midterm Flashcards
Dispositions & Attitudes
- Critical appraisal
- Curiosity and inquiry
- Open-mindedness
BCCNM Professional Standards
Knowledge-based practice: clinical practice
- Find. Interpret. Appraise.
- Bases practice on current evidence from nursing science
BCCNM Professional Standards
Knowledge-based practice: clinical practice
- Finding
- Knows how and where to access information to support the provision of safe, competent ethical care
BCCNM Professional Standards
Knowledge-based practice: clinical practice
- Critically Appraising
- Uses critical thinking when collecting and interpreting data, planning, implementing, and evaluating nursing care
BCCNM Professional Standards
Knowledge-based practice: clinical practice
- related to #1
- Shares nursing knowledge with clients, colleagues, students and others
Sources of Knowledge
Primary research literature
Systematic reviews
Evidenced informed decision-making PROCESS
Define
Search
Appraise
Synthesize
Adapt
Implement
Evaluate
Evidence-based practice EBP
consists of 3 things:
Clinical expertise \+ Best research evidence \+ Patient values and preferences
def: Define
need to define a searchable clinical question using PICO from a clinical practice problem
PICO
Population
Intervention/factors/treatment
Comparison (can be none)
Outcomes
6S pyramid
Systems Summaries Synopses of syntheses Syntheses Synopses of single studies Studies
What is the 6S pyramid for?
The 6S pyramid is a guide for finding the best available research evidence quickly and efficiently.
Each level draws on research from the lower levels.
The higher the level, the more synthesized evidence and stronger.
Type: Research/primary
Def, use, limitation
A paper reporting on the result of a single study. The authors conducted the study.
Used to learn specific knowledge about a research topic.
Not synthesized evidence so it only provides a limited understanding of how to apply something to practice Ex. it is only 1 piece of evidence to support practice decisions.
Type: Case study
Def, use, limitation
Description of one person’s experience/condition.
Used to understand that specific experience/condition.
Hard to generalize.
Type: Review of literature
Def, use, limitations
Combination of relevant articles on a topic to explain the state of the literature on this topic.
Used to put many sources of evidence into one big bundle of evidence in one place.
It is not systematic so there can. be bias of inclusion and what the researchers decide to include and the quality of what they do include.
Type: Systematic Review
Def, use, limitations
Summary of the evidence about a particular topic and synthesized.
Used to put lots of information together. Less user-friendly way because it is more rigorous, can provide weightier evidence about how to act towards a particular practice question
Difficulty with reading and taking in the scope of findings.
Type: Meta-analysis
Def, use, limitations
Systematic review that uses statistical review.
Used to synthesize numerically everything about a topic. It is stronger than just a systematic review because it combines what is known about a topic with actual numerical findings together.
Difficulty with reading. Difficulty combining studies (ex. did all authors measure the same outcome and with the same method of measurement?)
Type: Meta-synthesis
Def, use, limitations
Systematic review of qualitative data, draws together major themes.
Uses overview of themes, synthesizing that qualitative literature says about a certain topic. Is st
Type: Professional communications/books/letters to the editor/book reviews
Def, use, limitations
Offers opinions on the articles or books.
Useful to add to understanding.
Biased opinions, not peer-reviewed.
Def: Evidence
Astle’s def
+
CNA’s def
=
Information acquired through research and the scientific evaluation of practice, including rigorous methods (qualitative and quantitative), and reported in a variety of sources ( academic publications, consensus documents, reports) that are believed to be true (proven), which are SYSTEMATICALLY OBTAINED and SYSTEMATICALLY REVIEWED.
Def: Systematically obtained
referring to “evidence”
Evidence/facts obtained in a way that is replicable, observable, credible, verifiable, or basically supportable.
3 questions to guide the search process
Q: What am I looking for?
Q: How will I find it?
Q: What will I do with it?
The search process
clinical practice problem -> defined research question-> main concepts-> PICO(T)-> keyword search terms-> additional keywords-> limiters-> subject headings
Is a systematic review a primary or secondary source?
secondary
Peer-reviewed article
criteria:
Q: Is the article peer-reviewed or not?
- peer-reviewed (refereed, scholarly)
- authors (expertise, credentials, affiliations)
- abstract (highlights, implications for practice)
- jargon (language to fit the audience, formal presentation)
- length (depth, details like graphics)
- references (to support)
- ethical approval?
Anatomy of a Research paper
IMRD
Intro
Methods (of collecting data, of analysis, of reviewing, tools, how they gathered subjects etc.)
Results (data, findings)
Discussion
Evidence-Informed Practice:
aims to search for and appraise the best evidence as well as the inclusion of a practitioner’s judgment and client values.
Why does evidence-informed practice matter to nursing practice?
BEST evidence to confirm, modify, change, develop knowledge, skills and attitudes to provide safe provision of optimal care and service for clients, communities.
Process of bringing evidence into practice+ role of evidence in clinical decision making
the nurse bases treatment decisions on 3 things: research evidence, patient values and preferences, and clinical experience
Research literacy:
Def & importance to nursing
Def: Understanding research language and its application to practice.
Importance:
-be involved in the process of evidence-informed decision making which supports your ability to communicate with other professionals and clients
- remain current, reflective, critical, responsive in your work
- make the best possible choices and provide the best possible care or interventions to clients
- be a better consumer and an advocate of the best use of health care resources
Evidence-informed decision-making:
the process of defining problems and questions; searching; appraising; and synthesizing the available research evidence; and then adapting, implementing, and evaluating best evidence for practice.
the Define step
Begin by focusing on your topic, defining the terms of what you want to understand, and defining the boundaries of what you want to better understand.
ex. “health” is too general. Narrow it to mental, physical, cardiovascular health ect.)
ex. a particular population ? Factors such as age, gender, race, education level, socioeconomic status, existing health conditions, location?
Rationale for PICO
a tool for question formulation. It helps make a question searchable and therefore answerable.
Sensitivity:
1/2 of the main goals in the searching stage. To not miss any of those papers that are relevant to the question.
Specificity:
1/2 of the main goals in the searching stage. To retrieve only those papers that are relevant to the search question
Why is there a Peer-review process?
to ensure only those studies with methods and findings that have been evaluated by other experts in the field and determined to be both original and of high quality are published.
Double-blind peer-review:
authors of the study and the reviewers are unaware of each other’s identities to prevent any personal bias from influencing the process of peer-reviewing
Other ways to check if an article is peer-reviewed:
- visit the journal’s website to confirm editorial practices
- use limiters when searching a database
Research vs Evidence-informed practice
think “outcome” or “end goal”
Research’s outcome: contribute to understanding
Evidence-informed practice’s outcome: bring about
changes in practice
1/5 Abstract:
Brief summary of the research including the main question, method, results, and implications
2/5 Introduction
Introduces the topic, purpose of the study, provides background research leading up to the new question in the study.
3/5 Methods
Describes the mechanics of the study (participants, measures used, and procedure)
4/5 Results
Describes what was found in the study with statistics, tables, narrative description and analysis of the tables.
5/5 Discussion
Describes the limitations and implications of the study.
So you can understand how these findings relate to. your practice and whether changes in your practice are advisable.
primary vs secondary
Primary sources represent original thinking, reports on discoveries or events, or they can share new information. … Secondary sources involve analysis, synthesis, interpretation, or evaluation of primary sources
Truncation:
Truncation is a searching technique used in databases in which a word ending is replaced by a symbol. For example: If the truncation symbol is , then the truncated word, laugh, will search for results containing laugh, laughter, laughing etc. …
