Medhin Kahsay RN,BSN. MN519 Evidence based practice Project Seminar Presentation. 03/02/09 NUR 310 Students

OBJECTIVES Explain the difficulties of applying evidence based practice in clinical settings. Identify the barriers to research, evidence based practice in nursing. Describe the three competence of evidence based practice. Explain the evidence uses best evidence.

OBJECTIVES Explain how every nurse plays a role in using research evidence. Describe the five fundamental step of evidence based practice. Explain the format that formulates evidence based practice.

Learn from the Beger(1999) Quote “Nursing research is only an academic exercise unless the facts and theories produced are employed by practicing nurses” Beger ,W.(1999). Fundamentals of Nursing. 2nded Appleton & Lange: Connecticut.

Evidence Based Practice Why is it difficult as a practicing clinician to conduct research and apply research findings to the clinical setting? What are the strategies to encourage evidence-based nursing care?

Evidence Based Practice EBP has been recognized: By the healthcare community &Regulatory agencies. As a Gold standard for the provision of safe and compassionate health care.

BARRIERS TO RESEARCH EVIDENCE-BASED PRACTICE IN NURSING Research-related barriers Nurse-related barriers Organizational barriers Barriers related to the nursing profession Polit ,B.(2006). Essential of Nursing Research: Methods, Appraisal, and Utilization.6thed. Lippincott Williams and Wilkins, Philadelphia.

The most common barriers of practicing nurse As explained by Burns & Grove(2006), the nurse barriers are as follows: lack of expertise unaware of findings unaware of guidelines that developed for practice unwilling to change current practice do not value the use of research to change practice belief changing practice based on research will benefit minimal.

Nurse Related Barrier Every nurse plays an important role in using research evidence. A nurse should: Read widely and critically. Attend professional conferences. learn to expect evidence that a procedure is effective. Become involved in a journal club. Pursue and participate in RU/EBP projects.

Evidence based practice Three important areas of research competence are: (1) interpreting and using research, (2) evaluating practice, and (3) conducting research.

Evidence uses best Evidence Scientific knowledge from randomized clinical trials. Observational studies . Expert opinion Expert consensus

Evidence Based practice Houser, J.(2008).

Evidence based practice The risks, benefits, and costs should be thoroughly documented before findings are introduced in the practice. The study should address an important clinical problem. Clinical problem addressed in the study should or fall within the reader’s nursing specialty open of practice.

Evidence based practice The practice of Evidence-Based Practice includes five fundamental steps. Step 1: Formulating a well-built question Step 2: Identifying articles and other evidence-based resources that answer the question Step 3: Critically appraising the evidence to assess its validity Step 4: Applying the evidence Step 5: Re-evaluating the application of evidence and areas for improvement.

Why do care identifying research barriers Identifying barriers to using research findings in practice can: Promotes communication Communicate researchers, practicing nurses & administrators. Can facilitate Evidence based practice in health care organizations. Burns & Groove(2006).

Evidence Based Practice The format that defines Evidence based practice is PICO. “PICO” defines as: P=Population I= Intervention C= Comparison O= Out come. Burns & Grove(2006)

Why Use EBP? Advances quality of care provided by nurses. Increases satisfaction of patients. Refocuses nursing practice away from habits and tradition to evidence and research.

Evidence Based Practice EBP has repeatedly been show to improve patient outcomes(Joint Commission,2006). The Joint Commission (2008): Supported the implementation of EBP in nursing EBP a means of improving healthcare system.

Barriers to research utilization Major barrier to research utilization is the absence of published research on specific clinical issues. Nurses may lack experience reading and critiquing research reports. May have difficulty interpreting study designs and statistical findings.

Continued Many of today's experienced staff nurses Did not study research during their basic nursing programs . Have not had opportunities to do so through continuing education programs. The education barriers often are compounded by administrative barriers (e.g., lack of time, money, clinical resources) that thwart research utilization activities

Evidence based practice includes Best evidence, clinician expertise and judgment. patient preferences are integrated and aligned in making therapeutic. plans and treatment decisions.

Evidence based practice Staff nurses are at the fortunate position in bringing research based changing in clinical practice. The first step to overcoming barriers to EBP Assessing and identifying the obstacles to evidence-based care. Strengthen beliefs about the benefits of evidence-based care.

FACILITATORS OF RESEARCH UTILIZATION (Summary) Identification of clinically relevant problems and issues are most crucial. Other facilitating factors include environments in which individuals are committed to critical thinking and to the research utilization process.

Tell your story Do you have a research story. Listen to your patients Reflect on the care you provide Ask your self if you could do something even better Investigate it Write about it so others can read.

Reference Beger , W.(1999). Fundamentals of Nursing. (2nd Ed). Connecticut: Appleton & Lange. Beyea, S.& Nicoll, L.(1997).Barriers to &Facilitators of research utilization in peri operative Nursing practice. AORN journal Burns, N.,& Susan, G.(Ed.). (2005). Practice of Nursing Research: conduct, Critique, and Utilization.(5th Ed). Saunders. Houser, J.(2008). Nursing research. Reading, Using & creating Evidence. Jones &Bartlett. Levin, R. & Feldman, H.(2006). Teaching Evidence-Based practice in Nursing. Spring: New York. Polit DF., & Beck CT(2006). Essential of Nursing Research: Methods, Appraisal, and Utilization. (6th Ed). Philadelphia, PA. Lippincott Williams and Wilkins,