Evidence Based Nursing Practice PDF
Evidence Based Nursing Practice PDF
Evidence Based Nursing Practice PDF
Definitions
LOGO
Definitions
Best
available
research
Pa-ent
values
evidence
The three elements of evidence‐based practice
LOGO
Goals of EBP
Provide
prac-cing
nurses
with
evidence‐based
data
Resolve
problems
in
the
clinical
se=ng
Achieve
excellence
in
care
delivery
Introduce
innova-on
Reduce
varia-ons
in
nursing
care
Assists
with
efficient
and
effec-ve
decision‐making
LOGO
Goals
(con’t)
Using
best
evidence
to
implement
the
regula-on
of
nurses
Resolve
regulatory
problems
Achieve
excellence
in
regula-on
Introduce
regulatory
innova-on
LOGO
Why the rapid spread of
evidence-based practice?
1. To patients/consumers
LOGO
What are the benefits of
evidence-based practice?
2. To nurses
4. To
the
community
Through
the
u-liza-on
of
EBP,
finite
resources
are
not
wasted
on
the
delivery
of
ineffec-ve
interven-ons.
EBP
limits
the
amount
of
disability
and
suffering
throughout
the
community
by
ensuring
the
most
current
and
effec-ve
care
is
provided.
LOGO
1. Ask or identify the important clinical question
2. Collect the best and more pertinent evidence
3. Critically analyze and rate the evidence
4. Integrate the evidence into clinical decisions
5. Implement best evidence in clinical practice
6. Evaluation
LOGO
1. Ask or identify the important
clinical question
HOW?? PICO
Patient
Age, sex, ethnicity, etc.
Condition, diseases, general health status
Intervention
Education, diagnostics, treatment plan, self-care, etc.
Comparison Intervention
Placebo, etc.
Outcome
Expected and actual effects on patient LOGO
PICO
The nurses want to know:
What is the best way of obtaining a urine specimen
culture, from a child?
LOGO
PICO
The revised question:
In children suspected having of UTI, who are not yet toilet
training, what is the risk of culture contamination when
urine is obtained by bag-catch or clean catch, as
compared with urine obtained by suprapubic aspiration
directly from the bladder?
LOGO
Do nurse led tobacco cessation interventions
result in decreased smoking rates after hospital
admission for coronary heart disease?
LOGO
2. Collect the best and more
pertinent evidence
Where is the evidence located?
CINAHL® (Cumulative Index to Nursing and the Allied Health Literature)
Medline www.ncbi.nlm.nih.gov/PubMed/.
Proquest
http://www.proquest.com/pqdweb
username: 0NQTKKWNKM& Password:brawijaya
Ovid
http://gateway.ovid.com/
ID & Password : hsll199
EBSCO
http://search.epnet.com/
user : cathedral & password : dc
NEW: http://search.ebscohost.com
Id: n5000145, passwords LOGO
3. Critically analyze and rate the
evidence
LOGO
Grading of research studies that measure the
effect of an intervention, treatment or therapy
LOGO
Source : NHMRC 1999
Levels of evidence of effectiveness
Key points:
• Research evidence is, on its own, insufficient to ensure
the robust clinical decisions necessary for clinically
effective health care
Clinical
expertise
Consensus Intuition
Available
Experts
Resources
Media
LOGO
4. Integrate … cont’
Clinical expertise:
The ability to use our clinical skills and past experience to rapidly
identify each patient’s unique health state and diagnosis, their
individual risks and benefits of potential interventions, and their
personal values and expectations (Sackett et al 2000)
Intuitive practice:
A way in which we know and behave about the situation that is not
based on conscious reasoning or rational thought process
(Parahoo 1997)
… Builds on repeated practice situations, it is context specific and it
enables the integration of complex pieces of a data to derive a
decision that is difficult to articulate through linear rules
(Greenhalgh 2000)
LOGO
5. Implement best evidence in
clinical practice
Where to start?
LOGO
6. Evaluation
LOGO
How Do I Participate in an Evidence-
Based Practice?
LOGO
Godshall, Maryann 2010
LOGO