1. Nursing Research Council © 2008 ABC’s of EBP Easy Exchanges in Evidence Based Practice Education Session IV: February 2008

2. Nursing Research Council © 2008 Using Evidence Based Resources

3. Nursing Research Council © 2008 Steps in Evidence Based Practice 1.Ask the burning clinical question. 2.Collect the most relevant and best evidence. 3.Critically appraise and synthesize the evidence. 4.Integrate all evidence with one's clinical expertise, patient preferences and values 5.Evaluate the practice decision or change

4. Nursing Research Council © 2008 Using PICO  P  P atient/population of interest Particular characteristic (e.g., age; special subgroup) Setting  I  I ntervention of interest Define Focus search  C  C omparison of interest Another treatment Usual standard of care  O  O utcome of interest May be more than one!

5. Nursing Research Council © 2008 In elders with hip replacement, is a combination of low molecular-weight heparin and pneumatic compression more effective in reducing the incidence of deep vein thrombosis than pneumatic compression therapy alone? Clinical Question

6. P = I = C = O = Elders w/ hip replacement LMW Heparin + Pneumatic Compression  Incidence of DVT In elders with hip replacement, is a combination of low molecular-weight heparin and pneumatic compression more effective in reducing the incidence of deep vein thrombosis than pneumatic compression therapy alone? Nursing Research Council © 2008

7. Evidence Based Resources Regular vs. Premium Databases (CINAHL, MEDLINE/PubMed :  Cover a broad range of the nursing and medical literature. Some of this is research/evidence based, but not all. Evidence Based Resources – Value-Added :  Offer a synthesis or summary of the current evidence  Evaluate the quality of the research  Make recommendations for practice Nursing Research Council © 2008

8. Steps in Evidence Based Practice 1.Ask the burning clinical question. 2.Collect the most relevant and best evidence. 3.Critically appraise and synthesize the evidence. 4.Integrate all evidence with one's clinical expertise, patient preferences and values 5.Evaluate the practice decision or change

9. Evidence Based Resources  Available through Miner OnlineMiner Online Cochrane Database of Systematic Reviews Essential Evidence Plus Best Evidence UpToDate & PIER Journals that summarize primary research, including: Evidence Based Medicine (ACP Journal Club) Evidence-Based Nursing Evidence-based Complementary & Alternative Medicine Nursing Research Council © 2008

10. Evidence Based Resources  Available on the Internet – Free! National Guidelines Clearinghouse Health Services Technology/Assessment Texts AHRQ’s Evidence Reports Guide to Clinical Preventive Services Briggs Institute for Evidence Based Nursing RNAO Clinical Practice Guidelines NYS Dept. of Health - Clinical Guidelines NYS Dept. of HealthClinical Guidelines National Institutes of Health Use the search box to look for "practice guidelines" or "clinical guidelines." Nursing Research Council © 2008

11. Evidence Based Resources  Professional & Other Organizations (Fee) AACN (Am. Assoc. of Critical-Care Nurses) AACN (Am. Assoc. of Critical-Care Nurses) Links to standards of care and other clinical practice information. Includes both free and "member-only" information, as well as links for purchasing published standards. AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) Includes a list of the AWHONN-published evidence-based practice guidelines which are available for purchase. Summaries of the guidelines are available through the NGC by searching on "AWHONN." Oncology Nursing Society Includes information on evidence-based practice, as well as the Evidence-Based Resource Area, intended to: "provide nurses with a guide to identify, critically appraise and use evidence to solve clinical problems" and to "assist nurses...in developing evidence- based practice protocols." Evidence-Based Resource Area Nursing Research Council © 2008

12. ABCs of EBP Easy Exchanges on Evidence Based Practice Session V: Integrating Evidence into Practice Tuesday, March 25, 2008 7:45 a.m. & 2 p.m.