Evidence-Based Practice in Nursing
Define: Evidence-based practice - ANSW Systematic approach to rational decision
making that facilitates achievement of best practices
Six steps to EBP - ANSW 1. Ask a clinical question
2. Collect the most relevant and best evidence
3. Critically appraise the evidence you gather
4. Integrate all evidence with one's clinical expertise and patient preferences and values
in making a practice decision or change
5. Evaluate
6. Share outcomes of EBP changes with others
Ask a clinical question - ANSW • A problem or area of interest that could be performed
more efficiently, consumes healthcare dollars, or does not make sense
• A knowledge focused trigger
• Clinical trends
• Utilization of PICOT format to state your clinical question
Why should I use PICOT format to state my clinical question? - ANSW • The questions
you ask will eventually lead you to the evidence for an answer
• You want to be able to read the BEST four-to-six articles that specifically address your
practice question
• The more focused a question you ask, the easier it becomes to search for evidence in
the scientific literature
PICOT question - ANSW *P* = Patient population of interest
*I* = Intervention of interest
*C* = Comparison of interest
*O* = Outcome
*T* = Time
Collect the best evidence- what kind and includes - ANSW • Search for evidence!
• *Evidence includes but is not limited to*: agency policy and procedure manuals, quality
improvement data, existing clinical practice guidelines, agency experts, staff educators,
risk managers, infection control nurses, and peer reviewed articles (specifically within
the most recent 5 years from the present date)
Critically appraise the evidence you gather - ANSW • The most difficult step in the EBP
process
• Involves evaluation, determining if information is valuable and can be easily applied,
and if there is enough evidence for making a nursing practice change
• Thorough review of elements included in evidence-based articles
,Integrate the evidence - ANSW • How will you incorporate the evidence into practice?
• Integrate evidence with use of teaching tools, clinical practice guidelines, policies and
procedures, and new assessment documentation tools
• Consider staff support and available resources
• Conduct a pilot study and attempt to answer your PICOT question
Evaluate and share outcomes - ANSW • Did it work? Is it effective?
• Communicate the results to various groups of nurses or other care providers (facility
nursing practice council or research committee)
PICO four-step process - ANSW *P* - population of interest
*I* - intervention
*C* - comparison
*O* - outcome
Utilization of the research process - ANSW • Identification of a researchable problem
• Review of the literature
• Formulation of the research question or hypothesis
• Design of the study
• Implementation of the study
• Drawing conclusions based on findings
• Discussion of clinical implications
• Dissemination of findings
Identification of a researchable problem - ANSW • Sources:
* clinical situations
* the literature
* theories
• Repeat the study or design a similar one
• Test theoretical models
Review of the literature - ANSW • Comprehensive and covers all relevant research
• Essential to locate similar or related studies that have already been completed and on
which a new study can build
• Answer the question "what have other researchers and theorists written about this
problem?"
Two major categories in designing study - ANSW *experimental* (require quantitative
methodology)
*nonexperimental* (can be quantitative or qualitative methodology)
Implementation of the study involves two main task: - ANSW *Data collection*
(collected by those familiar with the study)
*Data analysis* (arrange information into meaningful patterns
, Drawing conclusions based on findings, Answer the question: - ANSW "What do these
findings mean?"
Discussion of clinical implications - ANSW • Suggest actions that can be taken as a
result of the research findings in the future
• Other questions to answer: Will the procedure be effective with patients who have a
different diagnosis? • Will age make a difference? What else do we need to know to
improve the care of patients?
• Also known as the rigor (potential threats to the validity and reliability of the study)
Dissemination of findings two major vehicles: - ANSW • Articles published in
professional journals
• Presentations given at conferences
Nursing student role in research - ANSW Learning about research: doing honors
projects or assisting in labs
BSN role in research - ANSW Identifies problems that can be studied; may do data
collection for research studies
MSN role in research - ANSW Replicates earlier research; beginning independent
research
Doctorate role in research - ANSW Generate and test theory; establish independent
research career
Academician role in research - ANSW Independent research with external funding
(e.g., NIH, foundation grants)
After formulation of the research question or hypothesis, the next step in the research
process is to:
A. Select the population
B. Review the literature
C. Design the study protocol
D. Discussion and/or clinical implications - ANSW *C. Design the study protocol*
After formulation of the research question or hypothesis, the next step in the research
process is to design the study. The study design will influence the data collection
process. Selecting the population is a component of this phase of the research process.
Obtaining necessary approvals is part of conducting the study, which follows the design
phase in the research process. Identification of the instrument to use for data analysis
occurs during the process of designing the study protocol. This step would occur during
the study design phase of the research process after the problem identification and
literature review has taken place.
Research is the same as problem solving. T or F - ANSW *False*
Define: Evidence-based practice - ANSW Systematic approach to rational decision
making that facilitates achievement of best practices
Six steps to EBP - ANSW 1. Ask a clinical question
2. Collect the most relevant and best evidence
3. Critically appraise the evidence you gather
4. Integrate all evidence with one's clinical expertise and patient preferences and values
in making a practice decision or change
5. Evaluate
6. Share outcomes of EBP changes with others
Ask a clinical question - ANSW • A problem or area of interest that could be performed
more efficiently, consumes healthcare dollars, or does not make sense
• A knowledge focused trigger
• Clinical trends
• Utilization of PICOT format to state your clinical question
Why should I use PICOT format to state my clinical question? - ANSW • The questions
you ask will eventually lead you to the evidence for an answer
• You want to be able to read the BEST four-to-six articles that specifically address your
practice question
• The more focused a question you ask, the easier it becomes to search for evidence in
the scientific literature
PICOT question - ANSW *P* = Patient population of interest
*I* = Intervention of interest
*C* = Comparison of interest
*O* = Outcome
*T* = Time
Collect the best evidence- what kind and includes - ANSW • Search for evidence!
• *Evidence includes but is not limited to*: agency policy and procedure manuals, quality
improvement data, existing clinical practice guidelines, agency experts, staff educators,
risk managers, infection control nurses, and peer reviewed articles (specifically within
the most recent 5 years from the present date)
Critically appraise the evidence you gather - ANSW • The most difficult step in the EBP
process
• Involves evaluation, determining if information is valuable and can be easily applied,
and if there is enough evidence for making a nursing practice change
• Thorough review of elements included in evidence-based articles
,Integrate the evidence - ANSW • How will you incorporate the evidence into practice?
• Integrate evidence with use of teaching tools, clinical practice guidelines, policies and
procedures, and new assessment documentation tools
• Consider staff support and available resources
• Conduct a pilot study and attempt to answer your PICOT question
Evaluate and share outcomes - ANSW • Did it work? Is it effective?
• Communicate the results to various groups of nurses or other care providers (facility
nursing practice council or research committee)
PICO four-step process - ANSW *P* - population of interest
*I* - intervention
*C* - comparison
*O* - outcome
Utilization of the research process - ANSW • Identification of a researchable problem
• Review of the literature
• Formulation of the research question or hypothesis
• Design of the study
• Implementation of the study
• Drawing conclusions based on findings
• Discussion of clinical implications
• Dissemination of findings
Identification of a researchable problem - ANSW • Sources:
* clinical situations
* the literature
* theories
• Repeat the study or design a similar one
• Test theoretical models
Review of the literature - ANSW • Comprehensive and covers all relevant research
• Essential to locate similar or related studies that have already been completed and on
which a new study can build
• Answer the question "what have other researchers and theorists written about this
problem?"
Two major categories in designing study - ANSW *experimental* (require quantitative
methodology)
*nonexperimental* (can be quantitative or qualitative methodology)
Implementation of the study involves two main task: - ANSW *Data collection*
(collected by those familiar with the study)
*Data analysis* (arrange information into meaningful patterns
, Drawing conclusions based on findings, Answer the question: - ANSW "What do these
findings mean?"
Discussion of clinical implications - ANSW • Suggest actions that can be taken as a
result of the research findings in the future
• Other questions to answer: Will the procedure be effective with patients who have a
different diagnosis? • Will age make a difference? What else do we need to know to
improve the care of patients?
• Also known as the rigor (potential threats to the validity and reliability of the study)
Dissemination of findings two major vehicles: - ANSW • Articles published in
professional journals
• Presentations given at conferences
Nursing student role in research - ANSW Learning about research: doing honors
projects or assisting in labs
BSN role in research - ANSW Identifies problems that can be studied; may do data
collection for research studies
MSN role in research - ANSW Replicates earlier research; beginning independent
research
Doctorate role in research - ANSW Generate and test theory; establish independent
research career
Academician role in research - ANSW Independent research with external funding
(e.g., NIH, foundation grants)
After formulation of the research question or hypothesis, the next step in the research
process is to:
A. Select the population
B. Review the literature
C. Design the study protocol
D. Discussion and/or clinical implications - ANSW *C. Design the study protocol*
After formulation of the research question or hypothesis, the next step in the research
process is to design the study. The study design will influence the data collection
process. Selecting the population is a component of this phase of the research process.
Obtaining necessary approvals is part of conducting the study, which follows the design
phase in the research process. Identification of the instrument to use for data analysis
occurs during the process of designing the study protocol. This step would occur during
the study design phase of the research process after the problem identification and
literature review has taken place.
Research is the same as problem solving. T or F - ANSW *False*
