2. EVIDENCE-BASED PRACTICE14
C H A P T E R
EVIDENCE-BASED PRACTICE

3. Critical Thinking Core of evidence-based practice (EBP)
Analytical, reflective thinking
Requires accurately defined problem
Based on reliable data

4. Importance of Critical Thinking
Necessary for analysis of patient data
Required to achieve improved outcomes

5. Evidence-Based Practice
Evolved to include nursing and allied health
Clinical practice guidelines
National Database of Nursing Quality Indicators

6. Reframing Education Create an environment of inquiry/self-reflection
Purpose of learning—to improve patient care
Teach knowledge, skills, and attitudes (Figure 14-3)

7. Stetler Model of Research Utilization
Used to direct clinical decision-making
Tool to create or change policy
Five-step process (Figure 14-4)

8. Iowa Model of Research-Based Practice
Triggers indicate issues or concerns (Figure 14-5)
Committee is formed to research the trigger

9. The Path to Evidence Ask the right questions
Look at a variety of sources
Do not rely on traditional practices

10. Appraising the Evidence
Evidence Hierarchy (Figure 14-6)
Integrative reviews
Systematic reviews
Meta-analysis vs. Meta-synthesis
Internet Exercise 14-1 guides the students through the Agency for Healthcare Research and Quality’s website to locate the Rating System of the Strength of Scientific Evidence.

11. Approaches to Generating Evidence
Quantitative
Qualitative
Intervention
Outcomes

12. Generating the Evidence
Formulate the question (PICO or PS) (Figure 14-8)
Find the evidence (Figure 14-9)
Case Scenario 14-1 has the students practice writing a question in PICO format, and conduct a literature search for clinical recommendations.

13. Obstacles to EBP Lack of time/access to information
Insufficient staffing