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Evidence-Based Practice (EBP)

Evidence-Based Practice (EBP). Joan Pollner, RN, BSN, CHPN October 18, 2006. Objectives. 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

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Evidence-Based Practice (EBP)

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  1. Evidence-Based Practice(EBP) Joan Pollner, RN, BSN, CHPN October 18, 2006

  2. Objectives • 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

  3. Some Definitions • 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)

  4. Definitions (con’t) • 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).

  5. Goals of EBP • Provide practicing nurses with evidence-based 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

  6. Goals (con’t) • Using best evidence to implement the regulation of nurses • Resolve regulatory problems • Achieve excellence in regulation • Introduce regulatory innovation

  7. Research Utilization Use results of studies Randomly selected Support nursing care Less systematic Evidence-Based Practice Considers all research Utilized thorough integrative review Context of clinical expertise and value system of the patient More systematic Research Utilization vs EBP

  8. EBP is multi-step process • 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

  9. Steven’s ACE Star Model • Discovery • Summary • Translation • Implementation • Evaluation

  10. Steven’s ACE Star ModelDiscovery • Original research • Conduct a literature search utilizing recognized techniques

  11. Steven’s ACE Star ModelSummary • 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

  12. Steven’s ACE Star ModelTranslation • Scientific evidence is considered in the context of clinical expertise and values • Results in clinical practice guidelines, best practices, protocols, standards or clinical pathways

  13. Steven’s ACE Star ModelImplementation • Translation of research into practice • Where changes take place

  14. Steven’s ACE Star ModelEvaluation • Impact of the change is measured • Assess variables (health outcomes, efficiency, cost or satisfaction)

  15. Challenges and Misconceptions • 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

  16. Resources • Yale University Nursing Library and Information Resources http://www.med.yale.edu/library/nursing/education/ebhc2.html • Oncology Nursing Society 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/evidencebasedpractice/index.html

  17. 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

  18. References • 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=%22evidence%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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