evidence based nursing practice lecture 2.pptx

element of proof in nursing practices and procedures

1. Component and steps of evidence based practice Presented by Madeena Eljack

2. The key components of evidence-based practice in nursing: Research Evidence : EBP emphasizes the use of high-quality research evidence derived from systematic reviews, clinical trials, and other studies to inform nursing practice. This evidence is obtained from credible sources and is critically appraised to determine its validity and reliability. • Clinical Expertise : Alongside research evidence, EBP recognizes the importance of clinical expertise

3. Cont ,,, . Nurses bring their own knowledge, skills, and experience to the decision-making process. Their clinical expertise allows them to interpret and apply the research evidence to individual patients' unique situations. • Patient Preferences and Values : EBP recognizes the significance of incorporating patient preferences and values into the decision-making process. Nurses engage in shared decision-making with patients to understand their goals, values, and concerns. This collaborative approach ensures that care plans align with patients' needs and preference

4. Implementation and Evaluation EBP involves the implementation of evidence-based interventions and the evaluation of their effectiveness. Nurses work as part of interdisciplinary teams to apply evidence-based guidelines and protocols in clinical practice. They continually assess patient outcomes and adjust care plans based on the results .

5. Steps in the Evidence-Based Practice Process Formulating a Clinical Question : The first step in the EBP process is to develop a well-structured clinical question that addresses a specific clinical issue or problem. The question should be focused clear relevant to patient care. It often follows the PICO format: Patient/Population, Intervention, Comparison, and Outcome

6. Searching for Evidence: Once the clinical question is formulated, the next step is to conduct a comprehensive search for relevant research evidence. This involves accessing databases, such as PubMed or CINAHL, and using specific search terms related to the question. The goal is to identify high-quality studies, systematic reviews, or clinical guidelines that provide evidence to answer the question.

7. Appraising the Evidence: After finding the relevant evidence, it is important to critically appraise the studies to assess their methodological quality Validity applicability to the clinical question. This step involves evaluating the study design, sample size, data collection methods, statistical analyses, and potential biases. Critical appraisal tools, such as checklists or appraisal frameworks, can be used to guide the evaluation process.

8. Converting information needs into clear questions Art to Phrasing Questions An art to phrasing questions in such a way as to elicit a meaningful answer, there are three key reasons for focusing questions:

9. Facilitating the search for relevant evidence. The more explicit the question, the easier it is to run searches on electronic databases such as those contained within the Library shelves, CINAHL (Cumulative Index of Allied Health and Nursing Literature, or MEDLINE

10. A non-focused question is more likely to yield larger numbers of non-relevant studies than a focused question, and valuable search time will be wasted trying to sift through the long list of retrieved references for relevant studies

11. Sorting best evidence from weaker, less valid evidence Deciding whether the evidence is applicable to our patients The PICO (population, intervention, comparison intervention, out­come) framework, devised by Saekett et al (1997), is a useful method for making questions more focused. The question is built in four (or three) parts

12. PICO Frame P=Population or Problem , it may be necessary to specify age, gender, disease type, disease severity or co-morbidity. This will depend on whether the results of a very broad, inclusive population could be applied to your specific patient group Define who or what the question is about

13. PICO Frame I=Intervention : Define which intervention, test or exposure you are interested in. An intervention is a planned course of action. An exposure is something that happens such as a fall, anxiety. The intervention (or test or exposure) may need to be described in some detail to ensure clarity Describe what it is you are considering doing or what it is that has happened to the patient

14. PICO Frame C=Comparison intervention : Define the alternate intervention Describe the alternative that can be compared with the intervention Outcomes: Define the important outcomes, beneficial or harmful Define what you are hoping to achieve or avoid

15. PICO Frame O=Outcomes : very general outcomes may be difficult to measure, and details of how outcomes can be objectively measured may need to be specified