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(if appropriate), and secondary sources (including the Internet). Evidence-based regulation also can include analysis of the outcomes of board functions and cost of policy options. (Adapted by Ridenour [2009, p. 277] from Strategic Policy Making Team Cabinet Office [1999]. Professional policy making for the twenty-first century.) 2. Evidence-based regulation is information that comes closest to the facts of the matter. The form it takes depends on context. Findings from high-quality, methodologically appropriate regulatory research are the most accurate evidence. Because research often is incomplete and sometimes contradictory or unavailable, other kinds of regulatory information are necessary supplements to or stand-ins for research. The evidence base for decision is multiple forms of evidence combined with rigor with expedience—while privileging the former over the latter. (Adapted by Ridenour [2009, p. 277-278] from Canadian Health Services Research Foundation. [2006]. 2005 Annual Report.) 3. Evidence-based regulation consists of findings from research and other knowledge that may serve as a useful basis for decision making in public health and health care. (World Health Organization Regional Office for Europe, 2004). sources for conducting research or collecting data in nursing boards rarely are considered a priority. In discussing knowledge management, Sin (2008) outlines several challenges related to the structures and culture of public institutions, which also could be barriers for fostering evidencebased regulation. They include: ● resistance to implementing evidence-based regulation ● rule-based culture that encourages compliance ● bureaucratic structure that slows communication and decision making ● high staff turnover and/or transfers ● political nature of government initiatives ● tendency for “change fatigue” to occur due to constant introduction of initiatives, often with confusing labels ● confidential nature of some information and knowledge, which inhibits sharing and access. Implementing Evidence-Based Regulation in Nursing How can regulators best implement evidence-based regulation in nursing? Many models can assist regulators to integrate the best available evidence into regulatory decisions and policy making. The examples below briefly describe three models regulators may find useful. The Disciplined Clinical Inquiry (DCI) model (Sanares-Carreon, Waters, & Heliker, 2009) might be the most appropriate model for nursing regulation. It offers a pathway for integrating evidencebased health care into individual and organizational performance. Its primary goal is to embed evidence-based health care into the nursing culture. DCI has five phases, which easily can be adapted for regulatory issues: 1. Phase I focuses on assessing the nurse’s attitude and skills related to evidence-based health care and conducting an environment scan. 2. Phase II engages the nurse in learning about evidence-based health care. 3. Phase III verifies the nurse’s ability to transfer learning into practice. 4. Phase IV evaluates the patient’s receipt of effective and individualized nursing interventions. 5. Phase V ensures nurses are engaged in ongoing critiques and evaluation of the process and outcomes, establishing a continuous process. The Academic Center for Evidence-Based Practice model (ACE model) depicts the relationships between the various stages of knowledge transformation. 1. During Discovery, the first stage, studies are identified. 2. During Summary, stage two, evidence is synthesized into a meaningful whole. 3. During Translation, stage three, scientific evidence is put in context with practice, and practice recommendations are made. 4. During Implementation, the fourth stage, changes take place and research is integrated into practice. 5. During Evaluation, the last stage, the impact of the change is evaluated. (For additional details on the ACE model, visit www.acestar.uthscsa.edu/Learn_model.htm.) A third model that can be used to implement evidence-based regulation is the Iowa Model of Evidence-Based Practice (Titler, 2006). The first step in this model is topic selection. Examples of potential topics are problems identified by staff or ideas generated from scientific papers or when encountering evidence-based guidelines published by federal agencies. If the topic is a priority for the organization, a team is formed to develop, implement, and evaluate the evidence-based practice. Next, the team retrieves the evidence, using the evidence-based health-care principles described above. After the studies have been critiqued and synthesized, the next step is to decide if the evidence supports changes in practice. If practice changes are warranted, these should be implemented and disseminated. Benchmarking While benchmarking per se is not a model for implementing evidence-based regulation, Ridenour (2009) and Howard & Kilmartin (2006) suggest it can be considered a strategy for measuring performance outcomes of governmental organizations. According to Howard & Kilmartin (2006, p. 8), 73% of governmental organizations currently use benchmarking activities; one third of the organizations achieved productivity gains and one fourth achieved cost improvements. One of the organizations saved the United States $28 million in 1 year. Retrieval of Research Data Nursing regulators need access to relevant studies to