Medhin Kahsay RN,BSN.MN519

Evidence based practice ProjectSeminar Presentation.

03/02/09 NUR 310 Students

OBJECTIVES

Explain the difficulties of applying evidence based practice in clinical settings.

Identify the barriers to research, evidence based practice in nursing.

Describe the three competence of evidence based practice.

Explain the evidence uses best evidence.

OBJECTIVES Explain how every nurse plays a role in

using research evidence.Describe the five fundamental step of

evidence based practice.Explain the format that formulates

evidence based practice.

Learn from the Beger(1999) Quote

“Nursing research is only an academic exercise unless the facts and theories produced are employed by practicing nurses”

Beger ,W.(1999). Fundamentals of Nursing. 2nded

Appleton & Lange: Connecticut.

Evidence Based PracticeWhy is it difficult as a practicing clinician

to conduct research and apply research

findings to the clinical setting? What are the strategies to encourage

evidence-based nursing care?

Evidence Based PracticeEBP has been recognized:

By the healthcare community &Regulatory agencies.

As a Gold standard for the provision of safe and compassionate health care.

BARRIERS TO RESEARCH EVIDENCE-BASED PRACTICE IN NURSING

Research-related barriersNurse-related barriersOrganizational barriersBarriers related to the nursing profession

Polit ,B.(2006). Essential of Nursing Research: Methods, Appraisal, and Utilization.6thed.

Lippincott Williams and Wilkins, Philadelphia.

The most common barriers of practicing nurseAs explained by Burns & Grove(2006), the

nurse barriers are as follows: lack of expertise unaware of findings unaware of guidelines that developed for

practice unwilling to change current practice do not value the use of research to change

practice belief changing practice based on research will

benefit minimal.

Nurse Related BarrierEvery nurse plays an important role in

using research evidence. A nurse should:

Read widely and critically. Attend professional conferences. learn to expect evidence that a procedure is

effective. Become involved in a journal club. Pursue and participate in RU/EBP projects.

Evidence based practiceThree important areas of research competence are:

(1) interpreting and using research,

(2) evaluating practice, and

(3) conducting research.

Evidence uses best EvidenceScientific knowledge from randomized

clinical trials.Observational studies .Expert opinionExpert consensus

Evidence Based practice

Houser, J.(2008).

Evidence based practiceThe risks, benefits, and costs should be

thoroughly documented before findings are introduced in

the practice.The study should address an important

clinical problem.Clinical problem addressed in the study

should or fall within the reader’s nursing specialty

open of practice.

Evidence based practiceThe 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.

Why do care identifying research barriers

Identifying barriers to using research findings in practice can: Promotes communication Communicate researchers, practicing nurses &

administrators.Can facilitate Evidence based practice in

health care organizations.

Burns & Groove(2006).

Evidence Based PracticeThe format that defines Evidence based

practice is PICO.“PICO” defines as:

P=Population I= InterventionC= ComparisonO= Out come.

Burns & Grove(2006)

Why Use EBP?Advances quality of care provided by nurses.Increases satisfaction of patients.Refocuses nursing practice away from habits

and tradition to evidence and research.

Evidence Based Practice

EBP has repeatedly been show to improve patient outcomes(Joint Commission,2006).

The Joint Commission (2008):Supported the implementation of EBP in

nursingEBP a means of improving healthcare system.

Barriers to research utilization

Major barrier to research utilization is the absence of published research on specific clinical issues.

Nurses may lack experience reading and critiquing research reports.

May have difficulty interpreting study designs and statistical findings.

Continued Many of today's experienced staff nursesDid not study research during their basic

nursing programs . Have not had opportunities to do so through

continuing education programs.The education barriers often are compounded

by administrative barriers (e.g., lack of time, money, clinical resources) that thwart research utilization activities

Evidence based practice includesBest evidence, clinician expertise and

judgment. patient preferences are integrated and

aligned in making therapeutic.plans and treatment decisions.

Evidence based practice Staff nurses are at the fortunate

position in bringing research based changing in clinical practice.

The first step to overcoming barriers to EBP

Assessing and identifying the obstacles to evidence-based care.

Strengthen beliefs about the benefits of evidence-based care.

FACILITATORS OF RESEARCH UTILIZATION (Summary)

Identification of clinically relevant problems and issues are most crucial.

Other facilitating factors include environments in which individuals are committed to critical thinking and to the research utilization process.

Tell your story

Do you have a research story.Listen to your patientsReflect on the care you provideAsk your self if you could do something even

better Investigate it Write about it so others can read.

Reference

Beger , W.(1999). Fundamentals of Nursing. (2nd Ed). Connecticut: Appleton & Lange.

Beyea, S.& Nicoll, L.(1997).Barriers to &Facilitators of research utilization in peri operative Nursing practice. AORN journal

Burns, N.,& Susan, G.(Ed.). (2005). Practice of Nursing Research: conduct, Critique, and Utilization.(5th Ed). Saunders.

Houser, J.(2008). Nursing research. Reading, Using & creating Evidence. Jones &Bartlett.

Levin, R. & Feldman, H.(2006). Teaching Evidence-Based practice in Nursing. Spring: New York.

Polit DF., & Beck CT(2006). Essential of Nursing Research: Methods, Appraisal, and Utilization. (6th Ed). Philadelphia, PA. Lippincott Williams and Wilkins,