Evidence Based Practice in nursing Research

Definition, process objective and purpose of EBP, Also including Model & their Barriers.

1. INTRODUCTION

o Evidence based practice is an approach that enables
clinicians to provide the highest quality of care in
meeting the multiphase needs to their parents and

family.

2. DEFINITION

o Evidence based practice (EBP) is the process of making
clinical decisions based upon evidence, combined with
clinical experience and patients expectations.

o Evidence based practice is the conscientious explicit and
judicious use of current. Best evidence in making decision
about the care of individual patients. The practice of evidence
based medicine means integrating individual clinical
expertise with the best available external clinical evidence fro
systematic research.

(Sackett. et al 1996)

3. PROCESS OF EBP

Clinical
expertise
Best Patient
research values and

evidence preferences

4. oo

000%

AIMS OF EBP

To provide the high quality and most cast efficient
nursing care possible.

To advance quality of care provided b health worker.
To increase satisfaction among patients,

To focus on nursing practice away from habits and
tradition to evidence and research.

It results in better patient outcomes.

It contributes to the science of nursing.

It keeps practice current and relevant.
Itincreases confidence is decision making.

5. OBJECTIVES AND PURPOSES OF EBP

o Evidence based practice seeks to replace practice as usual
with practice guided by rigorous outcomes oriented research
ideally randomized controlled trials.

o It also seeks to make practice a less subjective enterprise
and to rise it to a higher level of accountability.

o Reduces the variations in nursing care and assist with
efficient and effective decision making.

o Providing practice to the nurse evidence based data to
deliver effective care. $

6. NEED FOR EBP

o For making sure that each client get the best possible

services.
o Update knowledge and is essential for lifelong learning.
o Provide clinical judgment.
o Improvement care provided and save lives

o To provide framework for understanding the evidence

based practice process.

7. STEPS OF EVIDENCE BASED PRACTICE

— 1E

Applying the
evidence

8. STEP 1 IS BASED ON PICO :-

« The patient population of interest
» Intervention of interest or range of
intervention.e.g. exposure and risk behavior

« Comparison of intervention e.g, no
intervention.

« Outcomes of interest e.g. accuracy of
diagnosis risk of disease

9. MODELS FOR EVIDENCE BASED PRACTICE
1. The steler model
2. IOWA model

3. Ross worm and lama bee model

10. 1. STELTER MODEL

o It was developed as practitioner oriented model in 1994.

o It was revised in 2001 without changes in its focus on
critical thinking.

o It raised awareness about the importance of applying
research finding in nursing practice.

Meaning of evidence as per stelter model:-

Evidence is define as information or facts that are obtained
systematically evidence comes from two different sources

1. External evidence
2. Internal evidence @

11. CONT...

« Derived from opinions
of concepts.

« Comes from the experts
own experiences.

External
evidence

* It comes from
Internal systematically obtain

: facts or information at
evidence ground level.

12. STELTER MODEL

Phase 4

Translation
application

13. 2. IOWA MODEL

o Successfully implanted since 1994 intervention ally.
o Infuses research into practice to improve quality of care.

o Planned change principles integrated research and
practice.

o Utilizes a multidisciplinary team approach.

Highlights of the models :-

© itincorporates the use of research and other forms of
evidence.

o Interference to support research use might involve every
level of the organization.

o Evidence based practice is linked to quality assurance. @

14. CONT...

o Staff are given recognition for research work.
o Clinicians are given time and resources for research work.

o This model explains how organizations changes practice
based on research.

o It gives a systemic design.

o Itincludes both the practitioner and organizational
perceptive.

o It provides guide for regarding implementation of evidence

based practice.

15. IOWA MODEL BARRIERS TO USING

RESEARCH IN NURSING

16. 3. ROSS WORM AND LAREE MODEL

o Develop by rossworm and larabee in 1999, it is based
on theoretical and research literature.

o It begins with the assessment of need and integration
of an evidence based protocol.

o Focuses on the use of change theory, principles of

research and standardizations nursing nomenclature.

17. STAGES OF ROSSWORM AND LARABEE
MODEL

18. BARRIERS TO EBP

o Lack of value for research in practice.
o Difficulty in bringing change.

o Lack of administrative support

o Lack of knowledge.

o Lack of time for research.

o Many nurse have not receive any formal instruction in

research and they lack skill to judge the merits of study.

19. CONT...

o Unavailability of research reports, which are not easily
gathered.

o Complexity of the research regarding evidence based
practice.

o Organization have failed to motivate or rewards.

o There is a shortage of role models nurse who can be
evaluated for their success in using or promoting the use

of research in clinical practice.

20. ADVANTAGES OF EBP

o Information explores

o Provide better patient outcomes.

o Ebp increases the efficiency of nurses.

o Making decision based on knowledge that is backed by
research.

o It keeps nursing practice current to the new trends and

updated guidelines of care.

21. CONT...

o It provides variations in practice because it can help
determine high quality cast effective intervention that
actually work.

o It promotes high quality and cast effective
intervention and treatment.

o Using EBP to provide care to patients increases the

nurses confidence.