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