Evidence Flashcards
What is Evidence-based Practice (EBP) used for?
To form a bridge between research and nursing practice
Define research
A formal systematic way of answering a question or approaching a problem
Define evidence:
Clinical knowledge, expert opinion, or information resulting from research
What 3 components are included in EBP’s definition?
- Best evidence from most current research available
- Nurse’s clinical expertise
- Patient’s preferences which reflect: Needs, interests, and choices
When can nurses use EBP in clinical practice?
To improve patient care as they:
- Collaborate with other disciplines
- Assist patients through the system in various roles
- Ensure open, effective communication and continuity among healthcare team members, patients, and families
What can using EBP help nurses to do?
- ensure credibility of their profession
2. provide accountability for nursing care
What is quantitative research?
Uses precise measurement to collect data, analyze it statistically
What is Qualitative research?
Investigates a question through narrative data exploring subjective experiences
Where can funding for research come from?
- professional nursing organizations
- Corporations
- Foundations
- State agencies
- Federal organizations
- Awards given in all areas of nursing
What must a nurse think about when choosing participants for research?
- age, weight, gender, medical history
- type, the present stage of disease
- Present medications taken
- Qualifiers can be categorized as inclusion (acceptable) or exclusion (not acceptable) criteria for participation
- Vulnerable populations are subject to strict legal and ethical considerations (neonates, human fetuses, children, prisoners, educationally disadvantaged individuals, and cognitively impaired individuals)
What are research participants?
Volunteers for a specific study project who:
- Meet all inclusion criteria
- Have been informed of all aspects of study
- Have signed informed consent
What ethical and legal statutes must be followed for research?
- institutional review boards review research protocols to ensure that they adhere to ethical standards
- research must adhere to three main ethical principles
- They must have informed consent
What are the three main ethical principles?
- Respect for persons (acknowledging, protecting the autonomy of all potential participants)
- Beneficence (Protection of participants from injury, harm, and exploitation)
- Justice (Fair treatment of all participants)
What must be included in informed consent for research?
- the right to receive full disclosure and information regarding the study
- The right to withdraw from the study at any time
- Given in written form before the study begins
What are the steps to developing evidence-based practice?
- Develop a clinical question
- Retrieve the evidence
- Evaluate the Evidence
- Apply the evidence
What is PICOT and why is it used?
A mnemonic used to define, formulate a clinical question for EBP
What is PICOT stand for?
- Population of patients or Problem of interest
- Intervention, prognostic factor, or type of exposure
- Comparison of interventions or main alternative to intervention (including no intervention)
- Outcomes (the desired effect)
- Time frame (optional)
What is included in step 2 of Developing Evidence-based practice?
- Review of pertinent literature
- Nursing databases and resource links can yield a list of articles related to the question
- local reference librarians can help with access to electronic databases
- Many libraries have access to nursing journals
- Nurse can network with local chapters of professional organizations
What is the Agency for Healthcare Research and Quality?
- funds 13 Evidence-based practice centers
- reviews all relevant scientific literature
- synthesizes evidence
- Help to translate evidence-based research findings
What is included in step 3 of developing evidence-based practice?
- Evidence must be appraised for validity, reliability, and usefulness
- Nurses must be able to critique research articles to identify strengths and weaknesses of studies and their resulting evidence
- Appraisal answers the question: “Is the comparison difference significant enough to change nursing practice?”
- Categorize
- Rating evidence helps to identify the best choices
What do Green, yellow, and red mean in regards to research?
Green: Strong evidence supports interventions
- Not enough evidence to determine the effectiveness
- Red: Strong evidence that interventions likely to be ineffective or harmful
What is involved in Step 4 of Developing Evidence-based practice?
- integrate the best evidence with the nurse’s own clinical experience and patient preferences
- Evaluate the change in practice for an impact on patient outcomes
- If change is beneficial, work with management to modify the facility’s policies and procedures to reflect the new practice
What topics of evidence-based resources are there related to newborns and infants?
screening protocols for phenylketonuria and sickle cell disease
What are the healthy People 2020 objectives for children?
- reducing child mortality rates, decreasing the incidence of transmission of preventable diseases among children
- Increase access to physician-led patient-centered, coordinated health services for children with special needs
What are some topics of evidence-based resources related to children?
- vaccination programs
- obesity prevention
- Screening for visual impairments
What are the Healthy People 2020 objectives for Adolescents?
- Reducing adolescent mortality rate
- Increasing proportion of adolescents with special healthcare needs who get patient care within comprehensive, coordinated, family-centered system
What are some topics of evidence-based resources related to Adolescents?
- vaccination programs
- Obesity prevention
- Reduction of secondhand smoke exposure
What are the Healthy People 2020 objectives for Pregnant Women?
- Reducing mortality rates
- Reducing rate of pregnancy-related complications
- Reducing cesarean births among women at low risk for complications
What are some topics of evidence-based resources related to Pregnant Women?
- preventing excessive alcohol consumption by pregnant women
- Educating mothers about breastfeeding
- Screening for illnesses such as hepatitis B, bacterial vaginosis
What are the Healthy People 2020 objectives for Adults?
- Genomics (More accurate risk prediction, diagnosis, treatment of many health alterations)
- Global health (protecting health of national populations, limiting international transmission of infectious diseases)
What are the Healthy People 2020 objectives for older adults?
- an increasing number of individuals up to date on basic preventive care
- Decreasing incidence of health alterations, such as pressure injuries, fall-related injuries
What are some topics of evidence-based resources related to older adults?
Screening for illnesses such as breast cancer and colorectal cancer
What are the strategies to implement Evidence-based practice?
- self-assessment to determine how much of current nursing practice is evidence-based
- assess obstacles preventing more frequent use of EBP
- Practice raising questions about current clinical practices and problem-solving
- Acquire more information to correct misperceptions
- If time is limited, focus on evidence from on high-yield sources
- Use the internet to cut down the time
- Learn how to do a critical appraisal of evidence
- build awareness of how and why things are done
- Identify others interested in searching for and evaluating evidence for collaboration
- Volunteer to participate in a professional nursing practice committee
- participate in a research project
What are some barriers to evidence-based practice?
- work schedule and workload demands
- Patient preferences that might conflict
- Lack of access to technology
- limited knowledge of skills for finding and evaluating evidence
- lack of experience and confidence
- Lack of support from supervisors or agency personnel
- Lack of access to continuing education programs
- Attitudes of individual nurses
- Resistance to change from traditional patient care routines
