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Chapter 1: Problem 1

Place the steps of evidence-based practice in the correct order: 1 _________ Search the literature for evidence. 2 _________ Evaluate outcomes of the practice change. 3 _________ Communicate the findings. 4 _________ Apply evidence in making a practice change. 5 _________ Ask a PICOT question. 6 _________ Critique the available evidence.

Short Answer

Expert verified
The correct order is: 5, 1, 6, 4, 2, 3.

Step by step solution

01

Identify the Starting Point

Begin by identifying the need or problem that requires investigation. This is done by formulating a PICOT question, which stands for Population, Intervention, Comparison, Outcome, and Time. This step guides the entire process by focusing the inquiry.
02

Gather Information

Once the PICOT question is developed, the next step is to conduct a comprehensive search of the literature for evidence. This involves looking for existing research studies, articles, and papers that address the PICOT question.
03

Analyze the Findings

With the evidence gathered, the next step is to critique the available evidence. This involves evaluating the quality and relevance of the research to ensure it is reliable and applicable to the question.
04

Implement the Evidence

After critically appraising the evidence, the next step is to apply the evidence by making a practice change based on the findings. This involves using the best available evidence in clinical practice.
05

Measure Impact

Once the practice change has been applied, it is important to evaluate the outcomes of the practice change. This involves assessing whether the changes have had the desired effect on outcomes.
06

Share Results

Finally, communicate the findings of the practice change and its outcomes. This step ensures that information is shared with relevant stakeholders and contributes to broader knowledge within the practice community.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

PICOT question
A PICOT question forms the foundation of evidence-based practice. It helps to identify a clear, focused clinical inquiry that guides the entire research process. PICOT is an acronym where each letter stands for an element of the question:
  • P - Population: Who are the patients or the population that will be focused on?
  • I - Intervention: What is the main intervention or therapy considered?
  • C - Comparison: Is there an alternative treatment to compare?
  • O - Outcome: What outcomes are expected to be observed?
  • T - Time: What is the duration to achieve the outcome?
Each part of the PICOT question is important to guide research effectively. Formulating a well-structured PICOT question ensures that the evidence gathered is relevant and specific to the healthcare need.
Literature search
Once the PICOT question is formulated, the next critical step in evidence-based practice is conducting a literature search. This means finding existing research that addresses your PICOT question. When performing a literature search:
  • Start Broad: Look at a wide range of resources, including databases, journals, and conference papers.
  • Use Keywords: Utilize keywords from the PICOT question to better target the search.
  • Screen Abstracts: Review abstracts to determine which articles may be most helpful.
  • Access Full Texts: Read complete articles that appear relevant to gather comprehensive data.
The literature search is vital for obtaining evidence that helps to understand how the intervention can impact the specified patient population.
Critique evidence
Having collected the evidence, it is crucial to critique or evaluate its quality. Critiquing evidence involves assessing its reliability and applicability:
  • Check Validity: Is the study designed correctly? Ensure that the methodology is sound.
  • Analyze Relevance: Does the evidence directly relate to the PICOT question?
  • Consider the Source: Who authored the study, and where was it published? Credibility matters.
  • Review Results: Are the findings significant and applicable to practice?
A critical evaluation of evidence ensures that only high-quality, relevant data influences practice changes, reducing the risk of implementing ineffective strategies.
Practice change
After critiquing the evidence, the next step is to implement a practice change. This means applying the findings to real-world clinical settings:
  • Develop a Plan: Outline a detailed plan for integrating new practices.
  • Educate Staff: Ensure that all team members understand and support the change.
  • Implement Gradually: Introduce changes in phases to manage transition smoothly.
  • Monitor the Implementation: Keep an eye on how the change is adopted and adjust as necessary.
Practice change is about turning evidence into action, ensuring that patient care is continuously improved based on the latest research findings.
Outcome evaluation
To determine the effectiveness of the practice change, outcome evaluation is essential. This process involves assessing whether the changes have yielded the desired benefits:
  • Define Success: Clearly outline what successful outcomes look like.
  • Collect Data: Use data collection tools to measure results.
  • Analyze Outcomes: Compare outcomes with the objectives of the practice change.
  • Reflect and Adjust: Based on the outcomes, decide if further changes are needed.
Evaluation of outcomes is not only about measuring success but also about learning from practice changes to refine and enhance patient care further.

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Most popular questions from this chapter

A nurse is talking with colleagues and shares what she learned at a recent conference on wound care. She suggests that the group discuss which is the best antiinfective solution to use to clean infected incisions? Which type of trigger for a clinical question is this? 1 Problem-focused 2 Knowledge-focused 3 Peer-focused 4 PICOT-focused

A nurse has developed a clinical question, "Do oncology patients feel hopelessness when experiencing side effects of chemotherapy?" Which type of research article should the nurse be sure to include in her search for evidence on this topic? 1 Case study 2 Systematic review 3 Quality improvement project 4 Qualitative study

A group of nurses on an obstetric unit are discussing the results of their patient satisfaction scores. They've noticed the scores dropping over the last 3 months. Their manager has expressed concern as to why the female patients do not think that nurses are responsive to their needs. The nurses decide to address the issue in their EBP committee where they will form a PICOT question. This scenario is an example of which type of trigger for an EBP question? 1 Administrative-focused 2 Knowledge-focused 3 Problem-focused 4 Time-focused

A UPC is planning to adopt a new type of pulse oximeter to improve accuracy of measurement and reduce patient discomfort while wearing the device. Which resources should the committee consider before beginning a pilot evaluation of the oximeter? (Select all that apply.) 1 The accuracy of the device 2 Cost of the device 3 Support from doctors for the change 4 The patients' satisfaction with the device

Which question contains the primary components of a PICOT question? 1 Are oral steroids effective for female adults with adult-onset asthma? 2 Which steroid preparations are best for male teenagers with activity-induced asthma who play sports? 3 Does the use of inhalers improve bronchial air flow? 4 Does the use of medication via an inhaler versus a nebulizer affect oxygen saturation in asthmatic children?
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