Evidence-Based Practice Chapter 7 Evidence-Based Practice

Defining Evidence-Based Practice (EBP) Merging personal clinical expertise with the best available research results according to patient preferences and values Why is it important to utilize now?

Clinical Practice Guidelines Systematically developed statements Assist practitioners and client decisions about appropriate health care for clinical circumstances Multidisciplinary

Concepts Research utilization Evidence-based practice Are these interchangeable?

Criticisms of EBP Quality of life issues Restriction of freedom to practice Inconsistent practices at medical centers versus other hospitals

Finding Best Practices Location in literature Online database CINAH, MedLine, PubMed Evidence-based practice centers Cochrane Collaboration Journals Evidence-Based Nursing

Research Design Qualitative Quantitative Randomized Clinical Trial (RCT)

Evaluating Research U.S. Preventive Services Task Force (USPSTF) developed a system for: Rating guideline recommendations Evaluating strength of evidence Tables 7-1 and 7-2

ACE Star Model of Knowledge Transformation

Implementing New Practice Three steps in managerial support Establishing a new culture Creating capacity for organizational change Sustaining change through revision of system’s infrastructure

Barriers to EBP Implementation Lack of time Literature not readily available Uncertain of personnel’s ability to use research Critical colleagues

Barriers to EBP Implementation Lack of organizational support Lack of perceived power to effect change Cost to implement Interdisciplinary support

Five Steps to Ensuring Practice is Evidence-Based 1. Develop a researchable practice question 2. Design and implement an evidence search 3. Retrieve and appraise evidence

Five Steps to Ensuring Practice is Evidence-Based 4. Integrate clinical evidence in order to implement an evidence-based decision 5. Evaluate clinical practice and EBP process outcomes