Ch02.pptx

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 2 Evidence-Based Practice Copyright ©2023 F.A. Davis Company Learning Outcomes  Define evidence-based practice and evidence-informed practice.  Discuss why evidence-based practice should be used.  Explain how to id...

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 2 Evidence-Based Practice Copyright ©2023 F.A. Davis Company Learning Outcomes  Define evidence-based practice and evidence-informed practice.  Discuss why evidence-based practice should be used.  Explain how to identify nursing evidence that should be put into practice.  Describe the evidence-based practice process. Copyright ©2023 F.A. Davis Company Learning Outcomes (continued)  List the six steps of evidence-based practice.  Identify who should give evidencebased nursing care, including when and where care should be given.  Describe how the Quality and Safety Education for Nurses (QSEN) project can promote safe patient care. Copyright ©2023 F.A. Davis Company Chapter Concepts  Caring  Evidence-Based Practice  Health-Care Technology  Quality Improvement  Safety Copyright ©2023 F.A. Davis Company Evidence-Based Practice  Systematic process  Current evidence  Patient care decision making  Quality care  Optimal patient outcomes Copyright ©2023 F.A. Davis Company Evidence-Based Practice Decision Making  Evaluation of quality  Applicability of existing research  Patient preferences  Costs  Clinical expertise  Clinical setting Copyright ©2023 F.A. Davis Company Why Use Evidence-Based Practice?  Gold standard of health care  Nurses can give best care possible. Copyright ©2023 F.A. Davis Company Practice Analysis Tip: Linking NCLEX-PN® to Practice  The licensed practical nurse/licensed vocational nurse (LPN/LVN) will apply evidence-based practice when providing care. Copyright ©2023 F.A. Davis Company Outcome Measurement  Built into the process  Shows value of the practice change Copyright ©2023 F.A. Davis Company Multiple Evidence Sources  Dental  Dietetics  Gerontology  Medical  Nursing  Psychology  Social work  Other professions Copyright ©2023 F.A. Davis Company Levels of Evidence Quality I  II  III  IV V  VI  VII Copyright ©2023 F.A. Davis Company Practice Analysis Tip: Linking NCLEX-PN® to Practice (continued_1)  The LPN/LVN will use data from various credible sources in making clinical decisions. Copyright ©2023 F.A. Davis Company Level I  Strongest evidence  Systematic reviews of randomized controlled trials • True experimental studies • Factors that could falsely change results controlled as possible Copyright ©2023 F.A. Davis Company Level I Source Examples  Joanna Briggs Institute’s EvidenceBased Resources  Cochrane Reviews Copyright ©2023 F.A. Davis Company Level II  At least one well-designed randomized controlled trial Copyright ©2023 F.A. Davis Company Level III  Evidence obtained from quasiexperimental research studies • Factors that could falsely change the results are not controlled • Less predictive of effectiveness Copyright ©2023 F.A. Davis Company Level IV  Evidence from well-designed casecontrol or cohort studies Copyright ©2023 F.A. Davis Company Level V  Systematic review of qualitative or descriptive studies Copyright ©2023 F.A. Davis Company Level VI  Qualitative or a single descriptive study Copyright ©2023 F.A. Davis Company Level VII  Expert opinion  Weakest level of evidence Copyright ©2023 F.A. Davis Company Process for Evidence-Based Practice  Dependent nursing interventions • Delegated by health-care provider  Independent nursing interventions • Does not require health-care provider order • Under supervision of registered nurse Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_1)  Step 1: Ask the burning question. • “Why do we do it that way?” • “How could we do that better?”  PICOT • Organizing framework for database searches Copyright ©2023 F.A. Davis Company PICOT  Framework that identifies relevant searchable question keywords on databases  Time saver  Stands for • Population/ Patient Problem: Who is your patient? • Intervention: What do you plan to do for the patient? • Comparison: What is the alternative to your plan? • Outcome: What outcome do you seek? • Time: What is the time frame? (This element is not always included.) Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_2)  Step 2: Search and collect the most relevant and best evidence available. • Computer databases Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_3)  Step 3: Think critically. • Appraise evidence for ‒ Validity ‒ Relevance to situation ‒ Applicability Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_4)  Step 4: Measure outcomes before and after change. Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_5)  Step 5: Make it happen. Copyright ©2023 F.A. Davis Company Six Steps of EBP: “ASKMME!” (continued_6)  Step 6: Evaluate the practice change. Copyright ©2023 F.A. Davis Company EBP, Quality, and Safety: They Belong Together!  Quality and Safety Education for Nurses (QSEN) Project • www.qsen.org Copyright ©2023 F.A. Davis Company QSEN Areas of Focus  Evidence-based practice  Safety  Teamwork and collaboration  Patient-centered care  Quality improvement  Informatics Copyright ©2023 F.A. Davis Company Practice Analysis Tip: Linking NCLEX-PN® to Practice (continued_2)  The LPN/LVN will participate in quality improvement (QI) activities (e.g., collecting data, serving on QI committee). Copyright ©2023 F.A. Davis Company Review Question #1 The nursing practice committee reviews a literature search. Which factors are considered when deciding which evidence to use? Select all that apply. 1. Quality 2. Applicability 3. Nurse convenience 4. Cost 5. Clinical expertise 6. Clinical setting Copyright ©2023 F.A. Davis Company Review Question #1 Answer Correct Answer: 1, 2, 4, 5, 6 Copyright ©2023 F.A. Davis Company Review Question #2 The nurse evaluates research studies. What should the nurse consider the strongest level of evidence? 1. Level I 2. 3. 4. 5. 6. 7. Level Level Level Level Level Level Copyright ©2023 F.A. Davis Company II III IV V VI VII Review Question #2 Answer Correct Answer: 1 Copyright ©2023 F.A. Davis Company Review Question #3 The nurse is evaluating research studies. Which of these does the nurse identify as 1. Case study level I evidence? 2. One randomized controlled trial 3. Quasi-experimental research studies 4. Systematic review of randomized controlled trials Copyright ©2023 F.A. Davis Company Review Question #3 Answer Correct Answer: 4 Copyright ©2023 F.A. Davis Company Review Question #4 The nurse searches for level I evidence. Which sources can the nurse use? Select all that apply. 1. American Journal of Nursing 2. Cochrane Reviews 3. Google 4. Joanna Briggs Institute’s EvidenceBased Resources 5. WebMD.com Copyright ©2023 F.A. Davis Company Review Question #4 Answer Correct Answer: 2, 4 Copyright ©2023 F.A. Davis Company Review Question #5 The student nurse is to apply the six QSEN competencies to patient care. Which of these is a QSEN competency? Select all that apply. 1. Evidence-based practice 2. Family-centered care 3. Health insurance coverage 4. Safety 5. Quality improvement 6. Teamwork and collaboration Copyright ©2023 F.A. Davis Company Review Question #5 Answer Correct Answer: 1, 4, 5, 6 Copyright ©2023 F.A. Davis Company