evidence-based assessment

Question 1

what led to the development of evidence-based practice

Answer 1

The conviction that all patients deserve to be treated with the most current and best-practice techniques

Question 2

explain evidence-based practice in the 1850s and who was involved

Answer 2

historical evolution of the concept of “research” evidence began with Florence Nightingale when she used it to improve patient outcomes during the Crimean War

Question 3

explain evidence-based practice in the 1970s

Answer 3

evidence based medicine term was coined and defined in the context of clinical research methods

Question 4

who was an early proponent of evidence based practice (EBP) in the 1970s

Answer 4

British epidemiologist Archie Cochrane identified a pressing need for systematic reviews of randomized clinical trials

Question 5

explain evidence-based practice throughout the 1970s-1980s

Answer 5

there was a focus on “research utilization” which is now termed evidence based practice (EBP)

Question 6

what was the goal of evidence based practice

Answer 6

use research findings in practice to ensure high-quality, effective patient care

Question 7

what was integrated in evidence based practice

Answer 7

research evidence, clinical expertise, clinical knowledge (physical assessment), and patient values and preferences

Question 8

what are the 4 factors that clinical decision making depend on

Answer 8

best evidence from critical review of research literature, patient’s own preference, clinician’s experience/expertise, and physical exam

Question 9

what are the current ways in which health care educators attempt to make evidence based practice care the gold standard of practice

Answer 9

1. fostering a culture of EBP at the undergraduate and graduate levels and looking for gaps in the literature

Question 10

how is support facilitated for EBP on the organizational level

Answer 10

ensuring time for staff to review current literature; establishing a nursing research committee; holding EBP classes for interested staff; and ensuring access to resources.

Question 11

what are the 5 steps in evidence based practice

Answer 11

ask the clinical question

acquire sources of evidence

appraise and synthesize evidence

apply relevant evidence in practice

assess the outcomes

Question 12

describe the landmark case by Dr. Archie Cochrane and the use of clinical trials

Answer 12

multiple clinical trials published between 1972 and 1981 showed that the use of corticosteroids to treat women in premature labor reduced the incidence of infant mortality.

short course of corticosteroid stimulates fetal lung development, thus preventing respiratory distress syndrome, a serious and common complication of premature birth.

these findings had not been implemented into daily practice, and thousands of low-birth-weight premature infants were dying needlessly.

Following a systematic review of the evidence in 1989, obstetricians finally accepted the use of corticosteroid treatment as standard practice for women in preterm labor.

Corticosteroid treatment has since been shown to reduce the risk of infant mortality by 30% to 50%