Evidence-Based Practice in Nursing
Define: Evidence-based practice - question and answerSystematic approach to rational
decision making that facilitates achievement of best practices
Six steps to EBP - question and answer1. 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 - question and 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? - question and 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 - question and 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 - question and 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)
,Evidence-Based Practice in Nursing
Critically appraise the evidence you gather - question and 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 - question and 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 - question and 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 - question and answer*P* - population of interest
*I* - intervention
*C* - comparison
*O* - outcome
Utilization of the research process - question and 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 - question and answer• Sources:
* clinical situations
* the literature
* theories
• Repeat the study or design a similar one
• Test theoretical models
Review of the literature - question and 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?"
, Evidence-Based Practice in Nursing
Two major categories in designing study - question and answer*experimental* (require
quantitative methodology)
*nonexperimental* (can be quantitative or qualitative methodology)
Implementation of the study involves two main task: - question and answer*Data
collection* (collected by those familiar with the study)
*Data analysis* (arrange information into meaningful patterns
Drawing conclusions based on findings, Answer the question: - question and
answer"What do these findings mean?"
Discussion of clinical implications - question and answer• 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: - question and answer• Articles published
in professional journals
• Presentations given at conferences
Nursing student role in research - question and answerLearning about research: doing
honors projects or assisting in labs
BSN role in research - question and answerIdentifies problems that can be studied; may
do data collection for research studies
MSN role in research - question and answerReplicates earlier research; beginning
independent research
Doctorate role in research - question and answerGenerate and test theory; establish
independent research career
Academician role in research - question and answerIndependent 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 - question and answer*C. Design the study
protocol*
Define: Evidence-based practice - question and answerSystematic approach to rational
decision making that facilitates achievement of best practices
Six steps to EBP - question and answer1. 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 - question and 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? - question and 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 - question and 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 - question and 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)
,Evidence-Based Practice in Nursing
Critically appraise the evidence you gather - question and 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 - question and 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 - question and 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 - question and answer*P* - population of interest
*I* - intervention
*C* - comparison
*O* - outcome
Utilization of the research process - question and 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 - question and answer• Sources:
* clinical situations
* the literature
* theories
• Repeat the study or design a similar one
• Test theoretical models
Review of the literature - question and 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?"
, Evidence-Based Practice in Nursing
Two major categories in designing study - question and answer*experimental* (require
quantitative methodology)
*nonexperimental* (can be quantitative or qualitative methodology)
Implementation of the study involves two main task: - question and answer*Data
collection* (collected by those familiar with the study)
*Data analysis* (arrange information into meaningful patterns
Drawing conclusions based on findings, Answer the question: - question and
answer"What do these findings mean?"
Discussion of clinical implications - question and answer• 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: - question and answer• Articles published
in professional journals
• Presentations given at conferences
Nursing student role in research - question and answerLearning about research: doing
honors projects or assisting in labs
BSN role in research - question and answerIdentifies problems that can be studied; may
do data collection for research studies
MSN role in research - question and answerReplicates earlier research; beginning
independent research
Doctorate role in research - question and answerGenerate and test theory; establish
independent research career
Academician role in research - question and answerIndependent 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 - question and answer*C. Design the study
protocol*
