Evidence-Based Practice in Nursing

Evidence-Based Practice (EBP)

• EBP uses the best scientific evidence combined with clinical experience, patient values, and preferences in nursing practice.

EBP Process

• Ask the question: Use the PICOT format to clearly define the problem.
• Collect relevant evidence: Gather relevant peer-reviewed articles. Focus on research within the last 5 years, as newer research is more up-to-date.
• Critically evaluate evidence: Examine the research article's methodology, including the study design, strength of evidence, and results' validity and reliability.
• Integrate practice changes: Incorporate the evidence, clinical experience, and patient preferences to modify existing practices.
• Evaluate outcomes: Assess the effectiveness of the practice changes through ongoing monitoring and data collection.
• Disseminate outcomes: Share the results and improvements through presentations or publications.

Asking the Question

• Identify areas for improvement in current practice.
• Review relevant incident reports.
• Track nurse-sensitive indicators using databases like the National Database of Nursing Quality Indicators (NDNQI).
• Identify specific problems requiring attention, i.e., falls, HAPI's, CAUTIS, CLABSIS.
• Define the question you need answers for.

Developing PICOT Questions

• Population/problem: The group or patient being studied.
• Intervention: The specific treatment or action being investigated.
• Comparison: The standard or alternative treatment/practice.
• Outcome: The desired effect or result.
• Time: The timeframe for observing the outcome (optional).

Collecting Relevant Evidence

• Conduct a thorough literature review to find relevant and reliable sources.
• Use databases like CINAHL and MEDLINE for comprehensive resources.
• Consult clinical practice guidelines and systematic reviews.

Evaluating the Evidence: Reading Research

• Title: Summarizes the study's topic.
• Abstract: Provides a brief overview of the study (purpose, methods, results, conclusion).
• Introduction: Describes the background, problem, and research gap addressed.
• Literature Review: Explains prior research; helps understand the importance of the study.
• Methods: Explains how the study was conducted.
• Results: Presents findings and statistical analysis.
• Conclusion: Summarizes the key findings and implications.

Evaluating the Evidence: Study Designs

• Qualitative: explores experiences and creates theory.
• Quantitative: uses numbers and tests theories. Includes surveys, controlled trials, etc.

Evaluating the Evidence: Statistical Measures

• Mean: average value
• Median: middle value
• Mode: most frequent value
• Standard Deviation: measures the variation of data around the mean.

Evaluating the Evidence: Strength of Evidence

• Evidence levels (I-VII) indicate the reliability of the research design. Higher levels (I) are more reliable than lower levels (VII).

Integrating Practice Changes

• Integrate clinical expertise and patient values into the implementation of evidence-based practice changes.
• Establish Shared Decision Making processes for creating patient-centered care plans.

Evaluating Outcomes

• Monitor and evaluate the impact of changes on patient outcomes.
• Continuously look for opportunities for improvement.

Disseminating Outcomes

• Share results through reports, articles, and presentations.
• Disseminate findings to colleagues, organizations, and communities.