Chapter 7 EvidenceBased Practice Defining EvidenceBased Practice EBP
Chapter 7 Evidence-Based Practice
Defining Evidence-Based Practice (EBP) • Merging personal clinical expertise with the best available research results according to patient preferences and values • Why is it important to utilize now?
Clinical Practice Guidelines • Systematically developed statements – Assist practitioners and client decisions about appropriate health care for clinical circumstances • Multidisciplinary
Concepts • Research utilization • Evidence-based practice • Are these interchangeable?
Criticisms of EBP • Quality of life issues • Restriction of freedom to practice • Inconsistent practices at medical centers versus other hospitals
Finding Best Practices • Location in literature – Online database • CINAH, Med. Line, Pub. Med • Evidence-based practice centers – Cochrane Collaboration • Journals – Evidence-Based Nursing
Research Design • Qualitative • Quantitative • Randomized Clinical Trial (RCT)
Evaluating Research • U. S. Preventive Services Task Force (USPSTF) developed a system for: – Rating guideline recommendations – Evaluating strength of evidence – Tables 7 -1 and 7 -2
ACE Star Model of Knowledge Transformation
Implementing New Practice • Three steps in managerial support – Establishing a new culture – Creating capacity for organizational change – Sustaining change through revision of system’s infrastructure
Barriers to EBP Implementation • • Lack of time Literature not readily available Uncertain of personnel’s ability to use research Critical colleagues
Barriers to EBP Implementation • • Lack of organizational support Lack of perceived power to effect change Cost to implement Interdisciplinary support
Five Steps to Ensuring Practice is Evidence-Based 1. Develop a researchable practice question 2. Design and implement an evidence search 3. Retrieve and appraise evidence
Five Steps to Ensuring Practice is Evidence-Based 4. Integrate clinical evidence in order to implement an evidence-based decision 5. Evaluate clinical practice and EBP process outcomes
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