Evidence-Based Practice Overview
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Questions and Answers

What is the first step in the Seven-Step Process of Evidence-Based Practice (EBP)?

  • Evaluate the outcome(s) of a practice decision
  • Integrate best evidence with clinician expertise
  • Disseminate the outcome(s)
  • Ask the question in PICOT format (correct)
  • Which step involves comparing evidence-based practices with traditional practices?

  • Define clinical outcome
  • Identify practices supported by evidence
  • Compare evidence-based practices (correct)
  • Analyze impact of new practices
  • What should be integrated with best evidence to make the best clinical decision?

  • Clinician expertise and patient preferences (correct)
  • Current medical trends
  • Historical data and statistics
  • Insurance regulations
  • In the Outcomes Management process, what is the first step?

    <p>Define clinical outcomes to improve (B)</p> Signup and view all the answers

    What is the last step in the Seven-Step Process of EBP?

    <p>Disseminate outcome(s) (A)</p> Signup and view all the answers

    Which of these steps is part of creating Evidence-Based Quality Improvement (EBQI)?

    <p>Plan, Do, Study, Act (A)</p> Signup and view all the answers

    What is a key benefit of integrating patient/family-valued preferences in clinical decisions?

    <p>It improves patient compliance and satisfaction (A)</p> Signup and view all the answers

    After implementing new practices, what is crucial to assess?

    <p>Impact by remeasuring targeted outcomes (A)</p> Signup and view all the answers

    What does evidence-based practice (EBP) primarily combine?

    <p>Research Evidence, Patient Care Data, Clinician Expertise (C)</p> Signup and view all the answers

    Which of the following is NOT considered a benefit of EBP?

    <p>Reducing healthcare research budgets (C)</p> Signup and view all the answers

    How does EBP support hospitals and healthcare systems in achieving the quadruple aim?

    <p>By integrating various types of evidence and practices (D)</p> Signup and view all the answers

    Which element is part of the EBP problem-solving approach?

    <p>Expert Panels (B)</p> Signup and view all the answers

    What is a key facilitator for the implementation of EBP?

    <p>Culture that Supports Inquiry (B)</p> Signup and view all the answers

    Which of the following best describes evidence-based theories?

    <p>Theories that are tested and supported by evidence (B)</p> Signup and view all the answers

    What is one of the primary goals of incorporating EBP in nursing?

    <p>To achieve the highest quality of care (B)</p> Signup and view all the answers

    Which factor is NOT a barrier to implementing EBP?

    <p>Supportive culture and leadership (D)</p> Signup and view all the answers

    Which program focuses on transformational leadership and structural empowerment in nursing?

    <p>Magnet Recognition Program (A)</p> Signup and view all the answers

    Which of the following is NOT a goal of the Helene Fuld Health Trust National Institute for Evidence-Based Practice?

    <p>Conducting research to reduce costs of healthcare (C)</p> Signup and view all the answers

    What is one key feature of the national webinars conducted by the Helene Fuld Health Trust?

    <p>Guiding high-quality practice with the latest evidence (B)</p> Signup and view all the answers

    What does the acronym ARCC stand for in the context of the Helene Fuld Health Trust's implementation toolkit?

    <p>Assistance, Research, Consultation, Collaboration (B)</p> Signup and view all the answers

    What is a major outcome sought by the Helene Fuld Health Trust in advancing evidence-based care?

    <p>Reaching the quadruple aim of healthcare (A)</p> Signup and view all the answers

    Which organization is primarily designed to integrate EBP throughout nursing curricula?

    <p>Helene Fuld Health Trust National Institute (C)</p> Signup and view all the answers

    Which of the following is a characteristic of the Magnet Recognition Program?

    <p>Emphasis on empirical quality results (D)</p> Signup and view all the answers

    Which of the following statements regarding evidence-based practice is true?

    <p>Integration of evidence-based practices can be enhanced through mentorship. (D)</p> Signup and view all the answers

    What is an example of external evidence in healthcare research?

    <p>A research study testing a protocol for immobile patients published in a peer-reviewed journal (C)</p> Signup and view all the answers

    Which approach incorporates external evidence into decision making for clinical improvements?

    <p>Evidence-Based Quality Improvement (EBQI) (B)</p> Signup and view all the answers

    What is the primary focus of Quality Improvement (QI)?

    <p>Using internal evidence to guide practice changes (D)</p> Signup and view all the answers

    What is crucial for transforming QI into EBQI?

    <p>Including systemic search and appraisal of external evidence (D)</p> Signup and view all the answers

    Which term best describes the integration of clinical expertise, patient values, and the latest evidence?

    <p>Evidence-based practice (B)</p> Signup and view all the answers

    What role do federally funded initiatives play in evidence-based practice?

    <p>They facilitate advancements in healthcare strategies and evidence generation (A)</p> Signup and view all the answers

    What is one goal of the IOM’s Roundtable?

    <p>To accelerate progress toward a learning healthcare system (A)</p> Signup and view all the answers

    How is value generation in healthcare strategies measured according to key influencers in EBP?

    <p>By determining which strategies are most effective (A)</p> Signup and view all the answers

    What is a common barrier to implementing Evidence-Based Practice (EBP) in healthcare organizations?

    <p>Lack of time for critical evaluation of evidence (C)</p> Signup and view all the answers

    Which of the following is considered a facilitator for implementing EBP?

    <p>Leadership support for an EBP culture (A)</p> Signup and view all the answers

    What action is recommended to assess clinicians' readiness for EBP implementation?

    <p>Conduct surveys or focus groups (D)</p> Signup and view all the answers

    What is one of the proposed strategies to eliminate barriers to EBP?

    <p>Document the status of EBP to show outcome changes (D)</p> Signup and view all the answers

    Why might a culture steeped in tradition serve as a barrier to EBP?

    <p>It resists changes that conflict with established practices (B)</p> Signup and view all the answers

    How does having EBP mentors assist in implementing EBP in healthcare settings?

    <p>They possess excellent EBP skills and change strategy knowledge (B)</p> Signup and view all the answers

    What outcome is generally not expected from the successful implementation of EBP?

    <p>Continued dependence on traditional practices (A)</p> Signup and view all the answers

    Which statement accurately reflects a misconception about EBP?

    <p>EBP can be fully understood without training (B)</p> Signup and view all the answers

    What is identified as a barrier in the scenario described?

    <p>The timing and stipulations for attendance of the unit-based journal clubs (A)</p> Signup and view all the answers

    In patients with head injuries, what effect does positioning have on intracranial pressure?

    <p>Elevating the head by 30 degrees decreases intracranial pressure more than supine positioning (D)</p> Signup and view all the answers

    What role does the spirit of inquiry play in evidence-based practice?

    <p>It is critical for initiating the next steps in the EBP process (A)</p> Signup and view all the answers

    What was the outcome of the study published in Critical Care Medicine regarding rapid response teams?

    <p>A significant decrease in rates of in-hospital cardiac arrests (A)</p> Signup and view all the answers

    What action did the nurse take after learning about the rapid response team study?

    <p>Sought further evidence to support the implementation of rapid response teams (C)</p> Signup and view all the answers

    What is the primary focus of the spirit of inquiry in nursing practice?

    <p>To enhance curiosity and critical thinking in clinical settings (D)</p> Signup and view all the answers

    Why was the nurse manager excited about the findings regarding rapid response teams?

    <p>She recognized the potential for improved patient outcomes (D)</p> Signup and view all the answers

    What type of medication is metoprolol in the context of treating supraventricular tachycardia?

    <p>A β-blocker (B)</p> Signup and view all the answers

    Flashcards

    What is Evidence-Based Practice (EBP)?

    A problem-solving approach to healthcare delivery that combines evidence from research, patient data, clinician expertise, and patient preferences.

    How is EBP used clinically?

    A problem-solving approach to clinical practice integrating external evidence, evidence-based theories, opinion leaders, and expert panels.

    How does EBP contribute to healthcare's quadruple aim?

    EBP aims to achieve healthcare's quadruple aim, which focuses on improving patient experience, enhancing population health, reducing costs, and improving clinician experience.

    What are the steps involved in EBP?

    EBP involves identifying a clinical question, searching for evidence, critically appraising the evidence, applying the evidence to practice, evaluating the outcome, disseminating the findings, and fostering a culture of inquiry.

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    What is the difference between EBP and research?

    EBP focuses on using the best available evidence to guide clinical decisions, while research is the systematic investigation of a phenomenon.

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    How does EBP differ from quality improvement (QI)?

    EBP is a broader approach that integrates research findings into practice, while quality improvement (QI) focuses on improving processes and outcomes within a specific healthcare system.

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    What is evidence-based quality improvement (EBPQI)?

    EBPQI combines the principles of EBP and QI to optimize healthcare delivery by integrating evidence into quality improvement initiatives.

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    What are the key factors for implementing EBP?

    Implementing EBP requires a supportive environment where nurses feel empowered to question existing practices, access and utilize evidence, and participate in decision-making.

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    Evidence-Based Practice (EBP)

    A systematic approach to healthcare decision-making that uses the best available evidence, clinician expertise, and patient values.

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    EBP Process

    A process of systematically identifying, collecting, and evaluating evidence to answer clinical questions.

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    PICOT Format

    A format for structuring clinical questions to facilitate efficient and effective literature searches.

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    Critical Appraisal

    The ability to understand and critically evaluate research findings.

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    Evidence-Based Quality Improvement (EBQI)

    The process of applying evidence-based practices to improve quality of care and patient outcomes.

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    Clinical Outcome

    A measurable outcome that reflects the health status or well-being of a patient.

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    Evidence-Based Practices

    Practices supported by high-quality research that have demonstrated effectiveness in achieving desired clinical outcomes.

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    Practice Evaluation

    The process of comparing evidence-based practices with existing practices to identify areas for improvement.

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    External Evidence

    Using existing research findings from peer-reviewed journals to guide practice changes. It involves searching for and critically evaluating evidence to inform decisions about improving a clinical outcome.

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    Quality Improvement (QI)

    A quality improvement approach that relies heavily on data and evidence collected within the organization. Focuses on improving processes and outcomes based on internal observations and measurements.

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    IOM's Roundtable

    A key influencer in advancing EBP, the IOM Roundtable advocates for a healthcare system that uses and generates evidence to improve its practices. It emphasizes the importance of using research to guide care and develop new practices, as well as promoting public understanding of evidence.

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    Federally Funded Initiatives for EBP

    Federal initiatives, such as those in the US, play a crucial role in driving progress toward a healthcare system based on evidence. These initiatives aim to support and fund research to identify effective practices and improve healthcare outcomes.

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    Translational Research

    The process of translating research findings into practical applications in healthcare settings, bridging the gap between research and clinical practice.

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    Research Utilization

    The use of research findings to inform clinical practice and decision-making. It involves applying evidence-based knowledge in the context of patient care.

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    Magnet Recognition Program

    A program that recognizes healthcare organizations for providing exceptional nursing care and achieving excellence in nursing practice.

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    Structural Empowerment

    A key component of the Magnet Recognition Program, focusing on empowering nurses to lead and make decisions at all levels.

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    New Knowledge, Innovation and Improvements

    One of the five components of the Magnet Recognition Program that emphasizes the use of evidence-based practices and continuous improvement in care delivery.

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    Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare

    A non-profit organization dedicated to promoting evidence-based practice (EBP) in nursing and healthcare.

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    Organizational Culture and Context

    A crucial aspect of the EBP process, focusing on actively engaging clinicians and leadership to foster a culture of inquiry and continuous improvement.

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    Melnyk & Fineout-Overholt's EBP Process

    A structured approach to implementing evidence-based practice (EBP) that involves 6 steps, such as formulating clinical questions, searching for evidence, and evaluating outcomes.

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    Quadruple Aim

    The goal of promoting patient-centered care, improving population health, reducing costs, and enhancing provider well-being.

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    ARCC Model

    A model that focuses on translating knowledge into actions by addressing four key aspects: asking, acquiring, appraising, and applying evidence.

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    What are EBP Barriers?

    Factors that make it difficult for evidence-based practice (EBP) to be implemented and used consistently, even when it is beneficial.

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    What are EBP Facilitators?

    Factors that help evidence-based practice (EBP) to be adopted and used effectively within healthcare organizations.

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    What is an EBP Culture?

    A culture that values and prioritizes evidence-based practice (EBP) as the standard for decision-making and care delivery.

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    What is EBP Readiness?

    A collective assessment of an organization's readiness to implement evidence-based practice (EBP). It involves evaluating factors like staff knowledge, skills, beliefs, resources, and leadership support.

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    How do you know if EBP is effective?

    Using evidence-based methods to evaluate the effectiveness of EBP implementation. This includes tracking change in outcomes, patient satisfaction, and clinician experience.

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    What is the

    An EBP strategy that involves exposing staff resistant to EBP to real-life clinical scenarios where using evidence improved patient outcomes. This helps to build trust and address concerns about EBP effectiveness.

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    How do you correct misperceptions about EBP?

    To correct misconceptions about EBP, organizations need to provide accurate information about its benefits, address potential concerns, and showcase successful EBP implementation examples within the organization or in similar settings.

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    What are Journal Clubs?

    A strategy for promoting EBP where staff gather to critically analyze and discuss research findings and apply them to their clinical practices. This allows for collaborative learning and can help to identify and address knowledge gaps.

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    What is the spirit of inquiry?

    The spirit of inquiry is like a spark that ignites the EBP process. It's the curiosity and willingness to ask questions, seek better ways to care for patients, and challenge existing practices.

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    What is the barrier to implementing a new practice?

    The barrier in this scenario is the timing and stipulations for unit-based journal club attendance. It prevents the nurses from easily accessing and discussing the evidence needed to implement a new practice.

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    What is the strategic plan goal?

    The goal of the strategic plan is to ensure all policies and procedures are backed by evidence within three years. This aims to improve patient care by relying on research findings.

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    What are rapid response teams?

    Rapid response teams are a team of healthcare professionals who respond quickly to patients experiencing a medical crisis, often before their condition deteriorates significantly.

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    How do rapid response teams improve patient outcomes?

    A rapid response team can help decrease rates of in-hospital cardiac arrests and unplanned ICU admissions. This is because they provide timely interventions at the first sign of deterioration.

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    What does the nurse manager do to promote evidence-based practice?

    The nurse manager encourages the staff nurse to find more evidence about rapid response teams. This demonstrates a supportive environment for evidence-based practice.

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    What did the study's findings show?

    The study found a significant decrease in in-hospital cardiac arrests and unplanned ICU admissions after the implementation of a rapid response team. This suggests a strong correlation between rapid response teams and improved outcomes.

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    What triggers the nurse's interest in rapid response teams?

    The staff nurse notices an increase in patient acuity and mortality on her unit. This observation leads her to seek evidence-based solutions to improve patient care.

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    Study Notes

    Chapter 1: Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry

    • The chapter focuses on evidence-based practice (EBP) and its application in healthcare.
    • Learning objectives include understanding how EBP aids healthcare systems in achieving the quadruple aim, differentiating EBP from research, quality improvement, and evidence-based quality improvement, identifying the seven steps of EBP, and discussing barriers and facilitators of EBP implementation.

    What is Evidence-Based Practice in Nursing?

    • EBP is a problem-solving approach to healthcare delivery.
    • It combines best evidence from research, patient data, clinician expertise, and patient preferences/values.
    • EBP aims to achieve the highest quality of care and best patient outcomes.

    EBP Enhances the Patient Experience

    • EBP improves healthcare quality and safety.
    • Patient outcomes are enhanced.
    • Costs are reduced.
    • Nurse empowerment and improved work life result.

    Problem-Solving Approach to Clinical Practice

    • External evidence is generated from rigorous research.
    • Evidence-based theories are tested and supported through evidence.
    • Opinion leaders are respected and knowledgeable individuals influential in systems.
    • Expert panels are groups of specialists who evaluate and recommend on specific topics.

    Evidence-Based Decision Making

    • The figure illustrates connections between external evidence from research, opinion leaders, expert panels, clinical expertise (internal evidence), and patient-and family-valued preferences.
    • The figure connects evidence-based decision making and clinical practice to the healthcare quadruple aim.

    Seven-Step Process of EBP

    • The seven steps are detailed in a flow chart and include: a spirit of inquiry, PICOT formatting the question, systematic search for and collection of evidence, integrating evidence, evaluating outcomes of a decision or change, dissemination of outcomes, and incorporating the EBP steps to create EBP quality improvement.

    Outcomes Management

    • The four steps for outcomes management involve defining clinical outcomes, identifying evidence-supported practices, comparing practices, and analyzing implementation impact.

    Types of Evidence Used in EBP

    • External evidence comes from rigorous scientific research.
    • Internal evidence is generated from practice-based data.

    QI versus EBQI

    • Quality Improvement (QI) relies on internal evidence, often lacking a systematic evidence appraisal process, and its goal is to transition to EBQI by integrating EBP plan steps.
    • Evidence-Based Quality Improvement (EBQI) begins with internal evidence but also includes external evidence to identify process changes that improve outcomes.

    Question #1: External Evidence Example

    • Finding a research study, published in a peer-reviewed journal, that tests a protocol for turning immobile patients is an example of external evidence.

    Question #2: Best Practice Identification

    • Evidence-based practice involves merging evidence with clinical expertise, and patient preferences/values, to determine ideal practice.

    Key Influencers for Advancing EBP (Sections 1-5)

    • Sections 1 and 2 showcase influential organizations that promote EBP, including IOM's Roundtable, USPSTF, Community Services Task Force, PCORI, and the Magnet Recognition Program.
    • They promote learning healthcare systems, generate strong evidence, and improve public awareness of EBP.

    Key Influencers for Advancing EBP (Section 4)

    • The Helene Fuld Health Trust's National Institute for Evidence-Based Practice in Nursing and Healthcare develops and prepares interprofessional experts. It uses 5-day immersion programs, post-doctoral fellowships, and curriculum integration of EBP for higher caliber graduates.
    • It educates nursing and other transdisciplinary fields to access current best-practice standards, provides consultation, and assists healthcare leaders and clinicians to implement EBP.

    Key Influencers for Advancing EBP (Section 5)

    • The Institute conducts national webinars on current EBP best practices, and serves as a clearinghouse of information.
    • The Institute conducts research and works on transforming research into practice, and provides implementation tools.

    Question #3: Organizational Culture in EBP

    • Organizational culture and context are essential for implementing and sustaining evidence-based practice.

    Question #4: Steps to EBP Process

    • Melnyk & Fineout-Overholt identify seven steps, not six, in the EBP process.

    Barriers and Facilitators to EBP in Healthcare

    • Both barriers and facilitators influence the use and sustainability of EBP in healthcare.
    • Practitioners should address obstacles to implement EBP.
    • Examples of barriers include a lack of EBP knowledge, traditionally steeped culture, negative research perceptions, and limitations in time/resources.
    • Examples of facilitators include EBP as a norm, supportive leadership, stakeholder alignment, resources for data appraisal, and well-written research reports.

    Strategies for Eliminating EBP Barriers

    • Addressing implementation barriers includes assessing facilitators and readiness, conducting surveys, objectively documenting EBP status, implementing real-case scenarios, and correcting misperceptions.

    Question #5: EBP Implementation and Barriers in Healthcare

    • A scenario, in which a strategic plan establishes a core tenet of EBP implementation, but factors, such as timing/attendance restrictions can act as barriers, is described.

    Step 0-The Spirit of Inquiry

    • A spirit of inquiry involves questioning current practices, for instance, applying evidence to address issues in patients with head injuries and supraventricular tachycardia.
    • Without this questioning, the EBP process isn't likely to prosper.

    Case Scenario for EBP: Rapid Response Teams

    • The case study involves a staff nurse on a medical-surgical unit observing high acuity patients and cardiac arrests.
    • They find data relevant to implementing rapid response teams and present this to management.

    Video: Be Curious: Advancing the Nursing Profession Through Clinical Inquiry (John Hopkins)

    • The video emphasizes the importance of a spirit of inquiry for promoting nursing.

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    Description

    Test your knowledge of the Seven-Step Process of Evidence-Based Practice (EBP). This quiz covers fundamental concepts, steps involved, and the integration of best evidence into clinical decision-making. Perfect for healthcare professionals looking to reinforce their understanding of EBP principles.

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