Test Banks For Evidence-Based Practice in Nursing & Healthcare 4th Edition by Bernadette Mazurek Melnyk; Ellen Fineout-Overholt, Chapter 1-23

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?"