Healthcare 4th Edition by Bernadette Mazurek Melnyk; Ellen
Fineout-Overholt
Define: Evidence-based practice - ANSWER: Systematic approach to rational decision
making that facilitates achievement of best practices
Six steps to EBP - ANSWER: 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 - ANSWER: • 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? - ANSWER: • 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 - ANSWER: *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 - ANSWER: • 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 - ANSWER: • 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 - ANSWER: • 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 - ANSWER: • 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 - ANSWER: *P* - population of interest
*I* - intervention
*C* - comparison
*O* - outcome
Utilization of the research process - ANSWER: • 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 - ANSWER: • Sources:
* clinical situations
* the literature
* theories
• Repeat the study or design a similar one
• Test theoretical models
Review of the literature - ANSWER: • 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 - ANSWER: *experimental* (require
quantitative methodology)
*nonexperimental* (can be quantitative or qualitative methodology)
Implementation of the study involves two main task: - ANSWER: *Data collection*
(collected by those familiar with the study)
*Data analysis* (arrange information into meaningful patterns