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Evidence-Based Nursing Part Two. Integrating EBP Knowledge into Clinical Practice. Four Tools for Integration. Iowa Model for Evidence-Based Practice Journal clubs Critical Appraisal of Topics Clinical Audit. Iowa Model for EBP. Highlights of the Model. - PowerPoint PPT Presentation
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Evidence-Based Nursing Part Two
Integrating EBP Knowledge into
Clinical Practice
Four Tools for Integration
Iowa Model for Evidence-Based Practice Journal clubs Critical Appraisal of Topics Clinical Audit
Iowa Model for EBP
Highlights of the Model
Triggers: Problem-based and Knowledge-based
Organizational Priorities Sufficiency of the Research Base Appropriateness of change for the patient
population/organization Continuous feedback loops
Triggers
Triggers
Problem focused Risk management data Process improvement
data Internal / external
benchmarking data Financial data Identification of clinical
problem
(first and last are original)
Knowledge focused New research or other
literature Nat’l Agencies or
Organizational standards
Philosophies of care Questions from
Institutional Standards Committee
(first is new)
Priorities of the Institution
If Yes then….
Form a team Assemble relevant research & related literature Critique and synthesize research for use in practice Sufficient research to guide practice? (“no” is not a
stopping point) Develop a guideline or standard of practice Pilot change in practice / is change appropriate? Monitor process and outcome data / share results
Journal Clubs
Journal clubs
Teaching-based: emphasis on skill building, such as honing searching skills
Topic-based: often focused on critical appraisal
EBP skills-based: participants go through each step of EBP process
Can be nursing staff only or multidisciplinary
All clubs need a clinically meaningful context for their topics!
Critical Appraisal of Topics (CATS)
Assess the quality of a single study
Can results be applied to your patients?
Critical Appraisal of Topics
National Guideline Clearinghouse http://www.guideline.gov
Journals such as Evidence Based Nursing
EBM Tools at Centre for Evidence-based Medicine site http://www.cebm.net
Clinical Audit
Examine your care practices and compare your results with clinical guidelines or best practice statements
Define best practice Measure and compare Act to achieve change
Audit Cycle (simplified)
Defining quality
Measuring and comparing
Take action to improve
Reilly, L et al. “Reducing Foley Catheter Device Days in an Intensive Care Unit: Using the Evidence to Change Practice.” AACN Advanced Critical Care 17(3):272-83
Change: the final step
Method Smackdown
Discuss strengths and weaknesses of each method/approach to integrating EBP
Best area(s) for application of a method?Image courtesy WWE
Method Review
Iowa Model for Evidence-Based Practice Journal clubs Critical Appraisal of Topics Clinical Audit
Strengths and weaknesses Best time/place for application
Good Luck!