Evidence Based Practice Essay

6286 Words Apr 13th, 2006 26 Pages
Evidence Based Nursing Practice in Nursing

• "Doing the right things right" (Craig & Smyth, 2002, p.4)
• Used to improve the experiences associated with health care and illness
• Early examples o Infection control (aseptic technique) o DVT (deep vein thrombosis) prevention

Development of the EBP Concept
• Began with medicine o Archie Cochran, a British epidemiologist in 1972 published a book criticizing the medical profession for not reviewing medical research studies o Believed that the strongest evidence came from RCT (randomized clinical trials). RCT are the most strict kind of research design.
• A RCT has to have three things:
• Control group
• Placebo group
• Experimental group o Founded the Cochran Foundation in
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5. Evaluate the outcome
Challenges of EBP
• Gaps in the evidence for what nurses do
• Rapidly changing evidence bases
• Life-long learning which may challenge long-held beliefs
• Transferability to the clinical setting from the research setting

Seven Cardinal Sins of EBP
• Do research vs use research
• Do statistics vs interpret statistics
• Convenient and Comfortable vs patient-centered
• Evaluation of learners based on fact retention vs. application of knowledge
• Inflexible priorities vs. flexibility
• Rigid curricular parameters vs. open for rumination (there are no right or wrong answers)
• Discourage the "stupid question"

EBP Skills for the Baccalaureate Student
• Identify the 5 steps of the EBP
• Form a clinical question using PICO format for a therapy / intervention, diagnosis, harm, prognosis, meaning, or human response clinical problem
• Conduct a successful search for best evidence in response to a clinical question
• Critically appraise studies for validity, importance and applicability.
• Differentiate between statistical significance and clinical meaningfulness
• Apply best evidence from a search and critical appraisal
• Search for and critically appraise clinical practice guidelines and best evidence summaries
• Apply clinical practice guidelines and best evidence summaries to clinical practice.
• Discuss ethical issues in the conduct of
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