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Nursing Program - RN Information Literacy: Evidence Based Nursing Practice

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

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.

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

Searching CINAHL Tutorial

Image: Links to YouTube video on CINAHL

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?

 

Evidence Based Medicine - Primary Literature

EBM levels image, pyramid of evidence

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