NURS200 CH 5 EVIDENCE-BASED PRACTICE Flashcards
•Evidence from research studies and opinions of experts provide a
basis for nursing care.
A Case for Evidence
- •A response to societal forces
- •A problem-solving approach to practice
- •Challenge to obtain:
- –The very best information
- –The most current information
- –Information at the right time, when you need it for patient care
IMPORTANT to know
- •As the public becomes more computer literate, they have broader access to information regarding health care issues and the incidences of medical errors within health care facilities.
- •Use of evidenced-based practice (EBP) allows nurses to structure how to make accurate, timely, and appropriate clinical decisions.
- •EBP is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician’s expertise and patient preferences and values in making decisions about patient care.
- •Without evidence-based practice, nursing would be a practice based solely on tradition.
- •While in practice, you will need an up-to-date textbook, articles from peer-reviewed nursing journals, and nursing research.
•Six steps provide a systematic approach to rational clinical decision making:
- Ask the clinical question.
- Collect the best evidence.
- Critique the evidence.
- Integrate the evidence.
- Evaluate the practice decision or change.
- Share the outcomes of EBP changes with others.
•Developing a PICOT question:
–P = Patient population of interest
–I = Intervention of interest
–C = Comparison of interest
–O = Outcome
–T = Time
- •Identify patients by age, gender, ethnicity, and disease or health problem
- •Which intervention is worthwhile to use in practice (e.g., a treatment, diagnostic test, prognostic factor)?
- •What is the usual standard of care or the intervention used now in practice?
- •What result do you wish to achieve or observe as a result of an intervention (e.g., change in patient behavior, physical finding, patient perception)?
- •How much time is needed for an intervention to achieve an outcome (e.g., the amount of time needed to change quality of life or patient behavior)?
Gathering Evidence
- The more focused a PICOT question is, the easier it will become to search for evidence in the scientific literature.
- Expert clinicians are a rich source of evidence because they use it frequently to build their own practice and to solve clinical problems.
- The critique or evaluation of evidence includes determining the value, feasibility, and usefulness of evidence in making a practice change.
Nursing Research
- A way to identify new knowledge, improve professional education and practice, and use resources effectively
- The International Council of Nurses (ICN) supports the need for nursing research as a means of improving the health and welfare of people.
•A step-by-step process to ensure that findings from a study are ________________________ to a similar group of subjects
valid, reliable, and generalizable
- An orderly series of steps that allows a researcher to find the answer to a question
- Consists of five steps:
- –Identify problem.
- –Design study.
- –Conduct study.
- –Analyze data.
- –Use the findings.
•Informed consent means
–Participants receive full and complete information
–They can understand the information
–They have free choice to participate
–They understand how their confidentiality will be kept
•One type of QI Program, the PDSA cycle or approach, is described as
- Plan—Review available data to understand existing practice conditions or problems to identify the need for change.
- Do—Select an intervention on the basis of the data reviewed and implement the change.
- Study—Study (evaluate) the results of the change.
- Act—If the process change is successful with positive outcomes, act on these practices by incorporating them into daily unit performance.
