N244 Exam 1 2025

Steps to Evidence-Based Practice (EBP) - -1. Ask a well-built clinical question (a PICO(t)) 2. Search to find the research/evidence 3. Appraise the evidence 4. Integrate findings into your practice 5. Evaluate practice changes and patient outcomes 6. Disseminate findings ASAIED Apples So Aren't Into Eating Doctors Components of a PICO(T) question - - -P: patient, problem, or population -I: intervention -C: comparison or control -O: outcome -(T): time (this one is optional) Evidence heirarchy and name the levels - -puts types of evidence on levels from most reliable to least reliable 1: systematic reviews, meta-analysis, or EBP guidelines 2: randomized controlled trials 3: controlled trials without randomization 4: cohort studies or case-control studies 5: evidence from systematic reviews of descriptive or qualitative studies 6: evidence from single descriptive or qualitative studies 7: evidence from the opinion of Authorities and/or reports of Expert Committees *note that it is not always necessary to have evidence from the top of the hierarchy because not all PICO questions can be answered with systematic reviews which is level 1 Intervention/therapy PICO question - -aims to ask if one intervention is better than another Diagnosis or diagnostic test PICO question - -aims to ask how accurate a diagnostic test is prognosis/prediction PICO question - -aims to ask what the likely outcome, progression, or surival time for this condition is NUR244 NUR244 causation/harm/etiology PICO question - -aims to ask what are the causes of this condition or state of affairs cost effectiveness PICO question - -aims to ask if the intervention is more cost effective than the alternative quality of life PICO quiestion - -aims to ask what the quality of life will be for the patient following this intervention meaning PICO question - -aims to ask how people with a particular illness perceive aspects of their health What type of PICO question is this? Do adults who drink alcohol fewer than 2 hours before bed compared to those that don't, have poorer sleep quality? - -causation/harm/etiology What type of PICO is this? In children aged 5 and older, how does being born premature vs at term correlate with childhood learning disabilites? - -prognosis/prediction what type of PICO is this? In pregnant women, is a self-report survey about intimate partner violence more accurate than a NP interview in identifying risk of violence during pregnancy? - Diagnosis or diagnostic test What type of PICO is this? In women giving birth, does having their physicians wash their hands with chlorine vs not washing their hands? - -Intervention/therapy define a Case report/case series. also identify which level of the evidence hierarchy it falls under? - -a case report or a case series that is useful for the study of rare diseases, disorders, or reactions. These studies are not generalizable, but also may be the only source of information on that topic available this falls under level 6: evidence from a descriptive or qualitative study define a case-control study. identify what level of the evidence hierarchy it falls under - -examines a group of people who have experienced an event and a group of people who have not experienced that NUR244 NUR244 event. Useful for trying to find the cause of certain events. It also sometimes is the only way to do ethical research. These also look back in time at previous records to compare this falls under level 4: case control studies or cohort studies define a prospective cohort study. identify what level of the evidence hierarchy it falls under - -a study that follows a group fo people, which differs in respect to exposure to some suspected risk or protective factor, and looks at how outcomes differ between the people in the group/cohort falls under level 4: case control or cohort studies Prospective blind comparison to gold standard - -compares a new tool to a tool that is currently considered gold standard define randomized control trials. identify what level of the evidence hierarchy it falls under. - -a study in which participants are randomly asssigned to two or more groups; at least one receiving an interaction that is being tested and another receiving an alternative treatment or placebo. this falls under level 2: randomized control trials define systematic reviews. identify which level of the hierarchy it falls under- - -an unbiase, comprehensive review of all the relevant studies about a topic. Combines many studies by identifying, appraising, and summarizing studies that address a defined question it falls under level 1 define meta-analysis identify what level of the evidence hierarchy it falls under - -typically builds off of a systematic review, but combines studies in a statistical manner instead. More weight is given to results of studies with more events and sometimes to studies of higher quality. Considered the best of the best for evidence based information it falls under level 1