Fundamentals: Chapter 5 (Evidence-Based Practice) – Flashcards

It is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician's expertise, patient preferences, and values in making decisions about patient care.

a. Ask a clinical question b. Collect the most relevant evidence c.Clinically appraise the evidence d. Integrate all the evidence with one's clinical expertise, patient preferences, and values in making a practice decision e. Evaluate the practice decision or change f. Share the outcome of EBP changes with others

P = Patient population of interest Identify patients by age, gender, ethnicity, and disease or health problem. I = Intervention of interest Which intervention is worthwhile to use in practice (e.g., a treatment, diagnostic test, prognostic factor)? C = Comparison of interest What is the usual standard of care or current intervention used now in practice? O = Outcome 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)? T = Time What amount of 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)?

a. Agency policy and procedure manuals b. Quality improvement data c. Existing clinical practice guidelines d. Computerized databases

It means that a panel of experts familiar with the article's topic or subject matter has reviewed the article.

They are systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population.

Summarizes the purpose of study or clinical query, the major themes or findings, and the implications for nursing practice.

Contain information about its purpose and the importance of the topic for the reader.

A detailed background of the level of science or clinical information that exists about the topic of the article.

A. A clinical articles can contain a description of the population, the health alteration, how patients are affected, or a new therapy or technology. B. A research article contains a purpose statement, methods, or design.

A. In a clinical article, the author explains the clinical implications for the topic presented. B. In a research article, the author details the results of the study and explains whether a hypothesis is proven or how a research question is answered.

A section in a research article that explains if the findings from the study have clinical implications.

Apply the research in your plan of care for a patient using the evidence you find as a rationale for an intervention you plan to try, such as teaching tools, clinical practice guidelines, policies and procedures, and new tools.

Nursing research is a way to identify new knowledge, improve professional education and practice, and use resource effectively.

Outcomes research is a research designed to assess and document the effectiveness of health care services and interventions.

It is a systematic step-by-step process that ensures that the findings from a study are valid, reliable, and generalizable to subjects.

a. The problem area to be studied is identified. b. The steps of planning occur in an orderly fashion. c. External factors that may influence a relationship between the phenomena that are being studied are controlled. d. Empirical data are gathered. e. The goal is to understand the phenomena.

The conditions are tightly controlled to eliminate bias and to ensure that findings can be generalizable to similar subjects.

Information is obtained from populations regarding the frequency, distribution, and interrelation of variables among the subjects.

Evaluation involves finding out how well a program, practice, procedure, or policy is working.

a. ethnography b. phenomenology c. grounded theory

a. Identify the are of interest or clinical problem. b. Design the study protocol. c. Obtain necessary approvals, recruit subjects, and implement the study. d. Analyze the results of the study. e. Formulate recommendations for future research.

Informed consent is when research subjects arc given full and complete information about the purpose of the study, procedures, data collection, harms, and benefits; are capable of fully understanding the research and implications of participation; and have the power of free choice to voluntarily consent or decline and understand how the researcher maintains confidentiality or anonymity.

Quality improvement is an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others.

Performance improvement is when the organization evaluates and analyzes current performance to use results to develop focused improvement actions.

3. Together, the abstract and introduction tell you if the topic of the article is similar to your PICO question or related closely enough to provide you with useful information.

3. The summary details the results of the study and explains whether a hypothesis is supported. The results of other studies are not presented.

I. Clinical guidelines are systemically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population.

•A challenge in EBP is to obtain the very best, most current information at the right time, when you need it for patient care. •Using your clinical expertise and considering patients' values and preferences ensures that you will apply the evidence in practice both safely and appropriately. •The five steps of EBP provide a systematic approach to rational clinical decision making. •The more focused a PICOT question is, the easier it will become to search for evidence in the scientific literature. •The hierarchy of available evidence offers a guide to the types of literature or information that offer the best scientific evidence. •A randomized controlled trial is the highest level of experimental research •Expert clinicians are a rich source of evidence because they use it frequently to build their own practice and solve clinical problems.

•The critique or evaluation of evidence includes determining the value, feasibility, and usefulness of evidence for making a practice change. •After critiquing all articles for a PICOT question, synthesize or combine the findings to consider the scientific rigor of the evidence and whether it has application in practice. •When you decide to apply evidence, consider the setting and whether there is support from staff and available resources. •Research is a systematic process that asks and answers questions that generate knowledge, which provides a scientific basis for nursing practice. •Outcomes research is designed to assess and document the effectiveness of health care services and interventions. •Nursing research involves two broad approaches for conducting studies: quantitative and qualitative methods. •The research process usually consists of the following steps: identifying the problem, designing the study, conducting the study, analyzing the data, and using the findings. •A thorough analysis of QI data leads clinicians to understand work processes and the need to change practice.