Chapter 3 Understanding Evidence-Based Practice Flashcards
ACP Journal Club
The ACP (American College of Physicians) Journal Club summarizes and interprets the best evidence of one recent study or review article from traditional journals, based on the criteria provided by the practitioner.
Agency for Healthcare Research and Quality (AHRQ)
The AHRQ has promoted EBP through the establishment of 12 Evidence-Based Practice Centers (EPCs).
Background questions
- Questions focusing on basic or general knowledge about a condition and/or disorder.
- Components are only a question (who, what, where, how, why) and a verb.
- Examples: What causes migraines?; What is the best diagnostic test for a kidney stone?; How often should women over the age of 40 have mammograms?
Cochrane Database of Systematic Reviews
One of the most popular databases is The Cochrane Library, which reviews and summarizes individual clinical trials and systematic reviews from more than 100 medical journals.
Evidence-based medicine (EBM)
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
Evidence-based nursing (EBN)
The conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences.
Foreground questions
- Questions focusing on specific knowledge to inform clinical decisions or actions.
- Components are from the PICOT model (patient/population/problem; intervention; comparison; outcome; timeline).
- Examples: How should you treat acute bronchitis in children under the age of two?; Should patients with whiplash injury wear a cervical collar?
InfoPOEMS
Info-POEMS (Patient-Oriented Evidence that Matters) is a database similar to the ACP Journal Club; it reviews and provides commentary on recent articles.
Knowledge-focused triggers
- Ideas that emerge from staff when they read, listen to research presentations, or encounter EBP guidelines by federal agencies or specialty organizations.
- Examples: Pain management, prevention of skin breakdown, assessment of nasogastric tube placement, and patency of arterial lines.
- Reading a study in a specialty journal; hearing and reading a lot about evidence-based practice; knowing you should be using research findings in practice.
MD Consult
A database that provides full-text access to textbooks, journal articles, practice guidelines, patient education handouts, and drug awareness.
Meta-analysis
- A statistical method (not a research design) that takes the results of many studies in a specific area and synthesizes their findings to draw conclusions regarding the state of the science in the area of focus.
- Sometimes referred to as a quantitative synthesis - creates a large sample size that has the ability to detect differences whereas before, individual studies may have been underpowered and experienced Type II errors.
National Guideline Clearinghouse
This Clearinghouse provides a collection of evidence-based clinical practice guidelines.
PICOT model
Five components that provide structure when writing *clinical questions*: P—Patient/Population/Problem; I—Intervention (treatment, etc.); C—Comparison; O—Outcome; T—Timeline.
Problem-focused triggers (practice-based triggers)
- Ideas that emerge from staff in the context of clinical practice by examining quality improvement data, risk surveillance data, benchmarking data, or a recurrence of a clinical problem.
- Examples: Increased incidence of deep vein thrombosis and pulmonary emboli.
- Outcomes are not what they should be; a sense that something just is not working right; you’ve heard about a better way of doing something.
Research utilization
- The process by which knowledge generated from research becomes incorporated into clinical practice.
- Emphasizes translating empirically derived knowledge into real-world applications, with a focus on improving patient outcomes.