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Questions and Answers
What is the first step in Evidence-Based Practice (EBP) efforts?
What is the first step in Evidence-Based Practice (EBP) efforts?
Clinical practice guidelines provide specific recommendations for evidence-based decision making.
Clinical practice guidelines provide specific recommendations for evidence-based decision making.
True
What are two components that research evidence should be integrated with in EBP?
What are two components that research evidence should be integrated with in EBP?
Clinical expertise and patient preferences
The last step in individual EBP efforts is to assess __________.
The last step in individual EBP efforts is to assess __________.
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Match the following EBP concepts with their definitions:
Match the following EBP concepts with their definitions:
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What is research utilization (RU) in nursing practice?
What is research utilization (RU) in nursing practice?
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Evidence-based practice (EBP) relies solely on clinical experience.
Evidence-based practice (EBP) relies solely on clinical experience.
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Who is known as a pioneer of evidence-based medicine?
Who is known as a pioneer of evidence-based medicine?
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The strongest level of evidence is obtained from systematic reviews of __________.
The strongest level of evidence is obtained from systematic reviews of __________.
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Match the following evidence sources with their characteristics:
Match the following evidence sources with their characteristics:
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Which of the following is a common organizational barrier to EBP?
Which of the following is a common organizational barrier to EBP?
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The Cochrane Collaboration was created to promote the use of evidence-based practice in healthcare.
The Cochrane Collaboration was created to promote the use of evidence-based practice in healthcare.
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What major project sought to address the knowledge-practice gaps in nursing during the 1970s and 1980s?
What major project sought to address the knowledge-practice gaps in nursing during the 1970s and 1980s?
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What is the primary function of meta-analyses?
What is the primary function of meta-analyses?
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Clinical practice guidelines have a single, comprehensive guideline repository.
Clinical practice guidelines have a single, comprehensive guideline repository.
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Name one of the three widely referenced models for evidence-based nursing practice.
Name one of the three widely referenced models for evidence-based nursing practice.
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Meta-syntheses integrate and amplify findings across ________ studies.
Meta-syntheses integrate and amplify findings across ________ studies.
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Which of the following represents a step in the major steps of evidence-based practice?
Which of the following represents a step in the major steps of evidence-based practice?
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Match the following models with their purpose:
Match the following models with their purpose:
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What is the first step when investigating evidence for a specific nursing care problem?
What is the first step when investigating evidence for a specific nursing care problem?
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In a clinical question template, the population is _____ to identify in the nursing care problem.
In a clinical question template, the population is _____ to identify in the nursing care problem.
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Study Notes
Research Methodology - NURS3030
- Course prepared by Leemoy Weaver, UWISON, Mona
Chapter 2 - Fundamentals of Evidence-Based Nursing Practice
- Evidence-based nursing practice (EBP) involves basing clinical decisions on research findings and other factors.
- Research utilization (RU) is the use of study findings in a practical application, regardless of the original research.
Background of Evidence-Based Nursing Practice
- Research utilization (RU) emerged from recognizing knowledge-practice gaps, as identified in studies like Ketefian (1975).
- RU projects, such as the Conduct and Utilization of Research in Nursing (CURN) project, addressed these gaps in the 1970s and 1980s.
- RU efforts were later superseded by the call for evidence-based practice (EBP) in the 1990s.
Overview of the EBP Movement
- Archie Cochrane's work led to the establishment of the Cochrane Center in Oxford and the Cochrane Collaboration.
- Cochrane proposed an evidence hierarchy for evaluating the weight of evidence.
- David Sackett was a pioneer in evidence-based medicine at McMaster Medical School.
Evidence Hierarchies
- Evidence sources are ranked based on the strength of evidence they provide.
- Ranking can vary depending on the specific question being asked.
- Evidence quality can vary considerably within a given level.
Example of an Evidence Hierarchy
- The hierarchy is presented as a pyramid shape, with systematic reviews at the top, followed by randomized controlled trials, non-randomized trials, cohort studies, and case-control studies. Lower levels include cross-sectional studies, qualitative studies, and expert opinions, case reports and other less rigorous types of studies.
- Each level provides differing levels of evidence and implications.
Best Evidence
- Best evidence refers to research rigorously collected, methodologically sound, and clinically relevant to address important questions.
EBP Challenges
- Research-related barriers, such as a shortage of strong research evidence
- Nurse-related barriers, such as inadequate skills in locating and appraising evidence
- Organizational barriers, such as lack of financial support and time for EBP implementation.
Question: True or False?
- The strongest level of evidence is obtained from individual correlational studies.
- False. The strongest level of evidence comes from systematic reviews of randomized clinical trials (RCTs).
Resources for EBP
- Pre-appraised evidence has been selected from and evaluated for use by healthcare professionals.
- Systematic reviews, done rigorously and systematically, integrate evidence on a particular issue.
- Clinical practice guidelines offer specifics on how evidence-based decisions should be made.
Systematic Reviews
- Meta-analyses statistically combine results from quantitative studies.
- Meta-syntheses combine qualitative studies.
Clinical Practice Guidelines
- No single, universal repository of guidelines exists..
- When several guidelines exist, using the strongest evidence is crucial.
- AGREE (Appraisal of Guidelines Research and Evaluation) is a guideline for evaluating how good the guidelines are
Models for Evidence-Based Nursing Practice
- Several models are available.
- The Stetler model utilizes research to promote EBP.
- The Iowa model uses EBP for enhancing quality care.
- Rogers' Diffusion of Innovations Theory is another crucial model.
EBP in Individual Nursing Practice
- Nurses utilize EBP daily to make decisions and provide advice on diverse clinical scenarios.
- This includes questions like if there are reliable screening tools for Clostridium difficile risk among surgical patients or ways to reduce pain in children undergoing allergy tests.
Question: True or False?
- Meta-analyses use statistics to integrate findings from quantitative studies.
- True.
Major Steps in EBP
- 1. Ask clinical questions that address uncertainties.
- 2. Search for and compile evidence.
- 3. Appraise and analyze evidence.
- 4. Integrate with other sources of information.
- 5. Evaluate the effectiveness of the decision/advice.
Asking Clinical Questions
- Components for quantitative evidence include:
- Population
- Intervention
- Comparison
- Outcome
- Time (though not always specified)
Question Templates
- Templates can improve question formulation for clinical practice. Example: "In [population], what is the effect of [intervention], compared to [comparison], on [outcome]?"
Question:
- Which of the following is the first step in evaluating a nursing problem using EBP?
- Searching for possible evidence
- Asking answerable clinical questions
- Assessing the effectiveness of the decision
- Assembling existing evidence
- Answer: Asking answerable clinical questions.
Appraising the Evidence for EBP
- Key considerations for appraising evidence include:
- Evidence quality
- Magnitude of effects
- Precision of effect estimates
- Side effects
- Costs
- Relevance to the clinical situation.
Integrating Evidence in EBP
- Integrate research with clinical expertise and clinical setting knowledge.
- Incorporate patient preferences and values.
- Consider evidence from qualitative research.
EBP in an Organizational Context
- Knowledge-focused triggers originate from new innovations or research.
- Problem-focused triggers stem from troubling clinical situations.
EBP in an Organizational Context (cont.)
- Assess implementation potential (e.g., transferability, feasibility, cost-benefit).
- Implement and evaluate innovations.
Question: True or False?
- Clinical practice guidelines organize evidence into a usable form.
- True. Clinical practice guidelines provide specific recommendations for evidence-based decision-making, presenting the evidence in a usable format for implementation.
End of Presentation
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Description
This quiz covers the fundamentals of evidence-based nursing practice (EBP) as detailed in Chapter 2 of NURS3030. Key topics include the significance of research utilization (RU) and its evolution to EBP. Explore the historical context and important contributions to nursing practices based on research findings.
