What is EBP
"The integration of the best research evidence with clinical expertise and patient values." (Sackett, Straus, Richardson, Rosenberg & Haynes, 2000)
5 Steps in the EBP Process:
Models of Evidence-Based Practice
Iowa Model
Originally developed as a research utilization model at the University of Iowa Hospitals and Clinics, has been revised to focus on implementation of EBP at the organizational level (Titler et al. 2001).
1. Identify practice questions (problem-focused or knowledge-focused ‘triggers’)
2. Determine whether or not the topic is an organizational priority
3. Form a team to search, critique, and synthesize available evidence
4. Determine the sufficiency of the evidence (if insufficient, conduct research)
5. If evidence base is sufficient and the change appropriate, pilot the recommended practice change
6. Evaluate pilot success and if successful, disseminate results and implement into practice
- The Iowa ModelA description of how the Iowa Model of evidence-based practice works, with some examples of how it has been used in nursing research.
Library Databases for Primary Medical Literature
In both the PubMed and CINAHL databases, you can limit your searches to find only original research from peer-reviewed journals.
In PubMed, you can attempt to limit to 'free full-text' availability, however it doesn't always filter for only free content.
- PubMedMay apply filters after an initial search.
Evidence-based nursingEvidence-Based Nursing systematically searches a wide range of international medical journals applying strict criteria for the validity of research and relevance to best nursing practice. Content is critically appraised then the most relevant articles are summarised into a succinct expert commentary focusing on the papers key findings and implications for clinical practice.
Study Design Types
|
Type of Question-will lead you to the best study design. (information needed about: ) |
Type of Study |
|
Therapy: treatments |
Randomized Controlled Trial Cohort Studies Case Control Case Series |
|
Diagnosis: diagnostic test (sensitivity, accuracy, etc.) |
Controlled Trial |
|
Prognosis: course of disease over time, expected complications, etc. |
Cohort Studies Case Control Case Series |
|
Etiology: causes of disease or contributing factors |
Randomized Controlled Trial Cohort Studies Case Control Case Series |
|
Prevention: prevention of disease (immunization, social factors, etc.) |
Randomized Controlled Trial Cohort Studies Case Control Case Series |
|
Quality Improvement: clients’ and health professionals’ concerns |
Randomized Controlled Trial |
- Evidence-based Medicine Resources-Duke UniversityDescriptions of evidence-based resources, common types of questions, and types of study designs.
- Study Designs-Centre for Evidence-Based MedicineArticle gives a brief guide to the different study types and a comparison of the advantages and disadvantages.
Searching CINAHL Tutorial
Building a PICO(T) Question
PICO(T) (population, intervention, control, outcome, time) is a strategy for creating a research question.
P=Patient or problem-addressing a specific population, its important characteristics and demographic information.
I=Intervention or treatment of interest- the intervention can be a treatment, procedure, diagnostic test, and risk or prognostic factors.
C=Comparator or control-when a new therapy is compared to the current.
O=Outcome-is the effect of the intervention.
(T)=Time-to achieve the outcome or how long patients are observed; duration the data was collected (This element is not always included, which is why it is in parenthesis).
PICO examples:
|
P |
I |
C |
O |
|
In adults with cancer |
what are the current treatments |
|
in the management of fever and infection? |
|
In patients with acute bronchitis, |
do antibiotics |
none |
reduce sputum production or cough? |
|
Infants |
premature |
full-term |
lung problems? |
- PICO LinguistIt uses PICO’s interface, which has a fill-in-the-blank interface for specifying a condition or disease, a single intervention or treatment, multiple interventions or treatments that are to be compared (optional), and an outcome (also optional), plus a dropdown menu for selecting publication type from among clinical trial, meta-analysis, randomized controlled trial, systematic reviews, reviews, and practice guideline or, if none is specific, any of the above.
Evidence Based Medicine - Primary Literature
Learning Outcomes
Learning Outcomes:
- Students will be able to search for, locate and access primary, scholarly literature on a health topic
- Students will be able to identify higher levels of clinical evidence, such as controlled trials, and explain the purpose of clinical research
- Students will be able to apply PICO questions to searches of clinical literature
Related RN Program Outcomes:
- Implement one's role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving professional identity as a nurse committed to evidence-based practice, caring, advocacy and quality care (Nursing Intermediate Clinical Practice)
- Use information and technology to communicate, manage data, mitigate error, and support decision-making (Nursing Intermediate Clinical Practice)
Qualitative vs. Quantitative Research
