Exploring the Science of Evidence Based Nursing. Presented by Geneva Craig, PhD, RN

Transcription

1 Exploring the Science of Evidence Based Nursing Presented by Geneva Craig, PhD, RN

2 Exploring To make a careful investigation or study of something Making a careful search Searching for the purpose of discovery

3 Science A systematically organized body of knowledge about a particular subject Methodical activity = a step by step Methodical activity = a step by step procedure

4 Evidence Sign or proof to support something The data on which a conclusion or judgment may be based

5 Evidence Based Nursing Is it research? Does technology affect it? What does it require? Why is it important?

6 Importance! Nursing is a unique discipline that contribute to care outcomes Centered on nurses partnership with the Centered on nurses partnership with the patient & community

7 Definition evidence-based nursing, the practice of nursing in which the nurse makes clinical decisions on the basis of the best available current research evidence, his or her own clinical expertise, and the needs and preferences of the patient. Mosby's Medical Dictionary, 8th edition. 2009, Elsevier.

8 Best Evidence to make Decisions Comes from a thorough search of the nursing literature for articles and other publications that cover nursing research and that apply to a patient s problem The evidence is dependable and clinically applicable to the patient s current problem

9 Evidence Based Nursing involves a process: Crafting a clinical question Searching the nursing literature Selecting the best studies Critically evaluate the studies Apply the results to the patient

10 A Clinical Question Is specific and focus is on a knowledge gap about a particular treatment for a patient with a specific disorder. The question is carefully constructed so that the clinician can find as many articles on the topic as possible

11 Crafting a Clinical Question Acronym known as PICO P = patient or population I = intervention C = comparison (of some action to the intervention or lack of intervention) O = outcome

12 Learn About Components of a Clinical Question Visit the website for a breakdown of components Manuals Craig, J.V. & Smyth, R. L. (2002). Evidence based practice manual for nurses. Philadelphia: Churchill Livingston. Polit, D. & Beck, C. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Philadelphia: Lippincott Williams & Wilkins.

13 Examples In mechanically ventilated patients (P), how does a weaning protocol (I) compared with no weaning protocol (C) affect ventilator days (O)... Taken from: Stillwell, et al. Evidence- Based Practice Step by Step. AJN 2010; 110 (3):

14 Examples Continued In hospitalized adults (P), how does hourly rounding (I) compared with no rounding (C) affect fall rated (O)? Taken from: Stillwell, et al. Evidence- Based Practice Step by Step. AJN 2010; 110 (3):

15 Search the Literature Sophisticated Technology + Sophisticated Databases = Immense quantities of Information

16 Select the Best Studies Most respected methods for critiquing scientific information (methodologically rigorous) Meta-analyses Systematic reviews

17 Meta-analyses = quantitative methods Combination of many trial results a method designed to increase the reliability of research by combining and analyzing the results of all known trials of the same product or experiments on the same subject

18 Systematic reviews of randomized controlled trials descriptive combination of the data carried out in a methodical and organized manner generalize results across a comprehensive number of valid studies

19 Select the Best Studies Has the method been tested? Has it been subject to peer review? Is it linked to distinct standards? Is there broad approval by nursing s scientific community?

20 The better the studies that are related to your clinical question the stronger the evidence Then ask, is it applicable to the patient

21 Besides Improved Results for Patients Standard of care Legal Insurance Government Accreditation

22 Rule 702 of the Federal Rules of Evidence provides: [A] witness qualified as an expert may testify... if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case.

23 HHS Awards $475 Million in Patient- Centered Outcomes Research Funding AHRQ announced the award of $473 million in grants and contracts for a portfolio of coordinated projects designed to support patient-centered outcomes research, also known as comparative effectiveness research, which will help people make health care decisions based on the best evidence of effectiveness

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25 2 Essential Features of Professional Nursing Integration of objective data with knowledge gained from an appreciation of the patient s or group s subjective experience. Application of scientific knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking. ANA s Nursing Social Policy Statement

26 References What is evidence-based practice? Cullen L; Adams S; Journal of PeriAnesthesia Nursing, 2010 Jun; 25 (3): CINAHL AN: Database: CINAHL Plus with Full Text Evidence-Based Nursing, 2010 Apr; 13 (2): 44 (journal article) ISSN: PMID: CINAHL AN:

27 References Engage nurses in EBP with the nursing clinical question process. Pangarakis S; Graner T; Nursing Management, 2010 Jun; 41 (6): 15-7 CINAHL AN: Database: CINAHL Plus with Full Text Pick up some research to go!. Twibell, R; Siela, D., et al; American Nurse, 2010 Jul; 5 (7):