Evidence-based practice

Question 1

EBP

Answer 1

clinical expertise + best research evidence + patient needs and values

Question 2

Seven Steps (Melnyk, 2010)

Answer 2

0. Cultivate a spirit of inquiry
1. Ask a clinical question
2. Search for the best evidence
3. Critically appraise the evidence
4. Integrate the evidence with clinical expertise and patient preferences and values
5. Evaluate the outcomes
6. Disseminate results

Question 3

consensus statement

Answer 3

represents the collective opinion of a convened expert panel

not always evidence-based!

Question 4

evidence-based guideline

Answer 4

a systematically developed statement to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances

a series of recommendations on clinical care based on best available evidence

National Guidelines Clearinghouse!

Question 5

ACE star model

Answer 5

framework for understanding relationship b/w stages of knowledge transformation

systematically puts EBP process into action

at each stage, evidence is more useful at bedside

Question 6

Iowa model

Answer 6

starts with problem/knowledge-focused trigger

if organizational priority a team is formed

team synthesizes and critiques evidence

pilot practice change occurs if there is strong evidence

Question 7

Johns Hopkins Nursing EBP

Answer 7

3 cornerstones of professional nursing: practice, education, research

at core of model are sources of evidence

Question 8

quality/performance improvement (PI)

Answer 8

analyzes existing data to improve processes and outcomes

improves pt care, a clinical program, a work flow processes or service to achieve high quality, sustainable health services within an organization

Question 9

evidence-based practice

Answer 9

problem solving approach to clinical practice that integrates

• a systematic search for/critical appraisal of the most relevant evidence,
• one’s clinical experience,
• patient’s values and expectations

systematic approach that is evidence driven

answers clinical questions about pt care

Question 10

PDCA

Answer 10

PLAN for changes: ID problems, come up with ideas

DO changes: trial changes on small scale

CHECK to see if changes are bringing desired result and quality of output is constituent, investigate processes for problems

ACT: implement changes on larger scale

Question 11

six sigma/lean six sigma

Answer 11

• improves quality of process outputs by IDing and removing causes of errors and minimizing variability in processes
• Full Six sigma = 99.9997% accuracy
• uses a set of quality mgmt methods, inc stats methods, and creates special infrastructure of people within organization who are experts in these methods

Question 12

best practice

Answer 12

no consensus of meaning

• infusing nursing practice with research-based knowledge
• organizational process to improve practice
• based on tradition: proven effectiveness