students come to us mid-project needing targeted help with one specific deliverable.
Does my DNP capstone project need IRB approval?
Most DNP capstone projects are classified as quality improvement (QI) or program evaluation and do NOT require full IRB review under 45 CFR 46; they qualify for a QI determination or exempt status. However, the determination must be documented. We help you complete the QI determination checklist and, where needed, write the full IRB protocol for exempt or expedited review.