EVIDENCE-BASED PRACTICE

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EVIDENCE-BASED PRACTICE

• AND
• NURSING
• RESEARCH
• 
  
  

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Nursing research

• providesthe foundation for evidence-basednursing
  practice

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Evidence-based practice

• The process of systematically finding,
  appraising, and using research findings as the
  basis for clinical practice - for making
  decisions about patient care.

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Development of Nursing Knowledge

• Evidence-Based Practice (research-based practice,
  best practice)
• Integration of best research evidence with
  clinical expertise and patient values

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Evidence-Based Practice

• A move toward supporting practice with evidence
  began in the mid-1980s.
• Agency for Healthcare Research and Quality
  oversees publishing reviews of evidence and
  clinical guidelines and supports nursing
  research.

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The practice of Evidence-Based Practice includes
five fundamental steps

• Step 1 Formulating a well-built question
• Step 2 Identifying articles and other
  evidence-based resources that answer the question
• Step 3 Critically appraising the evidence to
  assess its validity
• Step 4 Applying the evidence
• Step 5 Re-evaluating the application of evidence
  and areas for improvement

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DEFINITION OF NURSING RESEARCH

• Nursing research is a systematic approach used to
  examine phenomena important to nursing and
  nurses, that clinical practice be based on
  scientific knowledge.
• Research is a process of systematic inquiry or
  study to build knowledge in a discipline.

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NURSING RESEARCH

• The purpose of research is to validate and refine
  existing knowledge and develop new knowledge.
• The results of research process
• provide a foundation on which practice decisions
  and behaviors are laid
• create a strong scientific base for nursing
  practice and application of results demonstrates
  professional accountability to insurers and
  health care consumers.

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• NURSING RESEARCH
• Nursing research aimed at impacting the direct
  provision of nursing and health care to
  recipients of nursing care, nursing research also
  is needed to generate knowledge in areas that
  affect nursing care processes indirectly.

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• EVIDENCE-BASED PRACTICE
• The introduction of evidence-based change into
  the direct provision of nursing care may occur at
  the individual level of a particular nurse or at
  varied organizational or social levels.
• Evidence generated by nursing research provides
  support for the quality and cost-effectiveness of
  nursing interventions.

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RESEARCH PRIORITIES

• often set by groups that fund research, encourage
  nurse researchers to invest effort and money into
  those areas of research likely to generate the
  most benefit to recipients of care,
• the funding opportunities offered by such groups
  don't hurt the research enterprise either.

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Sources of funding for nursing research

• The main outcome of research activity for a nurse
  is to eventually put the knowledge gained to work
  in health care delivery.
• In USA there are the National Institute for
  Nursing Research (NINR) and the Agency for
  Healthcare Research and Quality (AHRQ). Both of
  these organizations are funded by federal
  congressional appropriations.
• Private foundations and nursing organizations
  also provide funding for nursing research.

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Research is a process that takes place in a
series of steps

1. Formulating the research question or problem
2. Defining the purpose of the study
3. Reviewing related literature
4. Formulating hypotheses and defining variables
5. Selecting the research design
6. Selecting the population, sample, and setting
7. Conducting a pilot study
8. Collecting the data
9. Analyzing the data
10. Communicating conclusions

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STUDY DESIGNS

• Are plans that tell a researcher
• how data are to be collected,
• from whom data are to be collected,
• how data will be analyzed to answer specific
  research questions.

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Research studies are classified into two basic
methods

• Quantitative research is a formal, objective,
  systematic process in which numeric data are
  used.
• Qualitative research is a systematic approach
  used to describe and promote understanding of
  human experiences such as pain

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• NURSING RESEARCH DESIGNS
• The most common designs used in health care
  research are case study, survey, needs
  assessment, experimental, quasiexperimental,
  methodologic, meta-analysis, and secondary
  analysis.

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Case study designs

• Are used to present an in-depth analysis of a
  single subject, group, institution, or other
  social unit.
• The purpose is to gain insight and provide
  background information for more controlled
  broader studies, develop explanations of human
  processes, and provide rich descriptive anecdotes

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Extramural Priority Areas for Nursing research

• a. Chronic conditionsarthritis, diabetes,
  urinary incontinence, long-term care, and care
  giving
• b. Health promotion and risk behaviorswomen's
  health, adolescence, menopause,environmental
  health, exercise, nutrition, and smoking
  cessation
• c. Cardiopulmonary healthprevention and care of
  persons with cardiac or respiratory conditions,
  including research in critical care, trauma,
  wound healing, and organ transplantation

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• Extramural Priority Areas for Nursing research
• d. Neurofunction and sensory conditionspain
  management, sleep disorders, and symptom
  management in persons with cognitive impairment
  and chronic neurologic conditions
• e. Immune and neoplastic diseases(oncology)sympto
  ms primarily associated with cancer andacquired
  immune deficiency syndrome, such as fatigue,
  nausea and vomiting, and cachexia, as well as
  risk-factor prevention research
• f. Reproductive and infant healthprevention of
  premature labor, reduction of health-risk factors
  during pregnancy, delivery of prenatal care, care
  of neonates, infant growth and development, and
  fertility issues
• (From the National Institutes of Nursing Research
  (NINR)

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• NURSING RESEARCH
• Nursing research (links education, theory,
  nursing practice) provides the basic for
  expanding the unique body of scientific knowledge
  that forms the foundation of nursing practice.
• Research studies will emphasize clinical issues,
  problems, and outcomes. Priority will be given to
  research studies that focus on promoting health
  and developing cost-effective health care
  systems.

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RESEARCH UTILIZATION

• Through Research Utilization, efforts and
  knowledge obtained from research is transformed
  into clinical practice, culminating in nursing
  practice that is evidence-based, to help
  understand the importance of evidence-based
  practice.

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Nurse Researcher Roles

• Two nursing roles are specifically focused
  on research the clinical nurse specialist (CNS)
  and the clinical nurse researcher (CNR).

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• CONSUMER OF RESEARCH
• Nurses at all levels of educational preparation
  have responsibility to participate in the
  research process.
• Nurses become knowledgeable consumers of research
  through educational processes and practical
  experience, must have a basic understanding of
  the research process and critical appraisal
  skills that provide a standard for evaluating the
  strengths and weaknesses of research studies
  before applying them in clinical practice.

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CONSUMER OF RESEARCH

• A consumer of research uses and applies research
  in an active manner.
• The nurse must be knowledgeable consumer of
  research, one who can critique research and use
  existing standards to determine the merit and
  readiness of research for use in clinical
  practice.