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  • 1. Chapter 2Translating Research Evidence Into Nursing Practice: Evidence-Based Nursing Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 2. Research Utilization (RU) Versus Evidence-Based Practice (EBP)Research utilization (RU)The use of study findings in a practicalapplication unrelated to the originalresearchEvidence-based practice (EBP)Basing clinical decisions on bestpossible evidence—especially high-quality research Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 3. Resources for Evidence-Based Practice• Systematic reviews• Clinical practice guidelines• Other preappraised evidence Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 4. Research Integration and SynthesisForms of integrative reviews:• Narrative, qualitative integration (traditional review of quantitative or qualitative results)• Meta-analysis (statistical integration of results)• Metasynthesis (theoretical integration of qualitative findings) Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 5. Barriers to Using Research in Nursing Practice• Research-related barriers• Nurse-related barriers• Organizational barriers• Barriers related to the nursing profession Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 6. Steps of Individual EBP1. Framing an answerable clinical question2. Searching for relevant research-based evidence3. Appraising and synthesizing the evidence4. Integrating evidence with other factors5. Assessing effectiveness Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 7. Appraisal of Evidence• Validity of study findings• Clinical importance of findings• Precision of estimates of effects• Associated costs and risks• Utility in a particular clinical situation Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 8. EBP in Organizational Context• More formalized than individual EBP• Must take organizational and interpersonal factors into account• “Triggers” include both pressing clinical problems and existing knowledge Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 9. Organizational (Team-Based) EBP Projects• Involve the development or adaptation of clinical practice guidelines or clinical protocols• Assessment of implementation potential of the innovation Transferability Feasibility Cost/benefit ratio Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 10. Criteria for Evaluating the ImplementationPotential of an Innovation Under Scrutiny Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 11. Implementing and Evaluating the InnovationPilot Test• Develop an evaluation plan• Collect information on outcomes• Train staff in the use of the new guideline and, if necessary, “market” the innovation• Try the guideline out on one or more units or with a group of clients• Evaluate the pilot project Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
  • 12. Nurses’ Role in Using Research Evidence• Read widely and critically• Attend professional conferences• Learn to expect evidence that a procedure is effective• Become involved in a journal club• Pursue and participate in RU/EBP projects Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins