Evidence-Based Practice Chapter 5

collecting the best evidence 7 levels

(top to bottom) 1. systemic reviews and metaanalysis of randomized controlled trials 2. one-well designed RCT 3. well designed controlled trials without randomization 4. well designed case control studies 5. systematic reviews of descriptive and qualitative studies 6. internal organization - quality and risk management data 7. opinion of authorities or expert committees

nursing research

1. A systematic process that asks and answers questions that generate knowledge. The knowledge then provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions. 2. A way to identify new knowledge, improve professional education and practice, and use resources effectively.

5 steps of evidence-based practice

1. Ask the clinical question 2. Collect the best evidence 3. Critique the evidence 4. Integrate the evidence with one's clinical expertise and client preference and values 5. Evaluate the practice decision or change

5 steps of research process

1. Identify a problem 2. Design study 3. Conduct study 4. Analyze the data 5. Use the findings

scientific method

1. The foundation of research 2. The most reliable and objective means of acquiring and conducting research 3. A systematic step-by-step process to ensure that findings from a study are valid, reliable, and generalizable

7 parts of an evidence-based article resource

1. abstract, 2. introduction, 3. literature review, 4. manuscript narrative -purpose statement, 5. methods or design- (includes # of participants, type of data collected, instrument used to evaluate data), 6. results or conclusions, 7. clinical implications

collecting the best evidence 5 sources

1. agency policy and procedure manuals, 2. quality improvement data, 3. existing clinical practice guidelines, 4. computerized bibliographical databases 5. Comprehensive databases like MEDLINE and CINAHL

4 sources of evidence-based practice

1. evidence from research, theories, clinical experts, and opinion leaders 2. evidence from assessment of client 3. evidence from clinical expertise 4. evidence from information from client preferences and values

3 types of quantitative research

1. experimental research 2. surveys 3. evaluation research

2 types of nursing research

1. quantitative research 2. qualitative research

4 types of qualitative research

1. series of interviews 2. ethnography 3. phenomenology 4. grounded theory

4 ways of integrating evidence

1. teaching tools, 2. clinical practice guidelines, 3. policies and procedures, 4. new assessment or documentation tools

Quality Improvement

An approach to the continuous study and improvement of the processes of providing health care services to meet the needs of clients and others

research process

An orderly series of steps that allow a researcher to move from asking the research question to finding the answer

Performance improvement

An organization analyzes and evaluates current performance to develop focused improvement actions

asking the clinical question format

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

grounded theory

a method of collecting and analyzing qualitative data with the aim of developing theories and theoretical propositions that are grounded in real-world observations

phenomenology

a research method with roots in philosophy and a focus on what people experience in regard to daily practices or experiences and how they interpret those experiences

ethnography

involves the description and interpretation of cultural behavior

Quantitative Research-

precise, systematic objective examination of specific concepts. Focuses on numerical data, statistical analysis and controls to eliminate bias in findings

Qualitative Research

study of phenomena that are difficult to quantify or categorize. Describes information obtained in a non numerical form