Evidence-Informed Practice Quiz

Evidence Informed Practice/Research

• Evidence-informed practice/research is a process crucial for nurses' decision-making.
• It involves using the best available evidence, combining it with clinical expertise, and understanding patient values.
• Understanding the process and methodology of research is essential.

How to Make Important Decisions

• People use various factors, including gut feelings, trusted opinions, the internet, and books, to make decisions.
• What should nurses rely on for decision-making?

Ends in View

• Explain the need for evidence to inform nurse decision-making.
• Identify steps in evidence-informed decision-making.
• Discuss methods used to develop new nursing knowledge.
• Explain how nursing research improves nursing practice.
• Identify various approaches for new nursing knowledge development.
• Understand the process of reading evidence-informed journal articles.

Nursing Research

• Nursing research is a primary means to discover new knowledge for improving patient care.
• A systematic examination of topics important to nursing is key to defining and refining existing knowledge and discovering new knowledge to improve standards of practice.

Definitions

• "Google" is not a synonym for "research".
• "Google" is an internet search engine.

What is Research?

• Research is a primary means of discovering new knowledge and applying it to improve patient care.
• Research is a systematic assessment of phenomena relevant to nursing.
• Validating, refining, and discovering new knowledge improves nursing practice.

Importance of Nursing Research

• Nursing research empowers every nurse in their clinical practice.
• It assists in decision-making and helps nurses gain knowledge to improve patient care.

History of Nursing Research

• Nursing research began with Florence Nightingale during the Crimean War.
• Nursing research evolved throughout the 1900s and into the 21st century with the establishment of university nursing programs, research journals, conferences, and support programs.
• Government funding has played an important role in nursing research.

Research Process

• Research questions must be asked and the study's purpose defined.
• Relevant literature background and what is known should be studied to support the topic.
• An established theory or conceptual framework needs to be used, describing the problem, contributing factors, and potential outcomes.
• Research design should be determined to address the question.
• Setting, sample size, and participant recruitment methods must be described.
• How data will be collected and analyzed.
• Study findings, implications and limits should be communicated.

Research Questions (PICOT Format)

• Patient, problem, population of interest
• Intervention of interest
• Comparison of interest
• Outcome
• Time frame for change

Clinical Questions (PS Format)

• Population
• Situation

Research Design

• An overall plan to answer the research question.
• Design varies depending on the research approach.
• The approach helps to determine the research design.

Qualitative vs Quantitative

• Qualitative: studies phenomena, data is narrative, reasoning is inductive, trustworthiness is important, meaning is within the context, cannot be measured
  • Concepts, constructs, and variables are studied
  • Numerical data is collected
• Quantitative: studies concepts, constructs, and variables, data is numerical, reasoning is deductive, reliability and validity is important, measures relationship
  • Meaning is within a specific context

Deductive vs Inductive

• Deductive: moves from general principles to specific predictions.
• Inductive: moves from specific observations to more generalized rules.

Qualitative

• Qualitative research poses questions about nursing phenomena, focuses on subject perspective, and seeks to determine the extent to which findings can be transferred to other situations.

Qualitative Designs - Phenomenological

• Phenomenology stems from philosophy and psychology, looking at lived experiences
• It presumes that only those experiencing the phenomenon can describe it.
• Discusses descriptions of seniors' perceptions and relationships with home care providers.

Qualitative Designs - Grounded Theory

• Sociology-based, identifies patterns of behavior and uses constant comparison.
• Emerging categories and concepts are key to theoretical development.
• Real-world observations are used to develop theories.

Qualitative Designs - Ethnography

• Ethnography draws on anthropology and focusses on understanding the world view of participants within a cultural setting.
• Observational fieldwork is critical to understanding behavior and events.
• Focuses on participants' meanings of actions.

Qualitative Designs - Participatory Action Research

• The idea that knowledge can be political and used to exert power.
• Collaboration between researchers and participants to define problems, select approaches, and utilize findings.
• Researchers work with vulnerable groups.
• Involves thorough, in-depth analysis of individual, groups, institutions or other social units.
• Systematic studies are used to uncover facts and relationships about past events.

Quantitative Designs - Experimental

• Randomized controlled trials are used to determine relationships between variables.
• Random assignment to a group; Control group for comparison.
• Manipulation of a special treatment is done
• Hypothesis about the action of the variable is statistically tested.

Quantitative Designs - Quasi-experimental

• Lacks one of the characteristics of an experimental design (e.g. randomization, control group etc).

Quantitative Designs - Descriptive (Surveys)

• Gather data from groups or populations.
• Yields information on the topic of interest regarding relationship between variables.
• Sampling size can influence results accuracy.
• Measurement tools must yield accurate measurements.

Quantitative Designs - Exploratory Descriptive

• Describes populations or variables not previously studied.
• Provides detailed descriptions; no relationship is described.
• No active intervention is conducted by the researcher.
• Use of statistical analysis.

Research Synthesis

• Systematic review appraisal and synthesizing of findings from the literature on a specific topic.
• Literature screening and appraisal for quality.
• Work is often conducted in teams
• Generates new knowledge through findings synthesis.

Types of Research Synthesis

• Integrative reviews: Explore the breadth and depth of a topic.
• Scoping reviews: Map the extent, range and nature of research.
• Concept analysis: Refine the meaning of a concept.
• Qualitative meta-synthesis: Synthesizes qualitative findings.
• Meta-analysis: Integrates results from primary studies.
• Mixed-method synthesis: Reviews empirical qualitative, quantitative and mixed-methods studies.

Ackerman et al (2021)

• Discusses innovation based on three different projects.

Reading Research Papers

• Crucial to recognize the importance of each part of the research paper.

Parts of a Research Paper

• Abstract
• Introduction
• Literature review
• Method
• Results/Findings
• Discussion

Evidence Informed Practice

• Continuous process for selecting best available evidence.
• Essential to achieving optimum outcomes for patients, communities.
• Important element of nursing practice.

Evidence Based Practice

• Conscientious, explicit & judicious use of current best evidence to make decisions regarding patient care.
• Combines clinical expertise with best evidence from research.

Example of EBP - RNAO BPGs

• Focuses on developing and disseminating best practices.
• Translates research evidence into practical recommendations.
• Enhances work environments, and improves quality of care.

What did you find in BPG's?

• Person & Family centered care: development, potential for integration into practice.

What is Evidence-Informed Decision Making

• Ongoing process integrating research findings, clinical expertise, clients' preferences, and resources.
• Flexible approach utilizing various evidence levels.

Evidence-Informed Clinical Decision Making

• Obtaining information from multiple sources (research, theories, experts, patient preferences, etc.).

Evidence Based Process

• Requires appropriate question development.
• Collection of relevant evidence in a critical manner.
• Integrates evaluation with expertise and patient values.

Asking the question

• PICO(T) or PS format for a clear question.

Collect Best Evidence

• Databases for published empirical studies; peer reviewed.

Levels of Evidence (Quantitative)

• Levels of evidence for quantitative research.

Levels of Evidence (Table)

• Table summarizing levels of evidence sources.

Sources of research evidence

• Different sources to find research

Critique the evidence

• Essential competency for evidence-informed practice.
• Evaluate empirical literature for application.

Integrate the evidence

• Applying research into plans of care.
• Pilot studies might be considered.

Evaluate the change

• Formal evaluation, if necessary
• Long term evaluation timeframe.

Evidence-Informed Practice (Summary)

• Continuous process to use best available evidence to provide excellent patient care.

EBP vs EIP Comparison

• Comparison table highlighting differences between Evidence-Based Practice and Evidence-Informed Practice.

How do they differ?

• Evidence-Informed decision making is broader than EBP.
• Includes patient values, beliefs, practices, cultural context, relevant resources and more.

Evidence-Informed Decision Making Structure

• Includes work processes for improving patient outcomes, and patient records from the specific area or population.

Peer-Reviewed Articles

• Questions about peer-reviewed articles and how to ensure when searching.

In Summary

• Summary of evidence-informed decision making and practice and highlights the important role of research.

Next Week

• Upcoming study and project work