Evidence-Based Practice in Nursing
m m m
Define:mEvidence-basedmpracticem-
manswerSystematicmapproachmtomrationalmdecisionmmakingmthatmfacilitatesmachievementmofmbestmpractic
es
SixmstepsmtomEBPm-manswer1.mAskmamclinicalmquestion
2. Collectmthemmostmrelevantmandmbestmevidence
3. Criticallymappraisemthemevidencemyoumgather
4. Integratemallmevidencemwithmone'smclinicalmexpertisemandmpatientmpreferencesmandmvaluesminmma
kingmampracticemdecisionmormchange
5. Evaluate
6. SharemoutcomesmofmEBPmchangesmwithmothers
Askmamclinicalmquestionm-manswer•mAmproblemmormareamofminterestmthatmcouldmbemperformedmmore
efficiently,mconsumesmhealthcaremdollars,mormdoesmnotmmakemsense
• Amknowledgemfocusedmtrigger
• Clinicalmtrends
• UtilizationmofmPICOTmformatmtomstatemyourmclinicalmquestion
WhymshouldmImusemPICOTmformatmtomstatemmymclinicalmquestion?m-manswer•mThemquestionsmyoumaskmwill
eventuallymleadmyoumtomthemevidencemformanmanswer
• YoumwantmtombemablemtomreadmthemBESTmfour-to-
sixmarticlesmthatmspecificallymaddressmyourmpracticemquestion
• Themmoremfocusedmamquestionmyoumask,mthemeasiermitmbecomesmtomsearchmformevidenceminmthemscient
ific
literature
PICOTmquestionm-manswer*P*m=mPatientmpopulationmofminterest
*I*m=mInterventionmofminterest
*C*m=mComparisonmofminterest
*O*m=mOutcome
,*T*m=mTime
Collectmthembestmevidence-mwhatmkindmandmincludesm-manswer•mSearchmformevidence!
• *Evidencemincludesmbutmismnotmlimitedmto*:magencympolicymandmproceduremmanuals,mqualitymim
provementmdata,mexistingmclinicalmpracticemguidelines,magencymexperts,mstaffmeducators,mriskmman
agers,minfectionmcontrolmnurses,mandmpeermreviewedmarticlesm(specificallymwithinmthemmostmrecentm
5myearsmfrommthempresentmdate)
Criticallymappraisemthemevidencemyoumgatherm-manswer•mThemmostmdifficultmstepminmthemEBPmprocess
• Involvesmevaluation,mdeterminingmifminformationmismvaluablemandmcanmbemeasilymapplied,mandmifmthe
re
ismenoughmevidencemformmakingmamnursingmpracticemchange
• Thoroughmreviewmofmelementsmincludedminmevidence-basedmarticles
Integratemthemevidencem-manswer•mHowmwillmyoumincorporatemthemevidencemintompractice?
• Integratemevidencemwithmusemofmteachingmtools,mclinicalmpracticemguidelines,mpoliciesmand
procedures,mandmnewmassessmentmdocumentationmtools
• Considermstaffmsupportmandmavailablemresources
• ConductmampilotmstudymandmattemptmtomanswermyourmPICOTmquestion
Evaluatemandmsharemoutcomesm-manswer•mDidmitmwork?mIsmitmeffective?
• Communicatemthemresultsmtomvariousmgroupsmofmnursesmormothermcaremprovidersm(facilitymn
ursingmpracticemcouncilmormresearchmcommittee)
PICOmfour-stepmprocessm-manswer*P*m-mpopulationmofminterest
*I*m-mintervention
*C*m-mcomparison
*O*m-moutcome
Utilizationmofmthemresearchmprocessm-manswer•mIdentificationmofmamresearchablemproblem
• Reviewmofmthemliterature
, • Formulationmofmthemresearchmquestionmormhypothesis
• Designmofmthemstudy
• Implementationmofmthemstudy
• Drawingmconclusionsmbasedmonmfindings
• Discussionmofmclinicalmimplications
• Disseminationmofmfindings
Identificationmofmamresearchablemproblemm-manswer•mSources:
* clinicalmsituations
* themliterature
* theories
• Repeatmthemstudymormdesignmamsimilarmone
• Testmtheoreticalmmodels
Reviewmofmthemliteraturem-manswer•mComprehensivemandmcoversmallmrelevantmresearch
• Essentialmtomlocatemsimilarmormrelatedmstudiesmthatmhavemalreadymbeenmcompletedmandmonmwhi
chmamnewmstudymcanmbuild
• Answermthemquestionm"whatmhavemothermresearchersmandmtheoristsmwrittenmaboutmthismproblem?"
Twommajormcategoriesminmdesigningmstudym-
manswer*experimental* m(requiremquantitativemmethodology)
*nonexperimental*m(canmbemquantitativemormqualitativemmethodology)
Implementationmofmthemstudyminvolvesmtwommainmtask:m-
manswer*Datamcollection* m(collectedmbymthosemfamiliarmwithmthemstudy)
*Datamanalysis*m(arrangeminformationmintommeaningfulmpatterns
Drawingmconclusionsmbasedmonmfindings,mAnswermthemquestion:m-
manswer"Whatmdomthesemfindingsmmean?"
m m m
Define:mEvidence-basedmpracticem-
manswerSystematicmapproachmtomrationalmdecisionmmakingmthatmfacilitatesmachievementmofmbestmpractic
es
SixmstepsmtomEBPm-manswer1.mAskmamclinicalmquestion
2. Collectmthemmostmrelevantmandmbestmevidence
3. Criticallymappraisemthemevidencemyoumgather
4. Integratemallmevidencemwithmone'smclinicalmexpertisemandmpatientmpreferencesmandmvaluesminmma
kingmampracticemdecisionmormchange
5. Evaluate
6. SharemoutcomesmofmEBPmchangesmwithmothers
Askmamclinicalmquestionm-manswer•mAmproblemmormareamofminterestmthatmcouldmbemperformedmmore
efficiently,mconsumesmhealthcaremdollars,mormdoesmnotmmakemsense
• Amknowledgemfocusedmtrigger
• Clinicalmtrends
• UtilizationmofmPICOTmformatmtomstatemyourmclinicalmquestion
WhymshouldmImusemPICOTmformatmtomstatemmymclinicalmquestion?m-manswer•mThemquestionsmyoumaskmwill
eventuallymleadmyoumtomthemevidencemformanmanswer
• YoumwantmtombemablemtomreadmthemBESTmfour-to-
sixmarticlesmthatmspecificallymaddressmyourmpracticemquestion
• Themmoremfocusedmamquestionmyoumask,mthemeasiermitmbecomesmtomsearchmformevidenceminmthemscient
ific
literature
PICOTmquestionm-manswer*P*m=mPatientmpopulationmofminterest
*I*m=mInterventionmofminterest
*C*m=mComparisonmofminterest
*O*m=mOutcome
,*T*m=mTime
Collectmthembestmevidence-mwhatmkindmandmincludesm-manswer•mSearchmformevidence!
• *Evidencemincludesmbutmismnotmlimitedmto*:magencympolicymandmproceduremmanuals,mqualitymim
provementmdata,mexistingmclinicalmpracticemguidelines,magencymexperts,mstaffmeducators,mriskmman
agers,minfectionmcontrolmnurses,mandmpeermreviewedmarticlesm(specificallymwithinmthemmostmrecentm
5myearsmfrommthempresentmdate)
Criticallymappraisemthemevidencemyoumgatherm-manswer•mThemmostmdifficultmstepminmthemEBPmprocess
• Involvesmevaluation,mdeterminingmifminformationmismvaluablemandmcanmbemeasilymapplied,mandmifmthe
re
ismenoughmevidencemformmakingmamnursingmpracticemchange
• Thoroughmreviewmofmelementsmincludedminmevidence-basedmarticles
Integratemthemevidencem-manswer•mHowmwillmyoumincorporatemthemevidencemintompractice?
• Integratemevidencemwithmusemofmteachingmtools,mclinicalmpracticemguidelines,mpoliciesmand
procedures,mandmnewmassessmentmdocumentationmtools
• Considermstaffmsupportmandmavailablemresources
• ConductmampilotmstudymandmattemptmtomanswermyourmPICOTmquestion
Evaluatemandmsharemoutcomesm-manswer•mDidmitmwork?mIsmitmeffective?
• Communicatemthemresultsmtomvariousmgroupsmofmnursesmormothermcaremprovidersm(facilitymn
ursingmpracticemcouncilmormresearchmcommittee)
PICOmfour-stepmprocessm-manswer*P*m-mpopulationmofminterest
*I*m-mintervention
*C*m-mcomparison
*O*m-moutcome
Utilizationmofmthemresearchmprocessm-manswer•mIdentificationmofmamresearchablemproblem
• Reviewmofmthemliterature
, • Formulationmofmthemresearchmquestionmormhypothesis
• Designmofmthemstudy
• Implementationmofmthemstudy
• Drawingmconclusionsmbasedmonmfindings
• Discussionmofmclinicalmimplications
• Disseminationmofmfindings
Identificationmofmamresearchablemproblemm-manswer•mSources:
* clinicalmsituations
* themliterature
* theories
• Repeatmthemstudymormdesignmamsimilarmone
• Testmtheoreticalmmodels
Reviewmofmthemliteraturem-manswer•mComprehensivemandmcoversmallmrelevantmresearch
• Essentialmtomlocatemsimilarmormrelatedmstudiesmthatmhavemalreadymbeenmcompletedmandmonmwhi
chmamnewmstudymcanmbuild
• Answermthemquestionm"whatmhavemothermresearchersmandmtheoristsmwrittenmaboutmthismproblem?"
Twommajormcategoriesminmdesigningmstudym-
manswer*experimental* m(requiremquantitativemmethodology)
*nonexperimental*m(canmbemquantitativemormqualitativemmethodology)
Implementationmofmthemstudyminvolvesmtwommainmtask:m-
manswer*Datamcollection* m(collectedmbymthosemfamiliarmwithmthemstudy)
*Datamanalysis*m(arrangeminformationmintommeaningfulmpatterns
Drawingmconclusionsmbasedmonmfindings,mAnswermthemquestion:m-
manswer"Whatmdomthesemfindingsmmean?"
