Evidence Based Practice
Exam 1 | Practice
Questions, Study Guide &
Exam Review
|Guaranteed success|
,Clinical expertise/internal evidence Clinical expertise includes what clinicians know and can determine from:
assessment
professional experience
clinical judgment
available resources
practice-generated information
outcomes data
QI information
outcomes-management information
Internal evidence is generated within the clinical practice setting.
Examples:
your hospital's fall rate
your ICU's CLABSI rate
patient satisfaction data from your facility
medication-error data from your unit
results from a hospital QI initiative
outcomes following implementation of a new protocol
Patient/family values and preferences What matters to this particular patient and family?
Preferences might involve:
treatment goals
cultural values
acceptable risks
financial considerations
lifestyle
desired quality of life
family involvement
treatment burden
personal beliefs
previous experiences
, External vs Internal Evidence External evidence
Generated from rigorous scientific inquiry.
Generally intended to produce knowledge applicable beyond one local
clinical unit.
Examples:
published RCT
systematic review
clinical practice guideline
cohort study
qualitative research study
meta-analysis
Internal evidence
Generated from practice within a specific organization.
Examples:
falls per 1,000 patient-days at your hospital
local pressure-injury prevalence
hospital infection rates
QI findings
outcomes-management findings
EBP implementation project data
7 step EBP process steps 0-6
Step 0 foundational
Cultivate a spirit of inquiry within an EBP culture and environment
This comes before asking PICOT.
A spirit of inquiry means clinicians routinely question practice.
Examples:
“Why do we change this dressing every 24 hours?”
“Is this intervention actually supported by evidence?”
“Is there a better way to prevent falls?”
“Why do we continue doing this procedure this way?”
“Could outcomes improve if we changed this protocol?”
Burning clinical question
Often a clinical observation creates a “burning question.”
Step 1 Ask the clinical question in PICOT format
Transform the clinical concern into a searchable question.
PICOT:
P = patient/population/problem
I = intervention/issue
C = comparison
O = outcome
T = time
Step 2 Systematically search for and collect the most relevant best evidence
Now you search sources such as:
CINAHL
MEDLINE
Cochrane
other appropriate databases
The search should be systematic, rather than randomly Googling information.
Exam 1 | Practice
Questions, Study Guide &
Exam Review
|Guaranteed success|
,Clinical expertise/internal evidence Clinical expertise includes what clinicians know and can determine from:
assessment
professional experience
clinical judgment
available resources
practice-generated information
outcomes data
QI information
outcomes-management information
Internal evidence is generated within the clinical practice setting.
Examples:
your hospital's fall rate
your ICU's CLABSI rate
patient satisfaction data from your facility
medication-error data from your unit
results from a hospital QI initiative
outcomes following implementation of a new protocol
Patient/family values and preferences What matters to this particular patient and family?
Preferences might involve:
treatment goals
cultural values
acceptable risks
financial considerations
lifestyle
desired quality of life
family involvement
treatment burden
personal beliefs
previous experiences
, External vs Internal Evidence External evidence
Generated from rigorous scientific inquiry.
Generally intended to produce knowledge applicable beyond one local
clinical unit.
Examples:
published RCT
systematic review
clinical practice guideline
cohort study
qualitative research study
meta-analysis
Internal evidence
Generated from practice within a specific organization.
Examples:
falls per 1,000 patient-days at your hospital
local pressure-injury prevalence
hospital infection rates
QI findings
outcomes-management findings
EBP implementation project data
7 step EBP process steps 0-6
Step 0 foundational
Cultivate a spirit of inquiry within an EBP culture and environment
This comes before asking PICOT.
A spirit of inquiry means clinicians routinely question practice.
Examples:
“Why do we change this dressing every 24 hours?”
“Is this intervention actually supported by evidence?”
“Is there a better way to prevent falls?”
“Why do we continue doing this procedure this way?”
“Could outcomes improve if we changed this protocol?”
Burning clinical question
Often a clinical observation creates a “burning question.”
Step 1 Ask the clinical question in PICOT format
Transform the clinical concern into a searchable question.
PICOT:
P = patient/population/problem
I = intervention/issue
C = comparison
O = outcome
T = time
Step 2 Systematically search for and collect the most relevant best evidence
Now you search sources such as:
CINAHL
MEDLINE
Cochrane
other appropriate databases
The search should be systematic, rather than randomly Googling information.
