Evidence-Based Practice

Methods design

A research article contains several subsections within the narrative, including: __________ or __________ Explains how a research study was organized and conducted to answer the research question or test the hypothesis. This section explains the type of study that was conducted (e.g., RCT, case control study, or qualitative study) and the number of people who participated in the study.

Clinical implications

A research article contains several subsections within the narrative, including: __________ A research article includes a section that explains if the findings from the study have clinical implications. The researcher explains how to apply findings in a practice setting for the type of subjects studied.

Purpose statement

A research article contains several subsections within the narrative, including: __________ Explains the focus or intent of a study. It includes research questions or hypotheses—predictions made about the relationship or difference among study variables. An example of a research question is: Does music therapy reduce a patient's pain and anxiety?

Results conclusions

A research article contains several subsections within the narrative, including: __________ or __________ Both clinical and research articles have a summary section. In a clinical article, the author explains the clinical implications for the topic presented. In a research article, the author details the results of the study and explains whether a hypothesis is supported or how a research question is answered. This section includes a statistical analysis if it is a quantitative research study. A qualitative study summarizes the descriptive themes and ideas that arise from the researcher's analysis of data.

B

1. Which of the following is the first step of the research process? A. Analyze data B. Identify problem C. Conduct study D. Use the findings

D

2. Every health care organization gathers data on health outcomes. Examples of key quality-of-care or performance indicators include: A. discharges. B. medications administered. C. healthy births. D. infection rates.

Institutional Review Board (IRB)

A(n) __________ includes scientists and laypersons who review all studies conducted at the institution to ensure that ethical principles, including the rights of human subjects, are followed.

abstract

Elements of an article: A(n) __________ is a brief summary that quickly tells you if the article is research or clinically based. It summarizes the purpose of the article. It also includes the major themes or findings and the implications for nursing practice.

introduction

Elements of an article: The __________ contains more information about the purpose of the article. There is usually brief supporting evidence as to why the topic is important.

Manuscript narrative

Elements of an article: __________ is the "middle section" or narrative of an article. It differs according to the type of evidence-based article it is. A clinical article describes a clinical topic, which often includes a description of the patient population, the nature of a certain disease or health alteration, how patients are affected, and the appropriate nursing therapies. A research article contains several subsections within the narrative.

Literature review background

Elements of an article: __________ or __________. A good author offers a detailed background of the level of science or clinical information about the topic. It offers an argument about what led the author to conduct a study or report on a clinical topic. This section of an article is very valuable. Even if the article itself does not address your PICOT question the way you desire, it may lead you to other, more useful articles.

Cultivate a Spirit of Inquiry

Evidence-Based Practice (EBP) Step 0: __________ Question what does not make sense to you and what needs to be clarified Gain evidence-based practice (EBP) knowledge and skills Be committed to providing the best care possible Use problem- and knowledge-focused triggers Consider data gathered from a health care setting to examine clinical trends

Ask a Clinical Question

Evidence-Based Practice (EBP) Step 1: __________ Developing a PICOT question: P = Patient population of interest I = Intervention of interest C = Comparison of interest O = Outcome T = Time

Collect the Best Evidence

Evidence-Based Practice (EBP) Step 2: __________ Ask experts for help Nursing faculty Advanced practice nurses Staff educators Risk managers Librarians A medical librarian can Identify the databases that are available to you Identify key words that will provide the best answer to your PICOT question

Critically Appraise the Evidence

Evidence-Based Practice (EBP) Step 3: __________ After critiquing all articles for a PICOT question: Synthesize or combine the findings Consider the scientific rigor of the evidence and whether it has application in practice Elements of an article: Abstract Introduction Literature review or background Manuscript narrative Purpose statement Methods or design Results or conclusions Clinical implications

Integrate the evidence

Evidence-Based Practice (EBP) Step 4: __________ Integrating Evidence: teaching, assessment or documentation tools, clinical practice guidelines, policies and procedures Applying evidence: consider setting, staff support, scope of practice, resources

Evaluate the Practice Decision or Change

Evidence-Based Practice (EBP) Step 5: __________ After applying evidence, evaluate the outcome. When evaluating an EBP change determine: - Was the change effective? - Are modifications needed? - Should the change be discontinued? Unexpected events or results may occur. Never implement a practice change without evaluating its effects.

Share the Outcomes with Others

Evidence-Based Practice (EBP) Step 6: __________ After implementing an EBP change, it is important to communicate the results - Clinical staff on the unit - Nursing practice council or the research council - Clinicians - Professional conferences and meeting

descriptive qualitative

If RCTs are not available, you can use results from other research studies such as __________ or __________ studies, to help answer your PICOT question.

Evidence-Based Practice (EBP)

Steps of __________ 0. Cultivate a spirit of inquiry. 1. Ask a clinical question in PICOT format. 2. Search for the most relevant evidence. 3. Critically appraise the evidence you gather. 4. Integrate all evidence with your clinical expertise and patient preferences and values. 5. Evaluate the outcomes of practice decisions or changes using evidence. 6. Share the outcomes with others.

research studies

The best information is evidence that comes from well-designed, systematically conducted __________, mostly found in scientific journals.

clinical experts

The use of __________ is at the bottom of the evidence pyramid, but do not consider them to be a poor source of evidence.

Pilot study

When evidence is not strong enough to apply in practice, your next option is to conduct a __________ to investigate your PICOT question. It is a small-scale research study or one that includes a quality or performance improvement project.

quantitative

__________ approaches offer precise measurement and quantification. There are many of this type of research methods, including: experimental, nonexperimental, survey, and evaluation research.

RCTs

__________ are the most precise forms of experimental study and therefore are the gold standard for research. A single one is not as conclusive as a review of several on the same question. However, a single one that tests the intervention included in your question yields very useful evidence.

Confidentiality

__________ guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team.

Evidence-based care (EBC)

__________ improves quality, safety, patient outcomes, and nurse satisfaction while reducing costs.

Evidence-based practice (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. Today it is an expectation of all health care institutions and professional nurses.

qualitative

__________ nursing research is the study of phenomena that are difficult to quantify or categorize, such as patients' perceptions of illness or quality of life. This research involves inductive reasoning to develop generalizations or theories from specific observations or interviews. There are a number of different methods, including ethnography, phenomenology, and grounded theory. Each is based on a different philosophical or methodological view of how to collect, summarize, and analyze qualitative data.

Scientific Method

__________: The foundation of research The most reliable and objective means of acquiring and conducting research and gaining knowledge. A step-by-step process to ensure that findings from a study are valid, reliable, and generalizable to a similar group of subjects

Outcome research

__________: Helps patients, health care providers, and those in health care policy make informed decisions on the basis of current evidence. Typically focuses on the benefits, risks, costs, and holistic effects of a treatment on patients. Outcomes must be observable or measurable.

Quality Improvement

__________: Improves local work processes to improve patient outcomes and health system efficiency; results usually not generalizable

Research

__________: Systematic inquiry answers questions, solves problems, and contributes to the generalizable knowledge base of nursing; may or may not improve patient care

Evidence-Based Practice (EBP)

__________: Use of information from research and other sources to determine safe and effective nursing care with the goal of improving patient care and outcomes