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  • Step 4 asks you to integrate evidence. The evidence can be used to make new policy and procedure, guide clinical practice, and/or develop new teaching, assessment, or documentation tools.
    The last step is to evaluate the practice decision or make a change. Depending on the evidence found and the type of change made to practice, the evaluation may be on a small or grand scale.
  • Table 5-1 shows the 5 steps involved in the research process.
    Before research can be conducted a number of issues must be explored. All subjects must have informed consent. Their responses must be anonymous and confidential.
  • In performance improvement an organization analyzes and evaluates current performance, using the results to develop focused improvement actions. Remember that evidence-based practice and quality improvement go hand in hand. Combined, they are the foundation for client care and outcomes.
  • Chapter 5 Power point

    1. 1. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 5Chapter 5 Evidence-Based PracticeEvidence-Based Practice
    2. 2. 2Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Why EBPWhy EBP  Uncertainty in healthcareUncertainty in healthcare  It enables the clinicians the ability to provideIt enables the clinicians the ability to provide the best care availablethe best care available  Three questions:Three questions:  ““ when caring for a child in a MVA/ head injurywhen caring for a child in a MVA/ head injury would you want the most effective tx <ICP basedwould you want the most effective tx <ICP based on RCT’son RCT’s  Mother dx/Alzheimer’s –groups fromMother dx/Alzheimer’s –groups from qualitative/descriptive studyqualitative/descriptive study  DX/cancer- type of chemo/ based on clinical trialsDX/cancer- type of chemo/ based on clinical trials  Melnyk, Fineout-Overholt, 2005).Melnyk, Fineout-Overholt, 2005).
    3. 3. 3Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. A Case for EvidenceA Case for Evidence  A response to societal forcesA response to societal forces  A problem-solving approach to practiceA problem-solving approach to practice
    4. 4. 4Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.  "The most dangerous phrase in the language"The most dangerous phrase in the language is, 'We've always done it this way.'"is, 'We've always done it this way.'" --Rear Admiral Grace M. Hopper, U.S. Navy--Rear Admiral Grace M. Hopper, U.S. Navy
    5. 5. 5Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Steps to Evidence-Based PracticeSteps to Evidence-Based Practice  Five steps:Five steps:  Ask the clinical question.Ask the clinical question.  Collect the best evidence.Collect the best evidence.  Critique the evidence.Critique the evidence.  Integrate the evidence.Integrate the evidence.  Evaluate the practice decision or change.Evaluate the practice decision or change.
    6. 6. 6Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing ResearchNursing Research  A way to identify new knowledge, improveA way to identify new knowledge, improve professional education and practice, andprofessional education and practice, and use resources effectivelyuse resources effectively  ANA revised Standards of NursingANA revised Standards of Nursing Practice in 2003Practice in 2003  American Association of Critical Care Nurses,American Association of Critical Care Nurses, Oncology Nursing Society, and Sigma ThetaOncology Nursing Society, and Sigma Theta Tau International support nursing research.Tau International support nursing research.
    7. 7. 7Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Outcomes Management ResearchOutcomes Management Research  Designed to assess and document theDesigned to assess and document the effectiveness of health care services andeffectiveness of health care services and interventionsinterventions  A response of the health care industry toA response of the health care industry to demands from policy makers, insurers,demands from policy makers, insurers, and publicand public
    8. 8. 8Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Scientific MethodScientific Method  The foundation of researchThe foundation of research  The most reliable and objective means ofThe most reliable and objective means of acquiring and conducting researchacquiring and conducting research
    9. 9. 9Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and the ScientificNursing and the Scientific ApproachApproach  Nursing research provides a way forNursing research provides a way for nursing questions and problems to benursing questions and problems to be studied in broader context.studied in broader context.  QuantitativeQuantitative  QualitativeQualitative
    10. 10. 10Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Research ProcessResearch Process  An orderly series of steps that allows aAn orderly series of steps that allows a researcher to find the answer to a questionresearcher to find the answer to a question  Consists of five steps:Consists of five steps:  Identify problem.Identify problem.  Design study.Design study.  Conduct study.Conduct study.  Analyze data.Analyze data.  Use the findings.Use the findings.
    11. 11. 11Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. Quality and PerformanceQuality and Performance ImprovementImprovement  Every health care organization gathersEvery health care organization gathers data on health outcome measures as adata on health outcome measures as a way to gauge their quality of care.way to gauge their quality of care.  Quality ImprovementQuality Improvement  Performance ManagementPerformance Management
    12. 12. 12Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. ReferencesReferences  Melnyk, B., Fineout-Overholt, E., (2005).Melnyk, B., Fineout-Overholt, E., (2005). Evidenced-Based Practice in Nursing andEvidenced-Based Practice in Nursing and Healthcare. Phildelphia. Lippincott Williams, &Healthcare. Phildelphia. Lippincott Williams, & Wilkens.Wilkens.

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