EVIDENCE-BASED
PRACTICE IN
NURSING
GROUP 1
EVIDENCE-BASED PRACTICE
Evidence from research
studies and the opinions of
nursing experts provides a
basis for nursing care.
The Need for Evidence-Based Practice
EvidenceBased Care
> Improves quality, safety,
and patient outcomes
> Increases nurse satisfaction
> Reduces costs
Sources of
Evidence
> Textbooks
> Articles from nursing and health
care literature
> Quality Improvement and risk
management data
> Standards of care
> Infection control data
> Benchmarking, retrospective, or
concurrent chart reviews
> Clinicians’ expertise
Steps of Evidence-Based Practice
1. Cultivate a spirit of inquiry.
2.Ask a clinical question in PICOT format.
3.Search for the most relevant evidence.
4.Critically appraise the evidence you gather.
5.Integrate all evidence with your clinical expertise and patient
preferences and values.
6.Evaluate the outcomes of practice decisions or changes using
evidence.
7.Share the outcomes with others.
1. Cultivate a Spirit of Inquiry
• Question what does not make sense to you and what needs to be clarified.
• Gain evidence-based practice (EBP) knowledge and skills.
• Be committed to providing the best care possible.
• Use problem- and knowledge-focused triggers.
• Consider data gathered from a health care setting to examine clinical
trends.
2. Ask a Clinical Question:
Developing a PICOT question
P = Patient population of interest
I = Intervention of interest
C = Comparison of interest
O = Outcome
T = Time
3. Collect the Best Evidence
• Ask Experts for Help:
> Nursing faculty
> Advanced practice nurses
> Staff educators
> Risk managers
> Librarians
• A Medical Librarian can:
> Identify the databases that are available to you.
> Identify key words that will provide the best answer to your
PICOT question.
4. Critically Appraise the Evidence
• After Critiquing all Articles for a PICOT Question:
> Synthesize or combine the findings.
> Consider the scientific rigor of the evidence and whether it has
application in practice.
• Elements of an Article
> Abstract
> Introduction
> Literature review or background
> Manuscript narrative
-Purpose statement
-Methods or design
-Results or conclusions
-Clinical implications
5. Integrate the Evidence
• Integrating evidence: teaching, assessment or
documentation tools, clinical practice guidelines, policies and
procedures.
• Applying evidence: consider setting, staff support, scope of
practice, resources.
• A pilot study may be conducted when evidence is not strong
enough to apply in practice.
6. Evaluate the Practice
Decision or Change
• After applying evidence, evaluate the outcome.
• When evaluating an EBP change determine:
> Was the change effective?
> Are modifications needed?
> Should the change be discontinued?
• Unexpected events or results may occur.
• Never implement a practice change without evaluating
its effects.
7. Share the
Outcomes
with Others
-After implementing an EBP
change, it is important to
communicate the results with the:
1
Clinical staff on the unit
2
Nursing practice council or the
research council
3
Clinicians
4
Professional conferences and
meeting
Nursing Research
• A way to identify new knowledge, improve professional
education and practice, and use resources effectively.
• Many professional and specialty nursing organizations
support the conduct of research for advancing nursing
science.
Outcome Research
• Helps patients, health care providers, and those in
health care policy make informed decisions on the basis
of current evidence.
• Typically focuses on the benefits, risks, costs, and
holistic effects of a treatment on patients.
• Outcomes must be observable or measurable.
Scientific Method
• The foundation of research.
• The most reliable and objective means of acquiring and
conducting research and gaining knowledge.
• A step-by-step process to ensure that findings from a
study are valid, reliable, and generalizable to a similar
group of subjects.
Nursing and the Scientific Approach
Research allows you to study nursing questions and problems in greater
depth within the context of nursing.
Quantitative
> Experimental research
> Non-experimental research
> Surveys
> Evaluation research
Qualitative
>Ethnography
> Phenomenology
> Grounded theory
• Institutional Review Board (IRB)
Research
Process
• Human Research Terminology
• Informed consent means:
> Participants receive full and
complete information.
> They can understand the
information.
> They have free choice to
participate.
> They understand how their
confidentiality will be kept.
• Confidentiality
The Relationship between EBP,
Research, and QI
EBP
Use of information from research and other sources to
determine safe and effective nursing care with the goal of
improving patient care and outcomes
RESEARCH
Systematic inquiry answers questions, solves problems, and
contributes to the generalizable knowledge base of nursing;
may or may not improve patient care
QI
Improves local work processes to improve patient outcomes
and health system efficiency; results usually not generalizable
Thank You