- is the mechanism used to translate the knowledge that has been generated by research into clinical practice.
Research utilisation efforts
- are systematically introduced within a organisaton or institution and has a more formal or structured approach to research utilisation which leads to approved practices being in the organisation's procedure manual
Utilising research in
- structured & systematic way promotes consistant, cost-effective, & high-quality nursing care.
Barriers to research utilisation
- insufficient time to read research
- lack of authority to affect change
- lack of research skills
- inability to access & engage in research findings.
- lack of confidence in accessing & evaluating research.
1. formulating an EBP question
2. systematically searching for evidence
3. critically appraising evidence
4. change practice where indicated
5. evaluating the effects of change
Newman et al 2000
Formulating a question for EB nursing
- can use the PICO
Patient or populatin
Intervention of interest
Systematically searching for evidence in
- looking for the best evidence
such a 2 or more comparable RCT's
- often there is already best EBP available such in systematic reviews which is a rigourous review of evidence for practice. often they are used to base and develop clinical practice guidelines.
Critically appraising the evidence
- appraising the evidence for error or bias
- appraisal process of conducting a systematic review or developing clinical practice guidelines
Changing practice when indicated
- implementation of research finding by
1. easy to read summaries of research
3. evidence-based procedure manuals.
Evaluating the effects of the change
- evaluates the process & outcomes of care
- important method is practice evaluation is clinical audit
1. determining what is the bast practice
2. investigating current practice & comparing findings to best practice
3. if necessary, implement changes to improve practice.
What evidence-based practice does
- make available the most current & rigorous evidence to assist nurse in guiding individualised & contextualised research-based care decsisions.
Evidence-based Practice comprises of
1. converting the information you require into an answerable clinical question
2 tracking down, with maximum efficiency, the best evidence with which to answer it
3. Critically appraising that evidence for its
- validity ( closeness to the truth)
- impact ( size of the benefit)
- applicability ( clinical usefulness)
4. integrating that appraisal with your clinical expertise, patient biology, values & circumstances & Apply the results to your clinical practice
5. Evaluating your effectiveness & efficiency in executing previous steps & seek ways to improve your performance.
- use evidence to help with making decision about risks, benefits of care, intervention
Important tool for clinical decisions
- care pathways
- are clinical tools, developed & based on the best evidence available; therefore more likely to improve clinical effectiveness & efficiency.
Benefits of care pathways
- health management plan, assimilates information from a variety of source.
-provides a sequence of events & timing of interventions
- provides a baseline
- identifies variations from normal
- ensures that everyone follows prescriptive guidelines for assessment, planning, interventions, evaluations
- allows for quality nursing & improvement.
Uniqueness of care pathways
- based on the most up to date knowledge; & is contextual to the client group & available resource.
Care pathway patients
- report greater satisfaction with their care
Embedded in Evidence-based practice
- must be critical reflection, questioning & appraisal.
Critically appraised evidence
- randomised controlled trials
- systematic reviews
- cohort studies
- case-controlled studies
- qualitative studies
- economic evaluations
- diagnostic studies
Appraisal Tool for implementing evidence into practice & evaluation
Who is involved in research utilisation?
- client/ patient
- administrator/ nurse manager
3 approaches to exploring research literature
1. identification & review of the clinical & research priorities in a defined area of practice.
2. Identification of problems routinely confronted in clinical practice
3. Identification of useful research findings through scanning pertinent published resources
- start with qualitative research and then quantitative research support findings
- identification of the prevalance of a particular phenomenon with a population
- or any prob elms where there is need to interpret relationship
-begins with quantitative research and uses qualitative research support findings.
-used for detailed exploration of a little known problem
- or to explain the result of the quantitative study
- is academic writing in either producing new ideas or/ and challenging those ideas already established.