Unsystematic clinical observation
Chapter 25
Evidence-Based Practice
Why Evidence-Based Practice?
The most recent emphasis on evidence-based practice comes from a recognition that healthcare practitioners’ perceptions of the efficacy of their care may or may not be accurate
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Why Evidence-Based Practice?
The implementation of evidence-based practice is a means for reducing dependence on:
Intuition
Unsystematic clinical observation
Ungrounded opinion
Ritual and tradition
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The Evolution of Evidence-Based Practice
The evidence-based practice movement emphasizes appraisal of all relevant studies and consideration of their applicability to a particular patient, setting, and situation (Melnyk and Fineout-Overholt, 2004)
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The Evolution of Evidence-Based Practice
Evidence-based medicine is the use of current test evidence in making decisions about the care of individual patients (Sackett et al., 1996)
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The Evolution of Evidence-Based Practice
Evidence-based nursing is the use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences (Ingersoll, 2000)
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Basic Criteria for Evidence-Based Practice
Demonstrated efficacy in two or more RCTs
Include comparison or control group
Tested by more than one research team
Primary outcomes measured
Follow-up testing done if appropriate
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Expanded Criteria for Evidence-Based Practice
Is the study relevant to the topic of interest?
To what extent is the study well designed and well controlled?
Was the purposed intervention effective?
Are these results relevant to practice?
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Panel Reviews and Meta-analyses for Evidence-Based Practice
Summary in language that can be understood by nonprofessionals
Abstract that summarizes each section of the review
Background that includes details of what is known
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Panel Reviews and Meta-analyses for Evidence-Based Practice
Aim of the review
Criteria for selection of studies reviewed
How the search for relevant studies was conducted
Conduct of the review
Description of the studies included
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Panel Reviews and Meta-analyses for Evidence-Based Practice
Assessment of the quality of the included studies
Results of the review
Interpretations of the results
Implications for practice and for research
