Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.



Published on

Published in: Health & Medicine, Education
  • Be the first to comment


  1. 1. Chapter 5 Evidence-Based Health Care
  2. 2. Objectives <ul><li>Upon completion of this chapter, the reader should be able to: </li></ul><ul><ul><li>Know the history of evidence-based care (EBC) in nursing </li></ul></ul><ul><ul><li>Develop an understanding of evidence and its use in decision making </li></ul></ul><ul><ul><li>Assume responsibility for developing an evidence-based approach to patient care </li></ul></ul>
  3. 3. Objectives <ul><ul><li>Understand the terminology used to describe types of evidence and evidence-based care processes </li></ul></ul><ul><ul><li>Develop an informed view of the current state of evidence-based care and an understanding of the role of nursing in evidence-based decision making </li></ul></ul><ul><ul><li>Apply the steps needed to incorporate evidence-based care in their own practice </li></ul></ul><ul><ul><li>Conduct a search for evidence on a given topic </li></ul></ul>
  4. 4. History of Evidence-Based Care <ul><li>Initially began in Canada </li></ul><ul><li>Evidence-based care </li></ul><ul><ul><li>The process of providing clinically competent care that is based on the best scientific evidence available </li></ul></ul><ul><li>Includes all health disciplines </li></ul>
  5. 5. Implementation of Evidence Practice <ul><li>Find a source of evidence-based content that is developed using good research techniques </li></ul><ul><li>The evidence-based content itself must be efficient for clinicians to use at the bedside </li></ul><ul><li>Integrate the evidence-based content into order sets, plans of care, and documentation forms </li></ul>
  6. 6. The ACE Star Model of Knowledge Transformation <ul><li>Provides a framework for systematically putting evidence-based practice into operation </li></ul><ul><li>Star points </li></ul><ul><ul><li>Knowledge discovery </li></ul></ul><ul><ul><li>Evidence summary </li></ul></ul><ul><ul><li>Translation into practice recommendations </li></ul></ul><ul><ul><li>Integration into practice </li></ul></ul><ul><ul><li>Evaluation </li></ul></ul>
  7. 7. Research Terminology <ul><li>Absolute benefit increase </li></ul><ul><li>Best practice </li></ul><ul><li>Case-control study </li></ul><ul><li>Clinical practice guidelines </li></ul><ul><li>Cohort study </li></ul><ul><li>Control group </li></ul><ul><li>Correlational research </li></ul><ul><li>Dependent variable </li></ul><ul><li>Descriptive research </li></ul><ul><li>Evidence-based health care </li></ul><ul><li>Follow-up study </li></ul><ul><li>Health outcomes </li></ul><ul><li>Independent variable </li></ul>
  8. 8. Research Terminology <ul><li>Integrative review </li></ul><ul><li>Longitudinal study </li></ul><ul><li>Matching </li></ul><ul><li>Meta-analysis </li></ul><ul><li>Nonexperimental research </li></ul><ul><li>Number needed to treat </li></ul><ul><li>Outcomes research </li></ul><ul><li>Prospective study </li></ul><ul><li>Qualitative analysis </li></ul><ul><li>Quantitative analysis </li></ul><ul><li>Quasi-experiment </li></ul><ul><li>Randomized clinical trial </li></ul><ul><li>Relative risk </li></ul><ul><li>Research utilization </li></ul>
  9. 9. Research Terminology <ul><li>Retrospective design </li></ul><ul><li>Systematic review </li></ul><ul><li>Time series design </li></ul><ul><li>Translation </li></ul><ul><li>Treatment effect </li></ul><ul><li>Variable </li></ul>
  10. 10. Importance of EBC <ul><li>There is a lack of agreed-upon standards or processes that are based on evidence </li></ul><ul><li>EBC is a process approach to collecting, reviewing, interpreting, critiquing, and evaluating research </li></ul><ul><li>Leads to a state-of-the-art integration of knowledge and evidence that can be evaluated and measured through outcomes </li></ul><ul><li>Should be viewed as the highest level of care </li></ul>
  11. 11. Nursing and EBC <ul><li>The agency for Healthcare Research and Quality (AHRQ) launched twelve evidence-based practice centers </li></ul><ul><li>The initiative partnered with public and private organizations to improve the quality, effectiveness, and appropriateness of care </li></ul><ul><li>Nurses work with patients in deciding treatment options </li></ul>
  12. 12. Attributes of EBC <ul><li>Need to define the meaning of evidence in each health care agency </li></ul><ul><ul><li>Use the term in daily practice </li></ul></ul><ul><ul><li>Look for best evidence when evaluating new goals and programs </li></ul></ul><ul><li>Fundamental principles in EBC </li></ul><ul><ul><li>Evidence alone is never sufficient to make a clinical decision </li></ul></ul><ul><ul><li>Evidence-based care involves a hierarchy of evidence to guide decision making </li></ul></ul>
  13. 13. Challenges for Nurses <ul><li>Rapidly growing body of scientific literature </li></ul><ul><ul><li>No unaided human being can read, recall, and act effectively on the volume of material </li></ul></ul><ul><li>Literature is not in a form that is suitable for application to practice </li></ul><ul><ul><li>Needs to be evaluated and transformed in order to be useful </li></ul></ul>
  14. 14. Conducting Evidence Reports in Nursing <ul><li>Select problem </li></ul><ul><li>Review the evidence </li></ul><ul><li>Summarize the evidence </li></ul><ul><li>Report results </li></ul><ul><li>Make recommendations for potential clinical applications </li></ul><ul><li>Implement agreed-upon practice changes </li></ul>
  15. 15. Promoting Evidence-Based Best Practices <ul><li>The U.S. health care system does not have uniform definitions of what constitutes efficient, effective, quality health care </li></ul><ul><li>It is difficult to get all clinical health care providers to apply EBC processes at the unit level </li></ul>
  16. 16. Promoting Evidence-Based Best Practices <ul><li>EBC processes must be uniform enough to be valid, but also adaptable to specific needs of institutions </li></ul><ul><li>EBC requires involvement of and collaboration between clinical practitioners and health care researchers </li></ul>