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2 Evidence-Based Nursing Practice:
Fundamentals
S T U D E N T O B J E C T I V E S
On completing this chapter, you will be able to:
* Distinguish research utilization (RU) and evidence-based practice (EBP), and discuss their current status within nursing
* Identify several resources available to facilitate EBP in nursing practice
* Identify several models that have relevance for RU and EBP
* Discuss the five major steps in undertaking an EBP effort for individual nurses
* Identify the components of a well-worded clinical question and be able to frame such a question
* Discuss strategies for undertaking an EBP project at the organizational level
* Define new terms in the chapter
BACKGROUND OF EVIDENCE-BASED NURSING PRACTICE
Research Utilization
Evidence-Based Practice in Nursing
RESOURCES FOR EVIDENCE-BASED PRACTICE Systematic Reviews
Other Preappraised Evidence
Models of the Evidence-Based Practice Process EVIDENCE-BASED PRACTICE IN INDIVIDUAL NURSING PRACTICE
Clinical Scenarios and the Need for Evidence Asking Well-Worded Clinical Questions Finding Research Evidence
Appraising the Evidence Integrating Evidence
Implementing the Evidence and Evaluating Outcomes
EVIDENCE-BASED PRACTICE IN AN ORGANIZATIONAL CONTEXT
Selecting a Problem for an Institutional Evidence-Based Practice Project
Finding and Appraising Evidence: Clinical Practice Guidelines Actions Based on Evidence Appraisals
Implementing and Evaluating the Innovation RESEARCH EXAMPLES AND CRITICAL THINKING ACTIVITIES
CHAPTER REVIEW Key New Terms Summary Points
STUDIES CITED IN CHAPTER 2
Evidence-based practice (EBP) is the conscientious use of current best evidence in making clinical decisions about patient care (Sackett et al., 2000). A basic feature of EBP as a clinical problem-solving strategy is that it de-emphasizes decisions based on custom, authority, or ritual; the emphasis is on identifying the best avail- able research evidence and integrating it with other factors. Advocates of EBP do not minimize the importance of clinical expertise. Rather, they argue that evidence- based decision making should integrate best research evidence with clinical expert- ise, patient preferences and circumstances, and awareness of the clinical setting and resource constraints. EBP involves efforts to personalize evidence to fit a spe- cific patient’s needs and a particular clinical situation.
This book will help you to develop the methodologic skills you need for evalu- ating research evidence for nursing practice. Before we elaborate on methodologic techniques, we discuss key aspects of EBP to further clarify the key role that research now plays in nursing.