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Chapter 7

Chapter 7. Evidence-Based Practice. Defining Evidence-Based Practice (EBP). Merging personal clinical expertise with the best available research results according to patient preferences and values Why is it important to utilize now?. Clinical Practice Guidelines .

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Chapter 7

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  1. Chapter 7 Evidence-Based Practice

  2. Defining Evidence-Based Practice (EBP) • Merging personal clinical expertise with the best available research results according to patient preferences and values • Why is it important to utilize now?

  3. Clinical Practice Guidelines • Systematically developed statements • Assist practitioners and client decisions about appropriate health care for clinical circumstances • Multidisciplinary

  4. Concepts • Research utilization • Evidence-based practice • Are these interchangeable?

  5. Criticisms of EBP • Quality of life issues • Restriction of freedom to practice • Inconsistent practices at medical centers versus other hospitals

  6. Finding Best Practices • Location in literature • Online database • CINAH, MedLine, PubMed • Evidence-based practice centers • Cochrane Collaboration • Journals • Evidence-Based Nursing

  7. Research Design • Qualitative • Quantitative • Randomized Clinical Trial (RCT)

  8. Evaluating Research • U.S. Preventive Services Task Force (USPSTF) developed a system for: • Rating guideline recommendations • Evaluating strength of evidence • Tables 7-1 and 7-2

  9. ACE Star Model ofKnowledge Transformation

  10. Implementing New Practice • Three steps in managerial support • Establishing a new culture • Creating capacity for organizational change • Sustaining change through revision of system’s infrastructure

  11. Barriers to EBP Implementation • Lack of time • Literature not readily available • Uncertain of personnel’s ability to use research • Critical colleagues

  12. Barriers to EBP Implementation • Lack of organizational support • Lack of perceived power to effect change • Cost to implement • Interdisciplinary support

  13. Five Steps to EnsuringPractice is Evidence-Based 1. Develop a researchable practice question 2. Design and implement an evidence search 3. Retrieve and appraise evidence

  14. Five Steps to EnsuringPractice is Evidence-Based 4. Integrate clinical evidence in order to implement an evidence-based decision 5. Evaluate clinical practice and EBP process outcomes

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