Evidence-Based Practice Flashcards
PICOT
P = Patient population I = Intervention/Issue of interest C = Comparison (if there is a control) O = Outcome T = Time frame
Meta Analysis
Systematic review which incorporates quantitavtive methods to summarize the results from multiple studies
Hierarchy of evidence for intervention/treatment questions
I. systemative reivew and meta Analysis with RCTs
II. RCTs
III. CTs without R
IV. Case control or Chohort studies
V. Systematic reviews of discriptive or Qualitative studies
VI. Descriptive or Qualitative Studies
VII. Opinion of authorities or experts
Critical Appraisal Questions
- Validity of results
- Reliability of results
- Applicability of resutls
Translational Research
Research findings can be transported into clinical practice to improve care and patient outcomes
EBP Systematic Reviews and Guidelines Resources
Cochrane Library
National Guideline Clearinghouse
Three centers for EBP
UTHSC SA
Arizona State CoN
Case WEstern Reserve SoN
Core Competencies for Health Care Education (IOM; AACN)
- Pt centered care
- Interdisciplinary teamwork
- Employ EBP
- Apply quality improvement
- Utilize informatics
Two types of EB Questions
Background
Foreground
EB Background Question
Questions that need to be answered as a foundation for asking foreground questions.
EB Foreground Questions
Searchable answerable questons from scientific evidence about diagnoses, treatments, or assisting patients to understand their prognosis
Clinical Inquiry
Systematic process to gather data to appraise choices in treatment to find best choice of action
5 Types of Foreground questions
- Intervention
- Prognosis/Prediction
- Diagnosis
- Etiology
- Meaning
EB Intervention Questions
What intervention most effectively leads to an outcome
EB Prognosis questions
What indicators are most predictive of or carry most risk for an outcome
EB Diagnosis questions
What mechansim or test most accurately diagnoses an outcome
EB Etiology questions
To what extent a factor, process, or condition is highly associated with an outcome
EB Meaning questions
How an experience influences an outcome, scope of a phenomenon or influence of culture on healthcare
Steps to EBP Process
- Cultiate a spirit of inquiry
- Ask Clinical Question
- Search and Collect best evidence
- Appraise evidence
- Integrate evidence with one’s clinical expertise and patient preferences
- Evaluate outcomes
- Disseminate outcomes of EPB decision or change
Cycle of Knowledge Transformation
ACE Star Model Stages:
1 Knowledge discovery 2. Evidence summary 3. Translation into practice recommendations 4. Implementation into practice 5 Evaluation
Evidence Summaries
Reviews of literature that could answer a given clinical question
