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Week One Objectives - ANSWER-Discuss how evidence-based practice
(EBP) assists hospitals and healthcare systems achieve the quadruple
aim.
Describe the differences among EBP, research, and quality
improvement.
Identify the seven steps of EBP
Discuss barriers to EBP and key elements of cultures that support the
implementation of EBP
Chapter One: Making the Case for Evidence-Based Practice and
Cultivating a Spirit of Inquiry - ANSWER-PowerPoint
Quadruple Aim - ANSWER-•Evidence-based practice (EBP):
,•Enhances healthcare quality
•Improves patient outcomes
•Reduces costs
•Empowers clinicians
this is the purpose of evidence based practice
Is evidenced based practice the current standard of care? - ANSWER-
still often not the standard of care
implementation is not the norm
Why?
Clinicians often lack competency in EBP and practice is often steeped
in tradition (always done it this way) mentality;
Takes a lot of time for implementation. Corticosteroid shots for infant
lungs in premature took 17 years to implement.
The Three Components of EBP - ANSWER-•The conscientious use of
current best evidence in making decisions about patient care:
•A lifelong problem-solving approach to clinical practice that
integrates
•Critical appraisal and synthesis of the most relevant and best
research (external evidence)
,•One's own clinical expertise, which includes internal evidence
generated from outcomes management or quality improvement
projects, patient assessment, and evaluation
•Patient preferences and values
Internal evidence comes from ourselves. Things we’ve seen work.
Types of Evidence Used in EBP External evidence - ANSWER-·Evidence
generated through rigorous research (e.g., RCTs and cohort studies)
that is intended to be generalized to and used in other settings
Types of Evidence Used in EBP Internal evidence - ANSWER-·Evidence
typically generated through practice initiatives such as outcomes
management or quality improvement projects that are not intended
to be generalized to other clinical settings
Is the following statement true or false?
Finding a quasi-experimental study in a peer-reviewed nursing journal
article that tests a protocol for the frequency of turning for immobile
patients is an example of external evidence. - ANSWER-True
Rationale: External evidence includes peer-reviewed publications that
present the findings of research and are intended to be generalized to
other clinical settings.
, Research vs quality improvement: Research - ANSWER-•Uses a
scientific process to generate NEW knowledge/external evidence and
research utilization
•Research utilization-operationalized as the use of knowledge
typically based on a single study
Research vs quality improvement: Quality Improvement - ANSWER-
•Systematic internal process
•Often uses plan, do, study, act (PDSA) Model
•Often used by healthcare systems to improve their processes or
outcomes for a specific population
Quality improvement is not true research. Quality improvement
typically in one hospital to improve processes. Quality improvement is
specific to specific population.
Translational Research - ANSWER-•Often confused with EBP
•Translational research: rigorous research that studies how evidence-
based interventions are translated into real-world clinical settings
How the research is being put into real practice and then studying
how that works in practice.
Sub-components of EBP - ANSWER-•Systematic reviews of RCT
(randomized controlled trials), regarded as strongest level of evidence
(level I)
•Best level of evidence on which to base practice decisions