Evidence- based practice

What is Evidence- based practice?

• Application of research findings to practice

  • Best evidence is obtained and translated into direct client care

• EBP improves overall client outcomes

What are the benefits of EBP?

• Efficiency in obtaining evidence

• Improves client outcomes

• Standardized care based on solid research

• Quality of care improves

• Increased safety in health care

• Decreased health care costs

Whta are the steps to EBP?

• Ask – Pose a clinical question

• Collect – Gather evidence

• Analyze – Investigate and categorize evidence

• Integrate – Combine experience with new research

• Implement – Alter practice based on research

• Evaluation – Assess changes in practice

• Disseminate – Share knowledge with others

PICOT question?

• Focused way to ask question that addresses a clinical issue

  • P – Patient or Population

  • I – Intervention or Indicator

  • C – Compare or Control

  • O – Outcome

  • T – Time or Type

What are the levels of evidence?

• Level 1: Systematic review or meta- analysis (strongest)

• Level 2: At least one RCT

• Level 3: Controlled trials without randomization

• Level 4: Case-control or cohort studies

• Level 5: Systematic reviews of descriptive/qualitative studies

• Level 6: Single descriptive/qualitative study

• Level 7: Expert opinions (weakest)

How is evidence evaluated?

• Quality

  • Strength of evidence

  • What level is the evidence?

• Quantity

  • Amount of evidence available

• Consistency

  • Similarity in findings across different studies

What are the barriers to EBP?

• Decreased database access

• Lack of knowledge about EBP

• Lack of time

  • Nurses have high workloads already

• Limited access to resources

• Organizations that do not encourage EBP

• Have to get approval from IRB

What are the goverment resources for EBP?

• CDC

  • Promotes overall health of public

  • Provides evidence and guidelines for practice

• NIH: Office of Disease Prevention

  • Addresses research needs and gaps

• State and local health departments

  • Provide resources and statistics for best practice

What are the nonprofit resources for EBP?

• Cochrane

  • International organization of researchers

  • Locate and synthesize research for practice

• NHSPI

  • Addresses nation’s health security and preparedness level

• County health rankings

  • Community data available to the public

  • Can be used to guide change

What are the goals of healthy people 2030?

• National plan to improve health outcomes in U.S.

• Goals

  • Disease prevention

  • Eradication of health disparities

  • Improve health equity

  • Improve overall health of Americans

• Provides many EBP resource

What is quality improvement v assurance?

• Quality improvement

  • Implementing processes with less variation

  • Improves client outcomes

  • Positively impacts health care systems

• Quality assurance

  • Process for watching/evaluating a service or agency

  • Ensures standards are met to improve quality

What is the quality improvement frameworks (PDSA model)?

• PDSA Model

  • P – Plan the change

  • D – Do it (carry out the proposal)

  • S – Study the new outcomes

  • A – Act (make the change sustainable)

What does accreditation do for hospitals?

• National standards of care implemented

  • Hospitals, health departments, colleges, etc.

• Improve the quality of care provided

What is the community-engaged research?

• Investigates community health issues

• Focuses on community involvement in research process

• Begins with a thorough assessment of the community

• Ethical issues

  • Confidentiality

  • Need for education