Excellence in Nursing Practice Through Research, EBP & Application to Bedside Patient Care...
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Excellence in Nursing Practice Through Research, EBP & Application to Bedside Patient Care Chesapeake Bay Society of PeriAnesthesia Nurses Saturday, February 8 th , 2014 Kim A. Noble, PhD., RN, CPAN © Copyright Kim A. Noble; use prohibited without permission
Transcript of Excellence in Nursing Practice Through Research, EBP & Application to Bedside Patient Care...
Excellence in Nursing Practice Through Research,
EBP & Application to Bedside Patient Care
Chesapeake Bay Society of PeriAnesthesia NursesSaturday, February 8th, 2014Kim A. Noble, PhD., RN, CPAN
© Copyright Kim A. Noble; use prohibited without permission
Objectives
Following participation in this lecture, the learner will:Discuss the steps in the EBP process;Describe examples of EBP changes in
perianesthesia nursing;Develop, compare and refine a PICOT
question.
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A Little History…
A paradigm shift…Moved from an age of experts,
wisdom and experience…To evidence…
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A Little More History…
Nursing educationDiploma entry ADNBSN entry
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Final History…
Medical research history…Archie Cochrane (1909-1988)
Effectiveness and Efficiency: Random Reflections on Health Sciences (1972)
Evidence Based Medicine (1992)
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A History of Nursing Research
1900: AJN first published; 1923: First doctoral program in nursing at Teachers College:
Columbia; 1929: First masters program in nursing: Yale; 1950: ANA conducted study of nursing that led to 1959 first
standards; 1952: Journal of Nursing Research established; 1960-1970’s: Nursing models researched; 1970: ANA Commission on Nursing Research; 1970’s: Research added to BSN curriculum; 1972: Cochrane EBP established; qualitative research begins; 1980: First nursing research received federal funding. 1986: Nursing research included in NIH; 1993: NINR
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Evidence Based Practice
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What is Evidence Based Practice (EBP)?
The Same as research….Based in research…But also Different from research…
http://guides.mclibrary.duke.edu/content.php?pid=431451&sid=3529499©
Look Closer at EBP
A foundation in Critical ThinkingExplosion of journals
http://sundayresources.net/neil/2013/01/03/evidence-based-practice-in-the-church-2/
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Why Evidence?
http://www.nsttac.org/content/evidence-based-practices©
Why EBP Now?
Why is nursing evidence so important:High visibility of quality and safety
movement;Tremendous growth of new knowledge;Identification of delay in application of new
evidence;Decline in best-care knowledge for pt care;Tremendous consumer pressure.
White & Dudley-Brown, 2012, p. 4-5.
EBP Process Begins with Ideas
Come from your experience:Sacred cows?Questions?Ideas?
Guide practice change.Base nursing practice on
research findings;As the name implies… ©What is YOUR
question?
Your Idea Leads to a Question: PICO(T)
The Question guides the process.
Define your question:P: Population.I: Intervention.C: Comparison.O: Outcome.T: Timing. ©
So…Where Do We Start?
Begin with a question…
Your assignment…
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Let’s Look at the Question: PICOT: Population
P:PopulationGenderEthnicityDisease
Think about…
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PICOT: Intervention
I: Intervention (Indicator):Disease exposureRisk behaviorPrognostic factor
Think about…
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PICOT: Comparison
C: Comparison (Control)Placebo“Normal” TreatmentNo diseaseNo risk
Think about…
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PICOT: Outcome
O: Outcome:Risk of diseaseAccuracy of DiagnosisRate of occurrence
Think about…
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PICOT: Timing
T: Timing:Time for outcomeLength of study__# of sample
Think about…
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Types of Questions
Therapy/Intervention: In __, what is the effect of __ on __ compared
with__ within __? Etiology Diagnosis Prevention Prognosis/Prediction Meaning
P
T
I O
C
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The Question Forms the Literature Review
Keywords.Exclusion & inclusion criteria.Search:
CINHAL, Medline, Cochrane, JBI.
Records.
©YOUR new best friend!
Research Review
Challenging!Strategies:
Spread the terror.Consistency (tools). Practice improves ease.Mentoring process.
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Review Consensus
“Many hands makes light work.”This case many eyes.Discuss the research.Consensus for ranking of research
evidence.
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Practice Recommendations
Translation of research practice.
EBP recommendations answer your question.
Process can be used to guide policy.
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Boswell, C. & Cannon, S. (2007). Introduction to Nursing Research: Incorporating Evidence-Based Practice, Sudbury, MA: Jones & Bartlett.
Malloch, K. & Porter-O’Grady, T. (2006). Introduction to Evidence-Based Practice in Nursing and Health Care, Sudbury, MA: Jones & Bartlett.
White, K. M. & Dudley-Brown, S. (2012). Translation of Evidence Into Nursing and Health Care Practice, New York: Springer.
References
