EBP Exam 1
problem-focused triggers
ideas that emerge from staff in the context of clinical practice by examining quality improvement data, risk surveillance data, benchmarking data, or a recurrence of a clinical problem ex. increased incidences of deep vein thrombosis and pulmonary embolism
knowledge focused triggers
ideas that emerge from staff when they read, listen to research presentations, or encounter EBP guidelines provided by federal agencies or specialty organizations. ex: pain management, prevention of skin breakdown, assessment of nasogastric tube placement, and patency of arterial lines
Define EBP- using evidence to incorporate in your practice. Describe the purpose of the literature review. Building on evidence what another person already did research on. (not starting the research from scratch)
Define EBP- Describe the purpose of the literature review.
Empirical data
Documented evidence (data) gathered through direct observation rather than a researcher's subjective belief. findings are grounded in reality rather than personal bias or the subjective belief of the researcher
problem-solving approach that considers the context of the nurses current clinical experience knowledge and theory EBP
EBP contains several important features. first, EBP is a __approach that considers the context of the nurses current clinical experience EBP brings together the best available research evidence by combining research with__&__. allows patient values to be heard when nurses use research finding and the best available evidence as their foundation for clinical decision making, the outcome is __ ask: what is the best possible evidence available to solve a clinical problem?
cancerlit
indexes a variety of cancer literature.indexes include journal articles, government reports, technical reports, meetings abstracts and papers and monographs
embase (exerta medica database
a biomedical, life science, and pharmacological database produced by Elsevier. expensive
anonymity
a condition in which the identity of subjects remains unknown, even to the researchers, to protect subjects participating in a study and to promote objective results. use code number for subjects which locked up and limited to those who are intimately involved in the research
aidsline
indexes literature on HIV infections and AIDS. focus on the biomedical, epidemiological, oncological, health care administration, and social and behavioral sciences literature
clinical decision and actions based on research findings
__&__ mean that nurses engage in evidence-based practice (EBP) evidence-based nursing practice relies on evidence from research and refers to clinicians making an effort to integrate research finding into clinical thinking and decision making nursing is a discipline with its own body of knowledge that focuses on knowing and understanding individuals and their health experience
impact factor
__how many people have read this journal. get this by google target audience- who reads this article current- year that the article was published. want between 5-10 years. you want the articles the authors used to current date also systematic review- combines all literature so the person can review. establish the state of science literature review- different levels but tell us what do we know and what we do not know. looking for gaps in the literature level of evidence- page 70; page 68-69
Evidence based medicine (EBM) is a movement that has developed to assist health care professional to base their care on the best research evidence possible evidence based nursing (EBN) eliminates the attention paid to the type or research design and incorporates the use of theory-derived and research based information research utilization is the process by which knowledge generated from research become incorporated into clinical practice the practice of EBM is focuses on several steps including selecting and formulating clinical questions, forming a team, tracking down the best evidence, and appraising the evidence critically use of PICOT provides structure when framing a clinical question so that an appropriate literature review can be performed best evidence from research studies is found in a number of electronic databases. one of the best databases to search is the Cochrane database of systematic reviews a systematic review is a rigorous process of collecting and reviewing the literature to answer a specific clinical question a coherent clinical question is the key organizational element of a good systematic review use of any keyword or phrase that describes PICOT elements associated with a clinical question assists in obtaining the best search possible the preferred method of extracting and displaying data from a systematic review is the creation of matrix tables meta-analysis is a statistical technique that takes the results of may studies in a specific area and synthesizes their finding to draw conclusions regarding the state of the science in the area of focus it is important for health care professionals to share research evidence and findings with patients and their families, keeping in mind professional sensitivity and responsibility
__is a movement that has developed to assist health care professional to base their care on the best research evidence possible __ eliminates the attention paid to the type or research design and incorporates the use of theory-derived and research based information __ is the process by which knowledge generated from research become incorporated into clinical practice a delay in using nursing research findings in clinical practice still exits today the practice of EBM is focuses on several steps including selecting and formulating __, forming a __, tracking down the best __, and appraising the evidence __ use of __ provides structure when framing a clinical question so that an appropriate literature review can be performed best evidence from research studies is found in a number of electronic databases. one of the best databases to search is the __ a __ is a rigorous process of collecting and reviewing the literature to answer a specific clinical question a __ is the key organizational element of a good systematic review use of any __or__ that describes PICOT elements associated with a clinical question assists in obtaining the best search possible the preferred method of extracting and displaying data from a systematic review is the creation of __ __ is a statistical technique that takes the results of may studies in a specific area and synthesizes their finding to draw conclusions regarding the state of the science in the area of focus it is important for health care professionals to share research evidence and findings with patients and their families, keeping in mind professional sensitivity and responsibility
indexes abstracts
__provide bibliographic citations, including names, titles, journals, dates, and page. this is used for to find journal sources (periodicals) of data based and conceptual articles on various topic summaries of articles that appear in other journals. use this to see whether a particular reference is relevant to an area of study before searching for it on the shelves
literature review
a critical summary of the most important scholarly literature on a particular scholarly literature on a particular topic. scholarly literature can refer to research-based publication and conceptual or theoretical literature. the major purpose of reviewing the literature is to discover what is already known about the problem. provides the researchers with important information concerning what has been done and what needs to be done
scientific literature
a database of literature presenting reports of completed research
infoPOEMS (patient oriented evidence that matters)
a database similar to the ACP journal club that reviews and provides commentary on recent articles
clinical key
a database that provides full-text to access to textbooks, journal articles, practice guidelines, patient education handouts, and drug awareness material. use this when you need to find some quick background information on a particular topic in a variety of formats. provides current information
nonexperimental research
a descriptive study that does not exhibit a great amount of control over variables. exploratory in nature. researcher is interested in describing what already exists. "descriptive/correlational study"
research team
a group that collaborates to conduct research project, from determining the initial research question through communicating the results. nurses can collaborate on the development of an idea and actually participate in the design and production of a study
refereed journals
a journal that determines acceptance of manuscripts based on the recommendations of peer reviewers. the reviews are usually performed blind, meaning that the reviewers do not know the name of the authors
-expanding or further defining the problem statement -helping to establish a theoretical base -identifying relationships between variables evidence based medicine replication referred journal -ask questions that come up in daily nursing practice that need answers -provide data that document the effectiveness of nursing care -build a body of knowledge unique to the discipline of nursing formulating a research problem and purpose
a literature review serves several functions: they include a conscientious, explicit use of best evidence in making decisions about care is reproducing or repeating a study to determine whether similar findings will be obtained is referred to as journals that determine acceptance of manuscripts based on peer review are referred to as nursing research is the key to providing high quality health care. through the process of conducting research, nurses the scientific method incorporated those procedures used by researchers in the pursuit of new knowledge. the first step in the scientific method
research consumer-
a reader of nursing research whose objective is applying finding to nursing practice or using the findings to conduct further research. read and evaluate research reports
systematic review
a rigorous and orderly process of collecting and reviewing literature to answer a specific clinical question. this entails the use of a scientific approach to summarize, appraise, and communicate the results and implications of several studies. concise, coherent clinical question is usually stated at the beginning of the paper
meta-analysis
a statistical method that takes the results of many studies in a specific area and synthesizes their finding to draw conclusions regarding the state of the science in the area of focus.
experimental research
a study in which the researcher manipulates and controls one or more variables and observes the effect on an other variable. research having the ability to administer a treatment (intervention) to some participants in a study and not administering (or alternative treatment) to others ex: nurse might be interested in examinin the impact of preoperative teaching program with respect to use pain medication. she teaches one group and give a brouchure to the other
cross sectional research
a study that collects data at a particular point in time and does not require follow up. "what exist today
retrospective research
a study that examines data collected in the past. review of medical records
prospective research
a study that examines data collected in the present. more reliable bc greater control of data collection
Nursing research
a systematic process of investigating problems to gain knowledge about improving care that nurses provide. allows nurses to ask questions that are aimed at gaining new knowledge to improve patient care. nurses must examine how research can be incorporated into their everyday practice. systematic inquiry designed to develop knowledge about issues of importance to nursing. ex: systematic investigation of patients and their health needs is of primary concern to nursing
scientific method scientific method objectivity and the use of empirical data replicated
a systematic research process that involves the following steps: formulating research questions or hypotheses or both, collecting data, analyzing data, and reporting results. ex: nurse may have an idea that patients who receive preoperative teaching will have a healthier postoperative recuperative period achieving the research goal of discovering new knowledge and relationships requires understanding the __ 2 characteristics that are unique to the scientific method and not associated with other ways of knowing are __ (ability to distance the research process as much as possible from the scientist personal beliefs, values, and attitudes) and the use of __ the value of using the scientific method is that the method can be __ by other researchers
descriptive research
a type of nonexperimental study designed to provide knowledge base when little is known about a phenomenon; used to describe variables rather than to test a predicted relationship. uses questionnaires, surveys, interviews, or observations to collect data ex: investigated the intake of folic acid among women between 18-24; a convenience sample of 42 female college students enrolled in a small liberal arts college and eas invited to participate and fill out a survey form. with literature suggesting a link bw folic acid intake and the incidence of neural tube defects, the focus of the study was to determine whether young woman consume the recommended daily allowance of folic acid. there was no attempt to examine relationships or make predictions
basic research
a type of study designed to develop the knowledge base and extend theory without direct focus on clinical application. "pure or fundamental research" obtain empirical data that can be used to develop, refine, or test a theory without immediate concern for direct application to clinical practice. closely resembles the work done in laboratories and is associated with scientist. "advance knowledge in a given subject area" ex: researcher who examine the structure and function of parts of the brain are conducting information gained from basic research may be useful later in the development of a paritcular treatment or drug
applied research
a type of study designed to gather knowledge that has direct clinical application. research is usually perfromed in actual practice conditions on subjects who represent the group to which the results will be applied
objectivity
ability to distance the research process as much as possible from the scientist personal beliefs, values, and attitudes
nuremberg code
address protection of human participants and basic principles of ethical behavior . code empahsize adequate protections of subjects from risk or harm, the right to withdraw from experimentation, and adequate qualifications of those conducting research. must have informed consent
quantitative research
an approach for generating knowledge based on determining how much of a given behavior, characteristic, or phenomenon is present. "scientific inquiry". emphasize measurement, testing of hypotheses, and statistical analysis of data. they use experiments, questionnaires, and surveys to advance nursing science. (interviews, case studies, ethnographies, and narrative analyses are the tools to gain new knowledge in qualitative research)
qualitative research
an approach for generating knowledge using methods of inquiry that emphasize subjectivity and the meaning of an experience for the individual.emphasize verbal descriptions and the meaning of the experiece for the individual
ways of knowing knowledge
an assortment of methods used to acquire new knowledge, including tradition, authority, trial and error, and intuition. ex: you may say that you KNOW your friend, John KNOW that Earth revolves around the sun, KNOW how to give an injection, and KNOW pharmacology is information acquired in a variety of ways. acquired through tradition, authority, trial and error, personal experience, intuition, logical reasoning, and the use of the scientific method
cochrane library
an electronic library designed to make available evidence needed for informed health care decisions
scholarly publications principal investagator
are documents that communicate to other professionals the methods and achievements used in academic study and research investigation responsible for ensuring that data are of high quality and that steps are taken to prevent intentional withholding or selective reporting of data that may be contrary to investigator expectations recommended that original data be preserved for a period of 5 to 7 years or longer, as there is reasonable expectation that the original data will continue to be the basis of ongoing research, publication, or both
textbooks
as you begin to find the best evidence, start search broadly (indexes, journals, databases). __ will not be helpful, they are not appropriate for establishing the cause, diagnosis, prognosis, prevention, or treatment of a disorder
electronic databases
bibliographic files that can be accessed by the computer through an online search (directly communicating with a host computer over telephone lines or the internet) or by CD-RO (compact discs that store bibliographic information)
theoretical literature
conceptual articles presenting reports of theories some of which underlie research studies and other nonresearch-related material
national center for nursing research (NCNR) health promotion and disease prevention
conduct a program of grants and awards supporting nursing research and training, to promote health, and to further the prevention and mitigation of the effects of disease the focus of research priories is on __ and __; advancing quality of life' symptoms management; palliative and end of life care; investment in innovation, and investment in nurse scientists national institute of nursing research (NINR) mission is to promote and improve the health of individuals, families, communities, and populations. their goal is to enhance nursing science by integrating the biological and behavioral sciences, applying new technologies, promoting health equity, and developing scientist of the future. EX of NINR- cancer (it is possible to predict which cancer patients are likely to experience nausea during chemotherapy and to prevent or ease this unpleasant side effect and improve adherence to the life saving treatments
cochrane database of systematic reviews
database that reviews and summarizes individual clinical trials and systematic reviews from more than 100 medical journals.
empirical literature
databased literature that presents reports of completed research; also call scientific literature.
research findings
differentiated evidence based nursing from EBP by suggesting that EBN is the conscientious, explicit, and judicious use of theory-derived, research-based information in making decision about care delivery to individuals or groups of patients and in consideration of individual needs and preferences. EBN DEEMPHASIZES ritual, isolated, and unsystematic clinical experiences; ungrounded opinions; and tradition as bases for practice. instead, EBN stresses the use of __
nurse scientists are guided by principles that include respect for the integrity of knowledge, collegiality, honesty,trust, objectivity, and openness
every nurse scientist has the responsibility of promoting the integrity of nursing science. nurse scientists are guided by principles that include respect for the integrity of knowledge, collegiality, __,trust, __, and __
preferred reporting items for systematic reviews and meta analyses (PRISMA)
flow diagrams assist researchers in reporting results of systematic reviews and meta-analyses along with capturing essential information associated with the search strategy
healthSTAR
focus on both clinical and nonclinical aspects of health-care delivery. indexes material from books, book chapters, government documents, newspaper articles, and technical reports
PICOT
four elements (P-patient/population/problem; I- intervention; C- comparision; O-outcome; T-time frame) that provide structure when writing clinical questions. (time frame (T) and staring a comparison (C) are often not seen, but PIO are
1) researcher must avoid the temptation to include everything 2) well researched areas usually provide substantial amounts of literature directly related to the problem 3)a common misconception is that the significance of a problem is related to how much literature is available journals
guidelines that will help the researcher determine what i appropriate for the literature review: 1) researcher must avoid the temptation to__ 2) well researched areas usually provide substantial amounts of literature directly related to the problem 3)a common misconception is that the significance of a problem is related to __ which is not true because books usually take longer to publish, __ are the preferred mode for communicating the latest results of a research study. retrieving citation should be the priority
randomized clinical trials (RCT)
has became the gold standard for judging the strength and quality of grading the evidence
agency for healthcare research and quality (AHRQ)
has promoted EBP through the establishment of 12 evidence based practice centers
research discover new knowledge and relationships and find solutions research deals with discovering or generating new knowledge, whereas problem solving refers to using current knowledge
is a systematic inquiry into a subject that uses various approaches (quantitiative and qualitative methods) to answer questions and solve problems. goal of research is to discover __ and __ and find __ to problems or questions research deals with discovering or generating __, whereas problem solving refers to using __
systematic research review
it takes several studies to build a base of clinical knowledge. confirmation of similar findings across several studies ensures that results are consistent in different patients and settings. one way to combine the finding of several research studies is to conduct a __
concept mapping
method of understanding associations between similar words/phrases by creating a visual map useful in expanding keywords ex: key phrase is "critical care: mapping the phrase could include phrases such as " intensive critical care" or ICU
methodological and organized manner
methods associated with a systematic review are carried out in a __ and __ manner. in a traditional literature review, published papers are assembled that support and authors particular point of review or serve as a background discussion of a particular issue
nursing knowledge evidence based practice (EBP) knowing, experiencing, and understanding scientific method replicating
nurses are responsible for assuming an active role in developing a body of __ __ allows nurses to use the best research evidence available in making clinical decisions. collection, interpretation, and integration of valid research evidence, combined with clinical expertise, and an understanding of patient and family values preferences to inform clinical decision making nursing has its own unique body of knowledge that represents the __,__<&__ of phenomena related to providing patient care __ approach to gaining new knowledge that is a systematic collection of empirical data __ a study increases the extent to which research findings are verified by providing additional evidence of the validity of the findings
scientifically documented information
nurses who base their clinical decision on __ act in a professionally accountable manner and help define the identity of nursing and promote excellence in practice through knowledge development
clinical expertise
proficiency and judgement that nurses acquire through clinical experience and clinical proactive. this is what decides whether the evidence applies to the individual patient and how it is integrated into a clinical decision
confidentiality
protecting data that are gathered or learned from patient by not disclosing information without those patients permission.
national guideline clearinghouse
provides a collection of evidence based clinical practice guidelines. provides a collection of evidence based clinical practice guidelines without providing an integrative review
background questions
questions focusing on basic or general knowledge about a condition and or disorder. two essential components: a question (who, what, where, how, why) and the outcome of interest answered by checking a textbook and tend to be opinion based rather that evidence based ex: what causes migraines? what is the best diagnostic test for a kidney stone? how often should women over the age 40 have mammorgrams
foreground questions
questions focusing on specific knowledge to inform clinical decisions or actions. focus more on choices and decisions
research practice gap
refers to that period from the point at which knowledge is produced to the point at which is it practiced by health care professionals delays in using nursing research finding in practice bc: -dont know about research findings -not clear about who will benefit from the research findings or about the risks involved -nurses do not associate with scientist, academic researchers who produce knowledge. lack of dialogue between researchers and clinicians -use different languages -lack the skills of locating and reading research reports research is often reported in the language of statistics instead of being reported in clinically meaningful terms nurses and nurse manager do not develop opportunities for acceptance and introduction of innovation ex: no literature about Asian populations, but have literature about everything else (age groups)
retrospective= past prospecteve= future cross-sectional- exist today
retrospective= __ prospecteve= __ cross-sectional- __ first personal contact with research for a nursing student will be to invite patients ro participate in a study or students may help with data collection
secondary source
source reported by person other than the individual who conducted the research or developed the theory; usually represents a comment, summary, or critique of another work. brief description of a study, written by a person other than the original researcher
primary source
source reported by the person who conducted the research or developed the theory; refers to original data or firsthand facts
inclusion and exclusion criteria
specific conditions that determine what evidence in retained and which evidence is discarded ex: if the clinical question focuses on a particular age group (adolescents, older adults), then key terms, phrases, or subject heading need to reflect the particular age group so that citations would include only that particular age group
rigor
striving for excellence in research, which involves discipline scrupulous adherence to detail, and strict accuracy
ACP Journal club
summarizes and interpreter the best evidence of one recent study or review article from traditional journals, based on the criteria provided by the practitioner. is important wen you need to know quickly about one study or review
matrix tables methodological matrix results matrix evaluation matrix PICOT question
the perferred method of extracting and displaying data is the creation of __ organizes information on how the researcher organized information to answer the clinical question, organizes information on what researcher found organizes information about how much confidence researchers have in the evidence __ is the key organizational element of a good systematic review
research utilization
the process by which knowledge generated from research becomes incorporated into clinical practice. emphasizes translating empirically derived knowledge into real-world applications to improve patient outcomes.
scientific inquiry
the process of critically analyzing data that have been gathered systematically about a particular phenomenon. observable, verifiable data are systematically collected from our surroundings through our senses to describe, explain, or predict events
the problem statement presents the topic to be studies, along with a description of the background and rationale for its significance a good problem statement expresses a relationship between two or more variables and can be investigated by collecting and analyzing data the purpose of a study is expressed as a single statement or question that specifies the overall goal of the study nursing practice and personal experiences are good sources of research problems. ideas can also come from literature, nursing theory,and previous research a literature review involves identifying, obtaining, and analyzing literature that is related to the research problem
the __ presents the topic to be studies, along with a description of the background and rationale for its significance a good problem statement expresses a relationship between two or more variables and can be investigated by __&__ the purpose of a study is expressed as a single statement or question that specifies the overall goal of the study __&l __ are good sources of research problems. ideas can also come from literature, nursing theory,and previous research a literature review involves__, __, and __literature that is related to the research problem
replication
the ability of researchers to repeat a study using the same variables and methods of slight variation of them. repeating a study increases the extent to which the research findings can be generalized, providing additional evidence of validity
nursing science
the body of knowledge that is unique to the discipline of nursing.
evidence based medicine (EBM)
the conscientious, explicit, and judicious use of current best evidence in making decisions, about the care of individual patients. the practice means integrating individual clinical expertise with the best available external clinical evidence from systematic research.integrating individual clinical expertise with the best available external clinical evidence from systematic research
evidence based practice (EBP)
the conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patient and in consideration of individual needs and preferences. health care professionals should not center their practice on tradition or experience, but instead on scientific research findings consistent wit nursing goal of providing research based care to patients
evidence based nursing (EBN)
the conscientious, explicit, and judicious use of theory-derived, research-based, information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences
established reality
the importance of nursing research is an __; it is no longer necessary to justify its value. instead nurses must focus on improving their understanding of the research process and fostering the development of research designs that provide the information needed to explain, change, and expand nursing practice
MEDLINE
the larges searchable database covering medicine, health, and biomedical research. (premier biological database for journal articles in BIOMEDICAL and life sciences)
CINAHL (cumulative index of nursing and allied health literature
the largest and most in-depth nursing and allied health database. retrieves content from journals, books, drug monographs, and dissertation and covers a wide range of topics including nursing, biomediciine, alternative/complementary medicine and consumer health (cumulative index to NURSING and allied health literature)
clinicalTrials.gov
the largest registry of clinical trials run by the National library of medicine providing patients, family members, health care professionals, researchers, and the public with easy access to information on publicly and privately supported clinical studies on a wide range of diseases and conditions.
nature of the material studied people
the major difference between scientific research and nursing research is the __ nursing research primarily involves studying___, and people do not behave consistently, as do chemicals in a laboratory. in laboratory setting it is much easier to explain, predict, and control the situation
shortage of coherent consistent scientific evidence difficulties in applying any evidence to care of individual patients and barriers to any practice of high quality medicine
three limitations that are universal shortage of coherent consistent scientific evidence difficulties in applying any evidence to care of individual patients and barriers to any practice of high quality medicine to science include a initial steps associated with guiding the process of EBP include selecting a topic, asking a clinical questions, and forming a team
correlational research
type of nonexperimental study designed to examine the relationship between and among variable. the research collects data on at least 2 variables for the same group of individuals an calculates a correlation coefficient bw the measures ex: researchers examined the relationship of parenting style with A1C and diabetes self-care behaviors
stratified random sampling
type of random sampling in which the population is divided into subpopulations, or strata, on the basis of one or more variables, and a simple random sample is drawn from each stratum ex: a sampling frame was obtained of 462 female employee in clerical and lower administrative positions at a large public university. using stratified random sampling, 60 women were selected For example, suppose a research team wants to determine the GPA of college students across the U.S. The research team has difficulty collecting data from all 21 million college students; it decides to take a random sample of the population by using 4,000 students.
grey literature
unpublished evidence that has not been included in databases frequently seen in commercial or academic publishing.
triangulation
use of quantitative and qualitative methods to collect data about a particular phenomenon. also refer to various combinations of research designs or instruments used in the same study. a combination of psychosocial instruments, interviews, and observations can be used to describe a particularly complex phenomenon
boolean operators
words used to connect or exclude keywords in a search, resulting in more focused results AND operator- helpful when looking to link keywords together, however AND operator retrieves only those citations that contain both keywords and normally retrieves fewer results than if you searched for one key word or phrase on its own the OR operator expands a search when either keywords or phrases are included in the results. never use the word NOT
