Evidence-Based Practice in Healthcare
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Questions and Answers

What is the primary characteristic of a randomized controlled trial?

  • Participants are assigned to groups based on their preferences.
  • Participants are randomly allocated into experimental and control groups. (correct)
  • Participants are non-randomly selected based on observed outcomes.
  • Participants are randomly chosen from a population without grouping.
  • What distinguishes a cohort study from a case-control study?

  • A cohort study randomly selects participants while a case-control study does not.
  • A cohort study examines only participants with a specific outcome, while a case-control study examines only those without it.
  • A cohort study follows participants over time while a case-control study compares outcomes retrospectively. (correct)
  • A cohort study uses random allocation while a case-control study uses a historical approach.
  • In the PICO(T) format, what does the 'I' represent?

  • The intervention being studied. (correct)
  • The incidence rate of the outcome.
  • The investigation of control measures.
  • The inclusion criteria for participants.
  • Which type of study is most appropriate for assessing the relationship between smoking and mortality after an acute myocardial infarction?

    <p>Cohort study.</p> Signup and view all the answers

    Which study design is used to report on one or more participants with a unique condition?

    <p>Case report/case series.</p> Signup and view all the answers

    What is a significant barrier to implementing evidence-based practice in healthcare?

    <p>Access to professional resources</p> Signup and view all the answers

    Which of the following is NOT a reason why healthcare providers may not use research findings in their practices?

    <p>Difficulty in accessing funding for research</p> Signup and view all the answers

    What should healthcare providers do to effectively engage with evidence-based practice?

    <p>Actively participate in EBP projects</p> Signup and view all the answers

    What is one of the suggested ways to overcome time constraints in implementing evidence-based practice?

    <p>Introduce reliable administrative support</p> Signup and view all the answers

    Which stage is essential for healthcare providers to generate important questions for evidence-based practice?

    <p>Knowledge of the basis for nursing practice</p> Signup and view all the answers

    Which factor is commonly cited as a key barrier to the application of evidence-based practices in various professions?

    <p>Time limitations faced by professionals</p> Signup and view all the answers

    What role do healthcare providers have in evidence-based practice?

    <p>Disseminate project findings in various forums</p> Signup and view all the answers

    What is one of the consequences of healthcare organizations being unaware of scientific developments?

    <p>Stagnation in practice evolution</p> Signup and view all the answers

    What does the term 'quality' refer to in research evaluation?

    <p>The extent to which biases are minimized in study design</p> Signup and view all the answers

    Which of the following best describes what the PICO format is used for?

    <p>Formulating a clinical research question</p> Signup and view all the answers

    In the PICO model, what does the 'C' stand for?

    <p>Comparison</p> Signup and view all the answers

    What is indicated by the term 'consistency' in the context of research studies?

    <p>Whether different studies report similar findings</p> Signup and view all the answers

    Which type of question is primarily addressed in foreground questions within the PICO model?

    <p>Questions needing specific knowledge for clinical decision-making</p> Signup and view all the answers

    Which element of PICO identifies the specific characteristics of the population being studied?

    <p>Population/Patient</p> Signup and view all the answers

    What is NOT considered when evaluating the 'quantity' of research?

    <p>The presence of bias in individual studies</p> Signup and view all the answers

    What is a primary goal of the 'Ask' step in the PICO process?

    <p>To develop a focused and searchable clinical question</p> Signup and view all the answers

    What does the 'P' in the PICO framework represent?

    <p>Person</p> Signup and view all the answers

    Which component is NOT included in the PICO framework?

    <p>Evaluation</p> Signup and view all the answers

    Which type of literature is considered primary?

    <p>Research findings</p> Signup and view all the answers

    Why is it important to frame an evidence-based practice question clearly?

    <p>To ensure it is answerable</p> Signup and view all the answers

    What is the main benefit of using primary literature over secondary literature?

    <p>It provides original information</p> Signup and view all the answers

    What is one of the benefits of engaging with people during the evidence-based practice search?

    <p>It can provide pertinent evidence and perspectives</p> Signup and view all the answers

    What hierarchy is most often referenced in evidence-based practice?

    <p>Hierarchy of evidence</p> Signup and view all the answers

    What does secondary literature include?

    <p>Systematic reviews and guidelines</p> Signup and view all the answers

    What is one primary benefit of evidence-based practice for patients?

    <p>Promotes positive patient outcomes</p> Signup and view all the answers

    How does evidence-based practice contribute to reducing the risk of hospital-acquired infections?

    <p>By using proven infection control measures</p> Signup and view all the answers

    What impact does evidence-based practice have on healthcare costs?

    <p>It reduces healthcare costs by preventing complications</p> Signup and view all the answers

    In what way does evidence-based practice enhance patient safety?

    <p>By minimizing errors and preventing adverse events</p> Signup and view all the answers

    What is the primary limitation of cohort studies compared to randomized controlled trials?

    <p>Cohort studies are observational and more prone to bias.</p> Signup and view all the answers

    Which of the following is a benefit of evidence-based practice for healthcare providers?

    <p>It provides scientifically supported research for decision-making</p> Signup and view all the answers

    What role does evidence-based practice play in patient autonomy?

    <p>It involves patients in care planning</p> Signup and view all the answers

    Which study type combines the results of multiple studies using quantitative methods?

    <p>Meta-analysis</p> Signup and view all the answers

    What characterizes randomized controlled trials to reduce potential bias?

    <p>Randomization and blinding.</p> Signup and view all the answers

    How does evidence-based practice assist nurses with their duties?

    <p>By enabling access to new interventions and protocols</p> Signup and view all the answers

    What is one way evidence-based practice can alter methods of care?

    <p>By modifying care plans that do not align with best practices</p> Signup and view all the answers

    Systematic reviews primarily aim to:

    <p>Answer specific clinical questions.</p> Signup and view all the answers

    Which of the following studies identifies participants with a certain outcome and compares them to those without that outcome?

    <p>Case Control Study</p> Signup and view all the answers

    What main aspect makes randomized controlled trials reliable?

    <p>Participants are randomly allocated to groups.</p> Signup and view all the answers

    Which study type is particularly noted for reviewing and summarizing studies with sound methodology?

    <p>Systematic Review</p> Signup and view all the answers

    Why are cohort studies considered less reliable than randomized controlled trials?

    <p>They involve pre-existing differences in participant groups.</p> Signup and view all the answers

    Study Notes

    Evidence-Based Quality & Patient Safety Management

    • Evidence-Based Practice (EBP) is an approach to improving healthcare
    • EBP involves using the best scientific research evidence with clinical experience and patient values
    • Steps in EBP include: framing clinical questions, finding evidence, assessing the evidence, and making clinical decisions.
    • A cornerstone of the evidence-based movement was established by Dr. Archie Cochrane, a British epidemiologist.

    Introduction to Evidence-Based Practice and Inquiry

    • Part I covers the history, definition, components, advantages, disadvantages, and benefits of Evidence-Based Practice (EBP).
    • Part II covers barriers to adopting EBP, strategies for overcoming those barriers, the necessary skills for EBP, implementation challenges, and problems faced in implementing EBP.

    Brief History of EBP

    • Dr. Archie Cochrane highlighted the need for rigorous reviews of research evidence.
    • Cochrane advocated for the use of randomized clinical trials (RCTs) to determine preferred treatments and practices.
    • The Cochrane Library was developed as a systematic repository for this research evidence.
    • The term "evidence-based medicine" emerged during the 1980s, prioritizing scientific evidence in clinical decision-making.
    • The term shifted to "evidence-based practice" to emphasize the importance of several factors, not just scientific evidence in clinical decision-making.

    Evidence-Based Practices versus Practice Based Evidence

    • Evidence Based Practices (EBP) integrates the best research evidence with clinical expertise and patient values.
    • Practice Based Evidence is a range of approaches and supports that are locally derived.

    Comparison between EBP, research, and QI process

    • A table comparing EBP, Research and QI processes is presented, but the table has not been included in the summary.

    Importance of EBP to practice

    • EBP leads to better patient outcomes.
    • EBP keeps practice current.
    • EBP increases confidence in decision-making.
    • EBP supports regulatory requirements.
    • Integration of EBP into healthcare is crucial for high-quality care.

    The Benefits of Evidence-Based Practice

    • EBP promotes positive patient outcomes through a shared decision-making strategy.
    • EBP reduces hospital-acquired infections by using proven, evidence-based procedures.
    • EBP empowers patients by allowing involvement in their care planning.
    • EBP prompts method changes when evidence conflicts with current practice, resulting in improved care.
    • EBP helps to reduce healthcare costs by preventing complications.

    Increased Patient Safety

    • EBP plays a vital role in ensuring safe and effective care, minimizing errors, and preventing adverse events.
    • EBP provides up-to-date information on best practices for medication administration, infection control, and fall prevention.

    The Principles of Evidence-Based Practice

    • EBP is based on two principles - understanding that scientific evidence alone is insufficient for decision-making and that a hierarchy of evidence exists where some sources are more valid than others.

    Component of evidence-based practice

    • Key components of EBP include clinical expertise, management of patient values and preferences, practice management and decision-making, integration of best available evidence in clinical practice

    Four Elements of Evidence-Based Practice

    • The four elements of EBP are the best research available, expertise or clinical experience of the clinician, patient values/preferences, and the immediate surrounding environment.

    Advantages of evidence-based practice

    • EBP improves consistency of care across professional boundaries
    • EBP allows for client-focused care and establishes structured dissemination processes for best evidence
    • EBP makes practices more transparent and less open to misinterpretation
    • EBP makes information more readily available to the public and improves clarity regarding known versus unknown aspects, allowing for better research
    • EBP helps develop the scientific knowledge base within healthcare

    Disadvantages of evidence-based practice

    • EBP takes time and resources.
    • Limited evidence in some areas of practice.
    • Does not cater to all patient needs, especially those with complex or multifaceted needs.
    • May reduce professional judgment and autonomy.
    • Evidence not always available for certain areas of practice

    Barriers of evidence-based practice

    • Lack of value for research in practice
    • Difficulty in adopting changes
    • Lack of administrative support
    • Lack of credible knowledge mentors

    Strategies for overcoming barriers to adopting an EBP

    • Various strategies are presented, but the specific strategies are not included in the summary.

    Lack of knowledge about EBP and research

    • Methods for addressing strategies for overcoming the lack of knowledge and resources about EBP are presented, but the specific strategies are not included in the summary

    Lack of technological skills to find evidence

    • Ways to address barriers related to technological skills in finding evidence are included, but not in this summary

    Lack of resources to access evidence

    • Ways to overcome these barriers are outlined in the text but are not included here

    Lack of ability to read research

    • Ways to encourage a willingness to read and understand research are included in the text but are not included here

    Resistance to change

    • Ways to foster an environment of change are listed but not detailed here

    Organizational does not embrace EBP

    • Strategies for encouragement of EBP implementation are listed here but not detailed.

    Sources of EBP

    • EBP is based on four main sources: scientific literature, organization internal data, practitioner experience and stakeholders' values and concerns.

    5 Main Skills Required for Evidence-Based Practice

    • Critical thinking
    • Scientific mindset
    • Effective communication
    • Identifying knowledge gaps
    • Integrating findings into relevant practice

    Major Challenges Face in the Implementation of EBP

    • Lack of understanding or value
    • Fear of not being accepted.
    • Negative attitudes toward research and EBP.
    • Lack of knowledge in research methods
    • Resource constraints
    • Work overload
    • Inaccurate or incomplete research findings
    • Disconnection between patient needs and evidence-based practices
    • Lack of internet access

    Process of Evidence-Based Practice & critical appraisal of evidence

    • Process of EBP
    • Rating evidence/scientific evidence using a hierarchy
    • PICOT search steps

    The 5 Step EBP Process

    • ASK: Formulate an answerable clinical question
    • ACCESS: Identify and access the best available evidence
    • APPRAISE: Evaluate the validity and usefulness of evidence
    • APPLY: Integrate best evidence with your practice and patient needs
    • ASSESS: Evaluate the success of the EBP process

    Searching and accessing the evidence

    • Finding relevant evidence.
    • Using experts and librarians.
    • Locating primary sources such as original research and secondary sources like summaries or reviews, policy guidelines etc

    Hierarchy of evidence

    • Ranking based on trustworthiness of evidence (e.g., Systematic reviews are prioritized over individual case reports).

    Case control studies, Cohort studies, Meta-analysis, Randomized controlled clinical trials, Systematic Reviews

    • Descriptions and characteristics of each type of study design.

    Summary Studies definition

    • Definitions of Meta-analysis and Systematic review to summarize results; Randomised controlled trials, cohort studies, case control studies and case reports to aid in the apprasial of the evidence

    Application of best evidence to practice

    • Considering resources, staff, equipment, environment, time, funding.
    • Evaluating if evidence is compatible with wider service philosophy.
    • Review implications of EBP for other processes.

    Literature summary table

    • Table format for summarizing articles.

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