This document discusses evidence-based practice (EBP) in nursing. It defines research utilization (RU) as using study findings in practice, while EBP bases clinical decisions on the best available evidence, especially high-quality research. Resources for EBP include systematic reviews, clinical guidelines, and preappraised evidence. Barriers to using research in nursing include research-related issues, nurse-related factors, organizational barriers, and issues related to the nursing profession. Individual EBP involves framing a question, searching evidence, appraising evidence, integrating evidence with other factors, and assessing effectiveness.

1. Chapter 2
Translating 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 practical
application unrelated to the original
research
Evidence-based practice (EBP)
Basing clinical decisions on best
possible 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
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4. Research Integration and Synthesis
Forms 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
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6. Steps of Individual EBP
1. Framing an answerable clinical question
2. Searching for relevant research-based
evidence
3. Appraising and synthesizing the evidence
4. Integrating evidence with other factors
5. 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
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10. Criteria for Evaluating the Implementation
Potential of an Innovation Under Scrutiny
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11. Implementing and Evaluating the
Innovation
Pilot 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