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Flashcards in Week Eleven Deck (24):
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Theory

A set of established statements or rules that are able to be tested

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Research

Nursing research sets out to test the statements made by theorists

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Practice

When nurses carry out their actions which are driven by multiple factors, including theory and research

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Grand Theory

A global, conceptual framework that provides insight into abstract phenomena

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Middle-Range Theory

Are less abstract than grand theory.

Address more specific phenomena and reflect practice

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Descriptive Theory

Have the ability to explain, relate and predict phenomena of concern, specific to nursing

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Prescriptive theory

Addresses nursing interventions, and help predict the consequences of specific interventions

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Evidence Based Practice

The judicious use of current best evidence in making decisions about care of individual patients

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Evidence informed Practice

The integration of the most informative research evidence with the evidence from expert clinical practice and other sources to produce the best possible care for clients

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Steps for Generating Evidence Informed Practice

1⃣ask a question that clearly presents the clinical problem
2⃣identify and gather the most relevant and best evidence
3⃣critically appraise the evidence
4⃣integrate all the evidence with clinical expertise, clients' preferences, and clients' values to make a practice decision or change
5⃣evaluate the outcome of the practice decision or change

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Problem focused trigger

What is the best dressing to use for this wound?

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Problem focused trend

What can we do to reduce the number of ulcers developed in our unit

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Knowledges focused trigger

What is the current evidence to improve overall healing for diabetic ulcers

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Asking the Clinical Question

P patient population of interest
I intervention of interest
C comparison of interest
O outcome

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An evidence informed article must have?

Abstract
Introduction
Literature review
Manuscript narrative
Purpose Statement
Methods or Design
Results or Conclusions
Clinical Implications

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Questions to Critique the Evidence

Who wrote this article or conducted this research?...What are their credentials?

Has this published in a credible source?

Is the article based on their personal opinion or on a
research methodology?

Do you think the results are negatively influenced in any way? (bias)

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Fundamental Principles of Evidence Based Practice

Only intervene when it is known that a particular treatment is more effective than nature

Ensure that the benefits outweigh the risks

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Carper's Ways of Knowing

Each pattern may be conceived as necessary for achieving mastery in the discipline, but none of them alone should be considered sufficient

There are four patterns:
ethics - the moral component
esthetics - the art of nursing
personal knowledge - therapeutic use of self
empirics - hue science of nursing

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What is Empirical Knowing?

The Science of Nursing

Knowledge that is systematically organized into
general laws and theories

When reflecting on your practice, asking: What
evidence informed this decision?

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What is Personal Knowing?

Referred to as ‘therapeutic use of self’

It is essential that we know ourselves

Promotes wholeness and integrity in the personal encounter

Nursing is an interpersonal process

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What is Aesthetic Knowledge?

The Art of Nursing

Expressed through creativity and style

empathy, compassion, holism, and sensitivity

How was this person feeling? Did I accomplish what I set out to do?

What need is being expressed by the patient’s behavior

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What is Ethical Knowing?

One of Carper's ways of knowing

The moral component

Nursing knowledge goes beyond professional code of ethics and includes all voluntary actions that are deliberate and subject to judgement as right or wrong

Focuses on matters of obligation

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What are Best Practice Guidelines?

Guiding principles that lead to the most appropriate courses of action in certain practice situations

The Registered Nurses Association of Ontario (RNAO)

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Steps to Integrate Best Practice Guidelines into Practice

1⃣identify the problem, review and select knowledge
2⃣adapt knowledge to local context, stakeholder analysis, resource assessment
3⃣assess facilitators and barriers to knowledge use
4⃣select, tailor and implement intervention and implementation strategies
5⃣monitor knowledge use and evaluating outcomes
6⃣sustain knowledge use