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Evidence Based Practice in Nursing
Terms in this set (20)
Evidence-based practice is...
"An ongoing process by which evidence, nursing theory and the practitioners' clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual" (Scott and McSherry, 2009).
Evidence-based practice is a systematic approach to rational decision making that facilitates achievement of best practices. The six steps to EBP are:
- Ask a clinical question
- Collect the most relevant and best evidence
- Critically appraise the evidence you gather
- Integrate all evidence with one's clinical expertise and patient preferences and values in making a practice decision or change
- Share outcomes of EBP changes with others
(Potter, Perry, Stockert, and Hall, 2013)
Ask a clinical question...
A problem or area of interest that could be performed more efficiently, consumes healthcare dollars, or does not make sense
A knowledge focused trigger
Utilization of PICOT format to state your clinical question
Why should I use PICOT format to state my clinical question?...
- The questions you ask will eventually lead you to the evidence for an answer
- You want to be able to read the BEST four-to-six articles that specifically address your practice question
- The more focused a question you ask, the easier it becomes to search for evidence in the scientific literature
(Potter et al., 2013)
Developing a PICOT question...
P = Patient population of interest
I = Intervention of interest
C = Comparison of interest
O = Outcome
T = Time
Collecting the best evidence
Search for evidence!
Evidence includes but is not limited to: agency policy and procedure manuals, quality improvement data, existing clinical practice guidelines, agency experts, staff educators, risk managers, infection control nurses, and peer reviewed articles (specifically within the most recent 5 years from the present date)
Critically appraise the evidence you gather
The most difficult step in the EBP process
Involves evaluation, determining if information is valuable and can be easily applied, and if there is enough evidence for making a nursing practice change
Thorough review of elements included in evidence-based articles
Integrate the evidence...
How will you incorporate the evidence into practice?
Integrate evidence with use of teaching tools, clinical practice guidelines, policies and procedures, and new assessment documentation tools
Consider staff support and available resources
Conduct a pilot study and attempt to answer your PICOT question
Evaluate and share outcomes of EBP changes with others...
Did it work? Is it effective?
Communicate the results to various groups of nurses or other care providers (facility nursing practice council or research committee)
DO A POSTER PRESENTATION!!!
Answering questions regarding best practices by nurses - examining research literature...
PICO four-step process
P - population of interest
I - intervention
C - comparison
O - outcome
Utilization of the research process...
Identification of a researchable problem
Review of the literature
Formulation of the research question or hypothesis
Design of the study
Implementation of the study
Drawing conclusions based on findings
Discussion of clinical implications
Dissemination of findings
Identification of a researchable problem...
* clinical situations
* the literature
Repeat the study or design a similar one
Test theoretical models
Review of the literature...
Comprehensive and covers all relevant research
Essential to locate similar or related studies that have already been completed and on which a new study can build
Answer the question "what have other researchers and theorists written about this problem?"
Formulation of the research question or hypothesis (PICOT)...
- Sample research question or hypothesis:
- What are factors that affect quality of life and management of end-stage renal disease (ESRD) in adult African American men and women who receive hemodialysis or peritoneal dialysis?
Design of the study...
Two major categories:
- experimental (require quantitative methodology)
- nonexperimental (can be quantitative or qualitative methodology)
Implementation of the study...
Involves two main task:
* data collection (collected by those familiar with the study)
* data analysis (arrange information into meaningful patterns
Drawing conclusions based on findings...
Answer the question: "What do these findings mean?"
Discussion of clinical implications...
Suggest actions that can be taken as a result of the research findings in the future
Other questions to answer: Will the procedure be effective with patients who have a different diagnosis? Will age make a difference? What else do we need to know to improve the care of patients?
Also known as the rigor (potential threats to the validity and reliability of the study
Dissemination of findings...
Two major vehicles:
* articles published in professional journals
* presentations given at conferences
DO A POSTER PRESENTATION!!!
Roles of nurses in research...
- Nursing student
Bachelor's degree of Science In Nursing (BSN)
Master of Science in Nursing
Doctorate (e.g., PhD, DNP, EdD, DrPH)
Academician (after postdoctoral preparation)
Learning about research: doing honors projects or assisting in labs
- Identifies problems that can be studied; may do data collection for research studies
Replicates earlier research; beginning independent research
- Generate and test theory; establish independent research career
Independent research with external funding (e.g., NIH, foundation grants)
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