Presentation on theme: "Taylor, ch 5. A step-by-step dynamic process used to solve clinical problems EBP solves problems by applying best research data, best clinical judgment."— Presentation transcript:
A step-by-step dynamic process used to solve clinical problems EBP solves problems by applying best research data, best clinical judgment and expertise, and objective and subjective information from pts Finding this research involves looking at previous research studies to see what the best practice is for a particular condition or procedure
The client is the focus of EBP It is our duty as nurses to make sure the patient is receiving the best care possible Nurses need to contribute to the body of knowledge that makes up best practices by conducting research of their own
Directs nurses toward a common goal Leads to improved patient care Provides rational and knowledgeable reasons for nursing actions Gives nurses knowledge base necessary for appropriate actions Helps resolve current nursing issues Prepares nurses to question assumptions and values Serves research, education, and practice
Nursing research which is: ◦ “A diligent and systematic inquiry to validate and refine existing knowledge, and generate new knowledge that influences nursing practice.” (Burns & Grove, 2007)
Improve care of people in clinical settings Study people and the nursing process Develop greater autonomy and strength as a profession Provide evidence-based nursing practice
Quantitative—involves concepts of basic and applied research Qualitative—gain insight by discovering meanings. Based on belief that reality is based on perceptions that differ for each person and change over time
State the problem Define the purpose of the study Review related literature Formulate hypothesis and variables Select research design Select population and sample Collect data Analyze data Communicate findings and conclusions
Steps are same until the data collection process Data collection involves gathering information from the same population sample over a specific time period It analyzes the effects of a variable on that group at different phases of the members’ lives
Must know and accept responsibility for: Asking questions Reading literature Understanding Critical thinking Synthesizing info Applying science
An orderly series of steps that allows a researcher to find the answer to a question ◦ Identify the problem ◦ Gather data ◦ Analyze data ◦ Use the findings ◦ Evaluate outcomes
What do you want to do? ◦ Improve practice? ◦ Update knowledge? ◦ Validate a policy or procedure? ◦ Plan a new program or intervention?
P = Patient, population, or problem I = Intervention being considered C = Comparison of interest (old or new) O = Outcome wanted
“In a 55-year-old man with a 35-year-old history of chronic smoking, would the administration of bupropion as compared to a nicotine replacement therapy (NRT) be a better therapy in causing long-term abstinence from smoking?” Can you identify each PICO component?
Run a subject search thru Medline or CINAHL Consider hospital policies and procedures Clinical expertise Cost Chart reviews Patient preference
Which research applies best? How strong or weak is the research? Is this research relevant to the clinical situation?
Apply what you learned from the evidence Include clinical experience Include patient preferences
Did the application of your evidence improve the patient outcomes? If not, go back to one of the earlier parts of the process and start over, if necessary
Data: 9 randomized controlled clinical trial study used to address the problem of surgical site infections, CAUTIs PARTICIPANTS: Adults receiving topical antisepsis prior to surgery, blood cultures, and vascular catheter insertion INTERVENTIONS: Chlorhexidine gluconate COMPARISONS: Povidone-iodine OUTCOMEzation, catheter-related sepsis RESULT: The use of chlorhexidine for skin antisepsis, instead of povidone-iodine, would result in significant reductions in hospital-acquired infections
The positive outcomes from EBR can improve the overall performance of an institution The Quality Improvement department of the institution focuses on the continuing process of creating positive patient outcomes Part of the department includes Risk Management whose efforts are directed toward preventing errors in patient care
These reports contain information about circumstances involving errors in patient care that either led to or could lead to injury The report is not to be placed in the patient’s chart, but does become part of Risk Management and is used to track and prevent errors
Complete name of person and names of witnesses Factual account of incident Date, time, and place of incident Pertinent characteristics of person involved Any equipment or resources being used Any other important variables Documentation by physician of medical examination of person involved
This accrediting agency promotes quality in institutions by requiring them to meet Accountability Measures or standards of care for various patient conditions Meeting these measures and standards helps maintain quality of patient care These measures are based on evidence that the interventions are effective
Unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof Serious injury specifically includes loss of limb or function The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. JCAHO tracks these events in an effort to maintain quality patient care
NPSGs have come about based on the types of sentinel events that have occurred. The NPSGs are also part of Risk Management and Quality Improvement
A process that looks at the reasons that any error or “near miss” situation occurred There is usually more than one reason thus avoiding the “blame game” Root cause analysis transforms an old culture that reacts to problems to a new culture that solves problems before they escalate; thereby improving institutional and personal performances.