Transcript Evidence-Based Practice

Evidence-Based Practice
(EBP)
Joan Pollner, RN, BSN, CHPN
October 18, 2006
Objectives
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Define Evidence-based practice (EBP)
Identify the goals of EBP
Distinguish between the characteristics of
Research Utilization and EBP
Describe the steps in the EBP process
Explain the challenges and misconceptions of
EBP
Utilize resources to further knowledge of EBP
Some Definitions
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Evidence-based practice can be thought of as requiring
"the integration of the best research evidence with our
clincial expertise and our patient's unique values and
circumstances." (Straus, et al., 2005) "Fortunately,
evidence-based practice (EBP) is an approach that
enables clinicians to provide highest quality of care in
meeting the multifaceted needs of their patients and
families." (Melnyk & Fineout-Overholt, 2005)
(Yale, 2005)
Definitions (con’t)
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Integration of the best research evidence
with clinical expertise and patient values.
(Spector, n.d.).
“…using the best available research
findings “to make clinical decisions that
are most effective and beneficial for
patients.”” (Chitty, 2005).
Goals of EBP
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Provide practicing nurses with evidencebased data
Resolve problems in the clinical setting
Achieve excellence in care delivery
Introduce innovation
Reduce variations in nursing care
Assists with efficient and effective
decision-making
Goals (con’t)
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Using best evidence to implement the
regulation of nurses
Resolve regulatory problems
Achieve excellence in regulation
Introduce regulatory innovation
Research Utilization vs EBP
Research Utilization
 Use results of studies
 Randomly selected
 Support nursing care
 Less systematic
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Evidence-Based
Practice
Considers all research
Utilized thorough
integrative review
Context of clinical
expertise and value
system of the patient
More systematic
EBP is multi-step process
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Define patient problem
Identify information needed to solve problem
Search of literature
Critical appraisal of the evidence
Extraction of the clinical answer
Protocol development
Evaluation
Steven’s ACE Star Model
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Discovery
Summary
Translation
Implementation
Evaluation
Steven’s ACE Star Model
Discovery
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Original research
Conduct a literature search utilizing
recognized techniques
Steven’s ACE Star Model
Summary
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Synthesize all research into a single meaningful
whole
This step differentiates research utilization from
Evidence-based practice
Can be called evidence synthesis
Increase power and effect of data
Reduce bias
Assess consistencies
Establish generalizability
Reduce data into an manageable form
Steven’s ACE Star Model
Translation
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Scientific evidence is considered in the
context of clinical expertise and values
Results in clinical practice guidelines, best
practices, protocols, standards or clinical
pathways
Steven’s ACE Star Model
Implementation
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Translation of research into practice
Where changes take place
Steven’s ACE Star Model
Evaluation
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Impact of the change is measured
Assess variables (health outcomes,
efficiency, cost or satisfaction)
Challenges and Misconceptions
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Merely a collection of statistics?
Need more qualitative research
Nurses need to develop good search
strategies
Nurses must learn to do critical appraisals
Faculty members must embrace and learn
EBP
Resources
Yale University Nursing Library and Information Resources
http://www.med.yale.edu/library/nursing/education/ebhc2.html
 Oncology Nursing Society
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http://onsopcontent.ons.org/toolkits/evidence/
United States Department of Health and Human Services – Agency
for Healthcare Research and Quality
http://www.ahrq.gov/clinic/epcix.htm
 University of Iowa Hospitals and Clinics Nursing Services and Patient
Care
http://www.uihealthcare.com/depts/nursing/rqom/evidencebasedpracti
ce/index.html
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Resources (con’t)
University of Texas Health Science Center at San Antonio –
Acedemic Center for Evidence-Based Practice
http://www.acestar.uthscsa.edu/About.htm
 Medical Library Association – Nursing and Allied Health Resources
Section
http://nahrs.library.kent.edu/resource/symposium/
 University of Minnesota – Evidence-based Health Care Project
http://evidence.ahc.umn.edu/ebn.htm
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References
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Chitty, K.K. (2005). Professional nursing: Concepts and challenges.
4th ed. Philadelphia: Saunders.
Spector, N. (n.d.). Evidence-Based Health Care in Nursing
Regulation. Retrieved on October 8, 2006 from Nation Council of
State Boards of Nursing web site on World Wide Web:
http://www.ncsbn.org/pdfs/Evidencebased_NSpector.pdf#search=%22
evidence%20based%20practice%20in%20nursing%22
 Yale University. (2005). Evidence-Based Practice. Nursing Library
and Information Resources. Retrieved on October 8, 2006 from
World Wide Web:
http://www.med.yale.edu/library/nursing/education/ebhc2.html
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