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Chapter 5 Evidence based practice
Why is it critical to employ evidence based practice as a registered nurse?
Clients are more informed of their medical health
It guides nurses to structure how to make accurate, timely, and appropriate clinical decisions
Using EBP allows the nurse to provide the best and most accepted care for their clients
What are the steps involved in evidence based practice?
Ask a clinical question
Collect the most relevant and best evidence
Critically appraise the evidence you gather
Integrate all evidence with one's clinical knowledge and the patient's values & preferences
Evaluate the practice decision or change
What are the elements of PICO question and why is it important to use as many elements as possible when developing a clinical question?
= Pt population of interest - ID Pts by age, gender, ethnicity, and health problem
= Intervention of interest - What intervention is worthwhile to use in practice
= Comparison of interest - Usual standard of care
= Outcome - Desired results
The more focused a question you ask, the easier it will be to search for evidence
How can the nurse collect the best evidence to support practice?
Search agency policy and procedural manuals, QI data, existing practice guidelines, and computerized bibliographical databases such as CINAHL or MEDLINE.
Peer-reviewed articles have been reviewed by experts in the subject and hold more biases.
When critiquing evidence what should the nurse do first?
Evaluate the scientific merit and clinical acceptability of each study's findings.
Then, with a group of studies and expert opinion deter one what findings have stung enough basis for use in practice.
How does the nurse integrate evidence into practice?
1. Apply the research in your plan to care for a client
2. Use the evidence you find as rationale for an intervention you plan to try
Once evidence is used in practice what methods could the nurse use to evaluate its effectiveness?
Study design, how the research was conducted, and the data analysis
What is the importance of nursing research?
Nursing is a profession.
Nurses are accountable for interventions/outcomes.
It is from consumer demands as well as being requirements of external agencies.
What is quality improvement and how might it be utilized on a nursing unit?
as an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others & inform health care policy.
Ongoing process designed to prevent problems and errors that would have adverse effects on patients