NURS 257 (Exam #2)
What does evidence- based practice combine? - answer1. evidence (published
research)
2. clinician expertise
3. pt preferences & values to answer a practical, clinical question
how long can it take for evidence to be implemented into practice? – answer 15 to 20
years
what does PICO(T) stand for? – answer P= patient/ population
I= intervention
C= control/ comparison
O= outcome
T= time
what are the six evidence based practice steps? - answer1. ask a clinical guiding
question
2. search for the best evidence
3. appraise (critically) the evidence
4. integrate the evidence with ones clinical expertise
5. evaluate the outcomes of the EBP practice decision
6. disseminate findings
describe nursing research (NR) - answer- goal to generate knowledge
- conducts scientific studies when evidence is lacking (systematic inquiry that uses
disciplined methods to answer questions or solve problems
- results disseminated widely in peer-reviewed publications
- individuals must give consent to participate
describe quality improvement (QI) - answerresearch is complete (works on
implementation and improving care)
- apply knowledge to existing processes
improvement vs research studies - answerimprovement: aim for improvement in care,
real world observation with before/ after comparison, accept consistent bias, sample
size just enough data (small sequential samples), hypothesis is flexible & changes as
testing takes place, several sequential test, run charts, data used only by those involved
in improvement
research: aim for new knowledge, trial is blinded or controlled, designed to eliminate
bias, enough data to demonstrate statistical significance, fixed hypothesis, one large
test, hypothesis testing and statistical analysis, reattach subjects identity is protected
, therapy PICO question - answeris this intervention more effective than another? = use
randomized controlled trial (RCT)
diagnostic test PICO question - answerhow accurate is this diagnostic test?= use
prospective, blinded controlled test compared to gold standard test
prognosis PICO question - answerwhat is the likely outcome, progression, or survival
time for this condition?= cohort study> case-control> case series
causation/harm/etiology PICO question - answerwhat are the causes of this condition or
state of affairs? = use RCT> cohort study> case-control> case series
prevention PICO question - answerHow to reduce the risk of this disease?
- RCT> cohort studies> case-control
cost-effectiveness PICO question - answerIs intervention X more cost effective than
intervention Y?= use economic analysis
quality of life PICO question - answerwhat will the quality of life for the pt following this
intervention?= qualitative study, validated survey measurement of quality of life
case report/ case series - answerreport is one pt; series is multiple puts
- rare reactions, conditions
- sometimes only source of info
- not most reliable because only few cases
case-control studies - answer- look at group of pts who have a disease, condition, or
exposure compared to a group of pts who don't have that disease condition
- helps answer harm or etiology PICO questions due to ethical issues
prospecitve cohort study vs longitudinal cohort study - answerprospective= goes
forward in time
longitudinal= many go on for a long time (could be generations
cohort studies - answerfollows group, know as cohorts (groups that are linked in some
way) and follows them over time to see the effect of something
randomized controlled trial - answer- participants are randomly allocated to receive
either the new intervention being tested or a control treatment (standard treatment or
placebo)
- each arm of the study is then followed up and the amount or severity of the disease
measured in the intervention group is compared with control group
- trials need to be registered before participants are enrolled
What does evidence- based practice combine? - answer1. evidence (published
research)
2. clinician expertise
3. pt preferences & values to answer a practical, clinical question
how long can it take for evidence to be implemented into practice? – answer 15 to 20
years
what does PICO(T) stand for? – answer P= patient/ population
I= intervention
C= control/ comparison
O= outcome
T= time
what are the six evidence based practice steps? - answer1. ask a clinical guiding
question
2. search for the best evidence
3. appraise (critically) the evidence
4. integrate the evidence with ones clinical expertise
5. evaluate the outcomes of the EBP practice decision
6. disseminate findings
describe nursing research (NR) - answer- goal to generate knowledge
- conducts scientific studies when evidence is lacking (systematic inquiry that uses
disciplined methods to answer questions or solve problems
- results disseminated widely in peer-reviewed publications
- individuals must give consent to participate
describe quality improvement (QI) - answerresearch is complete (works on
implementation and improving care)
- apply knowledge to existing processes
improvement vs research studies - answerimprovement: aim for improvement in care,
real world observation with before/ after comparison, accept consistent bias, sample
size just enough data (small sequential samples), hypothesis is flexible & changes as
testing takes place, several sequential test, run charts, data used only by those involved
in improvement
research: aim for new knowledge, trial is blinded or controlled, designed to eliminate
bias, enough data to demonstrate statistical significance, fixed hypothesis, one large
test, hypothesis testing and statistical analysis, reattach subjects identity is protected
, therapy PICO question - answeris this intervention more effective than another? = use
randomized controlled trial (RCT)
diagnostic test PICO question - answerhow accurate is this diagnostic test?= use
prospective, blinded controlled test compared to gold standard test
prognosis PICO question - answerwhat is the likely outcome, progression, or survival
time for this condition?= cohort study> case-control> case series
causation/harm/etiology PICO question - answerwhat are the causes of this condition or
state of affairs? = use RCT> cohort study> case-control> case series
prevention PICO question - answerHow to reduce the risk of this disease?
- RCT> cohort studies> case-control
cost-effectiveness PICO question - answerIs intervention X more cost effective than
intervention Y?= use economic analysis
quality of life PICO question - answerwhat will the quality of life for the pt following this
intervention?= qualitative study, validated survey measurement of quality of life
case report/ case series - answerreport is one pt; series is multiple puts
- rare reactions, conditions
- sometimes only source of info
- not most reliable because only few cases
case-control studies - answer- look at group of pts who have a disease, condition, or
exposure compared to a group of pts who don't have that disease condition
- helps answer harm or etiology PICO questions due to ethical issues
prospecitve cohort study vs longitudinal cohort study - answerprospective= goes
forward in time
longitudinal= many go on for a long time (could be generations
cohort studies - answerfollows group, know as cohorts (groups that are linked in some
way) and follows them over time to see the effect of something
randomized controlled trial - answer- participants are randomly allocated to receive
either the new intervention being tested or a control treatment (standard treatment or
placebo)
- each arm of the study is then followed up and the amount or severity of the disease
measured in the intervention group is compared with control group
- trials need to be registered before participants are enrolled
