Professor. Dr.

Chong Mei Chan

Department of Nursing Science
Faculty of Medicine
University of Malaya
Email: [email protected]
Tel: +60163841844

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 What is EBP in Nursing?
 How to Integrate EBP into
Nursing Practice
 Hierarchy Evidence Search
 Clinical Practice Guidelines
 How does EBP Benefit Nurses and
Patients?
 Advantages of EBP for HealthCare
system.

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 EBP in nursing is an
integration of research
evidence, clinical
expertise and a patient's
preferences.
 This problem-solving
approach to clinical
practice encourages
nurses to provide
individualized patient
care.

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1. Form a clinical
question to identify a
problem.
2. Gather the best
evidence.
3. Analyze the
evidence.
4. Apply the evidence to
clinical practice.
5. Assess the result.

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 Claire Johnson, MSEd, DC
Journal of Manipulative & Physiological Therapeutics

Volume 31 Issue 3 Pages 169-170 (March 2008)

DOI: 10.1016/j.jmpt.2008.03.013
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 How to help patients
 Formulate detailed
clear questions
 More detailed better
answer will be found

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 high quality
target the highest
peer-reviewed sources (e.g.,
possible levels of
literature Cochrane
evidence
database)

high-quality complete articles are

retrieved from the
randomized articles have been
internet, local
clinical trial vs a identified
library, or other
case report legitimate sources

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Critical appraisal and thoughtful evaluation of the articles

Helps identify if the information is applicable to the

patient and/or clinical setting

Balance new information with one's own clinical

experience and patient values

The best evidence is selected from the appraised

information

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application of the best evidence and
relevant information to the patient and/or
clinical setting
combine the new information with one's
clinical experience while paying attention
to the patient's values

The selected information/

• solution is implemented

observations about its effects are made

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Was the application of the new
information or procedure
effective?

Should this new information

and/or clinical practice
procedure continue to be
included in day to day
applications?

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fundamental framework used in EBP

studies based on their level of evidence and reliability

determine the strength of the evidence

from the highest level of evidence to the lowest

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highest level of evidence

comprehensive and rigorous review of multiple

studies

Meta-analyses

precise estimate of the treatment effect

comprehensive overview of the available

evidence and are less prone to bias

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experimental studies : intervention and
control

highly reliable for evaluating the

effectiveness of interventions

Well-designed RCTs provide strong evidence

of causation and treatment efficacy

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 Follow A group of Observational but Investigating the
individuals over time provide a higher level natural course of
and assess the of evidence diseases and risk
outcomes based on factors
their exposure to A
particular risk factor
or intervention.

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observational studies that compare individuals
with a specific outcome (cases) to those without
the outcome (controls)

identifying potential risk factors that are more

susceptible to bias than cohort studies and RCTs

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collect data from a single point in time and examine
the relationship between variables at that moment.

primarily descriptive and do not establish causation

or temporality

valuable for exploring the prevalence of conditions

and associations

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Case series and case reports describe individual cases or
a small group of cases with a particular condition or
intervention.

They provide the lowest level of evidence and are

primarily used for generating hypotheses or reporting
rare events.

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cornerstone of (EBP)

comprehensive, rigorous, and structured reviews of existing

research studies on a specific topic or research question.

SR aims to provide a balanced and unbiased summary of the

available evidence

to inform clinical decision-making, policy development, and

further research.

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Comprehensive Literature Search

Inclusion and Exclusion Criteria

Quality Assessment:

Data Extraction and Synthesis

Transparent Reporting ( PRISMA)

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a systematic and exhaustive search of multiple
databases, journals, and other reputable sources

to identify all relevant studies on the chosen

topic.

This extensive search ensures that no relevant

evidence is overlooked.

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 establish clear criteria for including and excluding
Establish
studies.

ensure that the selected studies are relevant to the

Ensure
research question and

Meet meet predefined quality standards.

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 Systematic reviews Researchers assess
critically appraise the the risk of bias, study
quality and validity of design, sample size,
each included study. methodology, and

other factors that can

affect the reliability of
the findings.

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 Data from the Researchers then
selected studies are synthesize the findings,
extracted often using statistical
systematically. techniques,

Meta-analysis, a
to provide an overall statistical method, is
summary of the used to combine and
evidence. analyze data from
multiple studies.

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a transparent and standardized reporting
process,

guided by PRISMA

ensures that readers can assess the review's

methodological rigor and trustworthiness.

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Summarizing the
Best Available Minimizing Bias
Evidence

Informed Guiding Clinical

Decision-Making Practice

Identifying Efficiency and

Research Gaps Time Savings

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 The MOH has embraced EBP
principles to improve
healthcare quality, patient
outcomes, and the efficiency
of healthcare delivery:
 Clinical Practice
Guidelines

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https://www.moh.gov.my/index.php/pages/view/3962?mid=1570

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CPG DEVELOPMENT WIDE RANGE OF REGULAR UPDATES:
TOPICS

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Integration
into Accessible
Healthcare Resources
Delivery

Training
and
Education

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Quality
Indicators

Accreditation
Standards

https://patientsafety.moh.gov.my/v2/?page_
id=60

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Support for
Research

Evaluation of
Guideline
Adherence

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Nurses: Patients
 Provide scientific  increase their patients'
research to guide chances for recovery
decision  to have a proactive role
 updated with new in their own healthcare
medical protocols for since they can voice
patient care concerns, share their
 enables nurses to values and preferences
include patients in and make suggestions
their care plan on how they want to
proceed.

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A nurse can be a
As a transferor of
decision-maker and
knowledge
coordinator of care

Manage resources and

facilitate the success Encourage research
of unit-based EBP and research uses
workgroups
The registered nurse
utilizes current
evidence- based
Foster a climate of
nursing knowledge,
intellectual curiosity
including research
findings, to guide
practice
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the formulation evidence-based practice through research

Expect that evidence is the foundation of practice

Participate in EBP projects

Disseminate project findings in various forums

Collaborate with the healthcare team to provide quality care

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Professor. Dr. Chong Mei Chan
Department of Nursing Science
Faculty of Medicine
University of Malaya
Email: [email protected]
Tel: +60163841844
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