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Evidence-Based PracticeEvidence-Based Practice
(EBP)(EBP)
Joan Pollner, RN, BSN, CHPNJoan Pollner, RN, BSN, CHPN
October 1...
ObjectivesObjectives
 Define Evidence-based practice (EBP)Define Evidence-based practice (EBP)
 Identify the goals of EB...
Some DefinitionsSome Definitions
 Evidence-based practice can be thought of as requiringEvidence-based practice can be th...
Definitions (con’t)Definitions (con’t)
 Integration of the best research evidenceIntegration of the best research evidenc...
Goals of EBPGoals of EBP
 Provide practicing nurses with evidence-Provide practicing nurses with evidence-
based database...
Goals (con’t)Goals (con’t)
 Using best evidence to implement theUsing best evidence to implement the
regulation of nurses...
Research Utilization vs EBPResearch Utilization vs EBP
Research UtilizationResearch Utilization
 Use results of studiesUs...
EBP is multi-step processEBP is multi-step process
 Define patient problemDefine patient problem
 Identify information n...
Steven’s ACE Star ModelSteven’s ACE Star Model
 DiscoveryDiscovery
 SummarySummary
 TranslationTranslation
 Implementa...
Steven’s ACE Star ModelSteven’s ACE Star Model
DiscoveryDiscovery
 Original researchOriginal research
 Conduct a literat...
Steven’s ACE Star ModelSteven’s ACE Star Model
SummarySummary
 Synthesize all research into a single meaningfulSynthesize...
Steven’s ACE Star ModelSteven’s ACE Star Model
TranslationTranslation
 Scientific evidence is considered in theScientific...
Steven’s ACE Star ModelSteven’s ACE Star Model
ImplementationImplementation
 Translation of research into practiceTransla...
Steven’s ACE Star ModelSteven’s ACE Star Model
EvaluationEvaluation
 Impact of the change is measuredImpact of the change...
Challenges and MisconceptionsChallenges and Misconceptions
 Merely a collection of statistics?Merely a collection of stat...
ResourcesResources
 Yale University Nursing Library and Information ResourcesYale University Nursing Library and Informat...
Resources (con’t)Resources (con’t)
 University of Texas Health Science Center at San Antonio –University of Texas Health ...
ReferencesReferences
• Chitty, K.K. (2005).Chitty, K.K. (2005). Professional nursing: Concepts and challenges.Professional...
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  1. 1. Evidence-Based PracticeEvidence-Based Practice (EBP)(EBP) Joan Pollner, RN, BSN, CHPNJoan Pollner, RN, BSN, CHPN October 18, 2006October 18, 2006
  2. 2. ObjectivesObjectives  Define Evidence-based practice (EBP)Define Evidence-based practice (EBP)  Identify the goals of EBPIdentify the goals of EBP  Distinguish between the characteristics ofDistinguish between the characteristics of Research Utilization and EBPResearch Utilization and EBP  Describe the steps in the EBP processDescribe the steps in the EBP process  Explain the challenges and misconceptions ofExplain the challenges and misconceptions of EBPEBP  Utilize resources to further knowledge of EBPUtilize resources to further knowledge of EBP
  3. 3. Some DefinitionsSome Definitions  Evidence-based practice can be thought of as requiringEvidence-based practice can be thought of as requiring "the integration of the best research evidence with our"the integration of the best research evidence with our clincial expertise and our patient's unique values andclincial expertise and our patient's unique values and circumstances." (Straus, et al., 2005) "Fortunately,circumstances." (Straus, et al., 2005) "Fortunately, evidence-based practice (EBP) is an approach thatevidence-based practice (EBP) is an approach that enables clinicians to provide highest quality of care inenables clinicians to provide highest quality of care in meeting the multifaceted needs of their patients andmeeting the multifaceted needs of their patients and families." (Melnyk & Fineout-Overholt, 2005)families." (Melnyk & Fineout-Overholt, 2005) (Yale, 2005)(Yale, 2005)
  4. 4. Definitions (con’t)Definitions (con’t)  Integration of the best research evidenceIntegration of the best research evidence with clinical expertise and patient values.with clinical expertise and patient values. (Spector, n.d.).(Spector, n.d.).  “…“…using the best available researchusing the best available research findings “to make clinical decisions thatfindings “to make clinical decisions that are most effective and beneficial forare most effective and beneficial for patients.”” (Chitty, 2005).patients.”” (Chitty, 2005).
  5. 5. Goals of EBPGoals of EBP  Provide practicing nurses with evidence-Provide practicing nurses with evidence- based databased data  Resolve problems in the clinical settingResolve problems in the clinical setting  Achieve excellence in care deliveryAchieve excellence in care delivery  Introduce innovationIntroduce innovation  Reduce variations in nursing careReduce variations in nursing care  Assists with efficient and effectiveAssists with efficient and effective decision-makingdecision-making
  6. 6. Goals (con’t)Goals (con’t)  Using best evidence to implement theUsing best evidence to implement the regulation of nursesregulation of nurses  Resolve regulatory problemsResolve regulatory problems  Achieve excellence in regulationAchieve excellence in regulation  Introduce regulatory innovationIntroduce regulatory innovation
  7. 7. Research Utilization vs EBPResearch Utilization vs EBP Research UtilizationResearch Utilization  Use results of studiesUse results of studies  Randomly selectedRandomly selected  Support nursing careSupport nursing care  Less systematicLess systematic Evidence-BasedEvidence-Based PracticePractice  Considers allConsiders all researchresearch  Utilized thoroughUtilized thorough integrative reviewintegrative review  Context of clinicalContext of clinical expertise and valueexpertise and value system of the patientsystem of the patient  More systematicMore systematic
  8. 8. EBP is multi-step processEBP is multi-step process  Define patient problemDefine patient problem  Identify information needed to solve problemIdentify information needed to solve problem  Search of literatureSearch of literature  Critical appraisal of the evidenceCritical appraisal of the evidence  Extraction of the clinical answerExtraction of the clinical answer  Protocol developmentProtocol development  EvaluationEvaluation
  9. 9. Steven’s ACE Star ModelSteven’s ACE Star Model  DiscoveryDiscovery  SummarySummary  TranslationTranslation  ImplementationImplementation  EvaluationEvaluation
  10. 10. Steven’s ACE Star ModelSteven’s ACE Star Model DiscoveryDiscovery  Original researchOriginal research  Conduct a literature search utilizingConduct a literature search utilizing recognized techniquesrecognized techniques
  11. 11. Steven’s ACE Star ModelSteven’s ACE Star Model SummarySummary  Synthesize all research into a single meaningfulSynthesize all research into a single meaningful wholewhole  This step differentiates research utilization fromThis step differentiates research utilization from Evidence-based practiceEvidence-based practice  Can be called evidence synthesisCan be called evidence synthesis  Increase power and effect of dataIncrease power and effect of data  Reduce biasReduce bias  Assess consistenciesAssess consistencies  Establish generalizabilityEstablish generalizability  Reduce data into an manageable formReduce data into an manageable form
  12. 12. Steven’s ACE Star ModelSteven’s ACE Star Model TranslationTranslation  Scientific evidence is considered in theScientific evidence is considered in the context of clinical expertise and valuescontext of clinical expertise and values  Results in clinical practice guidelines, bestResults in clinical practice guidelines, best practices, protocols, standards or clinicalpractices, protocols, standards or clinical pathwayspathways
  13. 13. Steven’s ACE Star ModelSteven’s ACE Star Model ImplementationImplementation  Translation of research into practiceTranslation of research into practice  Where changes take placeWhere changes take place
  14. 14. Steven’s ACE Star ModelSteven’s ACE Star Model EvaluationEvaluation  Impact of the change is measuredImpact of the change is measured  Assess variables (health outcomes,Assess variables (health outcomes, efficiency, cost or satisfaction)efficiency, cost or satisfaction)
  15. 15. Challenges and MisconceptionsChallenges and Misconceptions  Merely a collection of statistics?Merely a collection of statistics?  Need more qualitative researchNeed more qualitative research  Nurses need to develop good searchNurses need to develop good search strategiesstrategies  Nurses must learn to do critical appraisalsNurses must learn to do critical appraisals  Faculty members must embrace and learnFaculty members must embrace and learn EBPEBP
  16. 16. ResourcesResources  Yale University Nursing Library and Information ResourcesYale University Nursing Library and Information Resources http://www.med.yale.edu/library/nursing/education/ebhc2.htmlhttp://www.med.yale.edu/library/nursing/education/ebhc2.html  Oncology Nursing SocietyOncology Nursing Society http://onsopcontent.ons.org/toolkits/evidence/http://onsopcontent.ons.org/toolkits/evidence/  United States Department of Health and Human Services – AgencyUnited States Department of Health and Human Services – Agency for Healthcare Research and Qualityfor Healthcare Research and Quality http://www.ahrq.gov/clinic/epcix.htmhttp://www.ahrq.gov/clinic/epcix.htm  University of Iowa Hospitals and Clinics Nursing Services andUniversity of Iowa Hospitals and Clinics Nursing Services and Patient CarePatient Care http://www.uihealthcare.com/depts/nursing/rqom/evidencebasedpractichttp://www.uihealthcare.com/depts/nursing/rqom/evidencebasedpractic e/index.htmle/index.html
  17. 17. Resources (con’t)Resources (con’t)  University of Texas Health Science Center at San Antonio –University of Texas Health Science Center at San Antonio – Acedemic Center for Evidence-Based PracticeAcedemic Center for Evidence-Based Practice http://www.acestar.uthscsa.edu/About.htmhttp://www.acestar.uthscsa.edu/About.htm  Medical Library Association – Nursing and Allied Health ResourcesMedical Library Association – Nursing and Allied Health Resources SectionSection http://nahrs.library.kent.edu/resource/symposium/http://nahrs.library.kent.edu/resource/symposium/  University of Minnesota – Evidence-based Health Care ProjectUniversity of Minnesota – Evidence-based Health Care Project http://evidence.ahc.umn.edu/ebn.htmhttp://evidence.ahc.umn.edu/ebn.htm
  18. 18. ReferencesReferences • Chitty, K.K. (2005).Chitty, K.K. (2005). Professional nursing: Concepts and challenges.Professional nursing: Concepts and challenges. 44thth ed. Philadelphia: Saunders.ed. Philadelphia: Saunders.  Spector, N. (n.d.). Evidence-Based Health Care in NursingSpector, N. (n.d.). Evidence-Based Health Care in Nursing Regulation. Retrieved on October 8, 2006 from Nation Council ofRegulation. Retrieved on October 8, 2006 from Nation Council of State Boards of Nursing web site on World Wide Web:State Boards of Nursing web site on World Wide Web: http://www.ncsbn.org/pdfs/Evidencebased_NSpector.pdf#search=http://www.ncsbn.org/pdfs/Evidencebased_NSpector.pdf#search= %22evidence%20based%20practice%20in%20nursing%22%22evidence%20based%20practice%20in%20nursing%22  Yale University. (2005). Evidence-Based Practice. Nursing LibraryYale University. (2005). Evidence-Based Practice. Nursing Library and Information Resources. Retrieved on October 8, 2006 fromand Information Resources. Retrieved on October 8, 2006 from World Wide Web:World Wide Web: http://www.med.yale.edu/library/nursing/education/ebhc2.htmlhttp://www.med.yale.edu/library/nursing/education/ebhc2.html
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