materi keperawatan kritis evidence_based Novita.pptx

materi keperawatan kritis evidence based nursing

1. EVIDENCE BASED PRACTICE IN NURSING Novita Kurnia Wulandari , M.Tr.Kep Jurusan Keperawatan Poltekkes Kemenkes Surakarta

2. Perawat Profesi Quality of care Improvement EBP

3. What is Evidence Based Practice? A process whereby research evidence, clinical knowledge and reasoning are used to make decisions about interventions that are effective for a specific client(s)

4. Apa Itu EBP? 🞇 Hasil penemuan riset yang telah diuji untuk membantu keputusan 🞇 Bertujuan meningkatkan pelayanan keperawatan

5. Mengapa Perawat Perlu EBP 🞇 Belajar dari Hasil Riset 🞇 Mengembangkan Prosedur 🞇 Mengembangkan Teknik 🞇 Menemukan Hal yang baru 🞇 Peningkatan Keselamatan Pasien

6. 500000 1000000 1500000 2500000 2000000 Trials Medical Articles per Year 5,000? per day 1,400 per day 55 per day BELAJAR DARI LITERATURE? MEDLINE BioMedical 2003 – one decade ago!

7. Apa Beda Riset dan EBP EBP BUKAN RISET TETAPI PENGGUNAAN HASIL RISET U PENGAMBILAN KEPUTUSAN DALAM ASUHAN KEPERAWATAN

8. Benefit of EBP Better outcomes for patients More efficient and cost effective health care Greater autonomy, professional credibility, accountability and satisfaction for nurses Demonstrates the value of what nurses do

9. Clinical assessment skills / expertise to properly identify the clinical problem Best evidence to address the clinical problem Knowledge of patient values to determine how / whether to apply the evidence to the clinical problem EVIDENCE NOT ENOUGH

10. Minimum Ketrampilan EBP Frame the clinical question Locate the best evidence Appraise the evidence (novice with guidance) Interpret the evidence Apply evidence

11. Steps in EBM process Formulate an answerable (searchable) question Track down the best evidence Critically appraise the evidence for its validity and clinical applicability Integrate with clinical expertise and patient values and unique biology 5. Change Practice 11 9/03/2014 Cheryl Waters

12. Asking Answerable Question Background Questions Basic understanding about the patient or disease Find the answers to background questions in textbooks Foreground Questions Specific questions about diagnosis, management, response or outcome Look for “best evidence” to answer

13. Pendekatan PICO 🞇 P = Problem or Population 🞇 I = Intervention (manipulated by reseacher/independen variabel) 🞇 C = Comparison Intervention 🞇 O = Outcome

14. AKSES FREE PERPUSTAKAAN NASIONAL

15. Evidence Pyramid

16. Sources for Clinical Practice Guidelines 🞇 Agency for Healthcare Research and Quality National Guideline Clearinghouse http://www.guideline.gov/ United States government source for national and international guidelines in English. Availability of versions in other languages noted. Provides structured summary and comparison tools. 🞇 Joanna Briggs Institute http://www.joannabriggs.edu.au/Best%20Practice%20Information%20Sheets Australian university- based institute to promote evidence-based nursing care. Best Practice materials now available by subscription only. 🞇 Ministry of Health Singapore Nursing Practice Guidelines http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/nurses /guidelines/cpg_nursing.html Also guidelines for physicians and allied health professionals with nursing implications. Recommendations available in “quick guide” formats.

17. Sources for Clinical Practice Guidelines 🞇 National Institute for Health and Care Excellence (NICE) http://www.nice.org.uk/#panel3 United Kingdom source for guidelines developed for the National Health Service. Includes NICE pathways, a graphic guideline search tool. 🞇 Registered Nurses Association of Ontario http://rnao.ca/bpg/guidelines/clinical Canadian best practice guidelines developed with funding from the Province of Ontario. Translations of selected guidelines into other languages (Chinese, French, Japanese, Italian, Spanish) sponsored by international partners. 🞇 World Health Organization http://www.who.int/publications/guidelines/en/index.html Guidelines with a global perspective, sometimes available in French or Spanish as well as English.

18. Barriers to EBP 🞇 Access and availability to information 🞇 Limited time 🞇 Lack of EBP skills 🞇 Confidence in the value of the evidence 🞇 Support from management ( The practice environment can be resistant to changing tried and true conventional methods of practice) 🞇 Lack of continuing education programs

19. Ways to Overcome barriers To EBP Full support from government and hospital Adequate time to critically appraise relevant & evaluate practice change through conferences, seminars, group meetings among others It is imperative for health care institutions to advocate 4. and require all nurses to update themselves with new trends and issue s based on evidence Establish translational research through adequate dissemination, oral presentation, publications, research and research seminars among others

20. Sources Adapted from David Sackett 1996 Selection of slides from a collection available on the Internet - Site for the Centre for Evidence Based Medicine http://cebm.jr2.ox.ac.uk/docs/downloads.html Some slides adapted from: Burns, S.K., Grove, N., & Stuppy, D.J (1999). Understanding Nursing research (2nd ed.) Philadelphia: Saunders (Instructors manual) DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence- based nursing: A guide to clinical practice St Louis: Elsevier. National Information Center on Health Services R esearch and Health Care Technology (NICHSR). (2008, 20/7/2007). HTA 101: Glossary

21. Thank You