Which is the order of evidence-based practice that the nurse would follow while caring for a client?

What is evidence-based practice?

Inhaltsverzeichnis Show

What is evidence-based practice?
How to apply EBP in clinical practice
Best Available Evidence
Clinician's Knowledge and Skills
Patient's Wants and Needs
Common EBP Models
What are the six steps of evidence informed practice in chronological order?
What are the 5 stages of the nursing process?
Which of the following should occur first in the steps of EBP?
Which of the following are steps in the evidence

videnced-based practice (EBP) is applying or translating research findings in our daily patient care practices and clinical decision-making.

EBP also involves integrating the best available evidence with clinical knowledge and expertise, while considering patients’ unique needs and personal preferences. If used consistently, optimal patient outcomes are more likely to be achieved.

Using EBP means abandoning outdated care delivery practices and choosing effective, scientifically validated methods to meet individual patient needs. Health care providers who use EBP must be skilled at discerning the value of research for their specific patient population.

How to apply EBP in clinical practice

Evaluating all of the available evidence on a subject would be a nearly impossible task. Luckily, there are a number of EBP processes that have been developed to help health care providers implement EBP in the workplace.

The most common process follows these six steps:

1. ASK a question. Is there something in your clinical setting that you are wondering about? Perhaps you wonder if a new intervention is more effective than the one currently used. Ask yourself: What works well and what could be improved? And, more importantly, WHY? Evaluate the processes and workflow that impact, or are impacted by, the identified practice gap. We’ll use a format called PICO(T) (pronounced “pee ko”). Learn more about PICOT questions in the next module.

2. ACQUIRE the current evidence. You’ll do this by conducting a literature search. Your search will be guided by your clinical question.

3. APPRAISE the literature. Or, in other words, sort, read, and critique peer-reviewed literature.

4. APPLY your findings to clinical decision-making. Integrate the evidence with clinical expertise and patient preferences and values. Then make evidence-based recommendations for day-to-day practice.

5. EVALUATE your outcomes. Review data and document your approach. Be sure to include any revisions or changes. Keep close tabs on the outcomes of your intervention. Evaluate and summarize the outcome.

6. DISSEMINATE the information. Share the results of your project with others. Sharing helps promote best practices and prevent duplicative work. It also adds to the existing resources that support or oppose the practice.

Though we may learn how to apply EBP by participating in project-based work, integrating EBP in our daily practice can help us strive to achieve the best possible patient outcomes. It requires us to be thoughtful about our practice and ask the right questions.

It's important to note that although applying evidence at the bedside can be conducted individually, working collaboratively as a team is more likely to result in lasting improvement.

Evidence-based practice includes the integration of best available evidence, clinical expertise, and patient values and circumstances related to patient and client management, practice management, and health policy decision-making.

All three elements are equally important.

Best Available Evidence

Although evidence-based practice encompasses more than just applying the best available evidence, many of the concerns and barriers to using evidence-based practice revolve around finding and applying research. APTA helps PTs and PTAs discover and use evidence-based resources.

Clinician's Knowledge and Skills

The physical therapist and physical therapist assistant's knowledge and skills are a key part of the evidence-based process. This personal scope of practice consists of activities undertaken by an individual physical therapist that are situated within a physical therapist's unique body of knowledge where the individual is educated, trained, and competent to perform that activity. Using clinical decision-making and judgment is key.

Patient's Wants and Needs

The patient's wants and needs are a key part of evidence-based care. Incorporating a patient's cultural considerations, needs, and values is a necessary skill to provide best practice services.

Evidence-based practice (EBP) results from the integration of available research, clinical expertise, and patient preferences to individualize care and promote effective care decision-making. Oncology nurses are perfectly positioned to be adopters and promoters of EBP, resulting in practice change for improved quality and safety.

The impact of EBP on nursing and patient outcomes is clearly evident. Many organizations have developed competency-based, nurse-led EBP programs that are redesigning care delivery to increase the effectiveness and efficiency of interventions while reducing costs and safety risks. For EBP integration to be successful and sustainable, a culture of EBP readiness must exist through ongoing leadership support, EBP resource availability, and adoption of an EBP implementation framework.

In recent years, nurse scientists have developed several EBP models to help demystify the process of translating research into clinical practice. Although the models include varying levels of detail, they share the following basic phases of the EBP process.

Ask: Identify a clinical problem.
Attain: Review relevant literature.
Appraise: Critically appraise evidence.
Apply: Evaluate the need for practice change and potential implementation.
Assess: Evaluate outcomes.

Organizations must adopt the EBP model that best fits their context of care, aligns with improvement goals, addresses priority clinical problems, and guides a systematic and evaluative approach to collaborative practice change.

Common EBP Models

The Iowa Model for Evidence-Based Practice to Promote Quality Care has been revised to better address sustainability of EBP, interprofessional change implementation, and patient-centric care for clinicians at all levels of practice, guiding them through a team-based, multiphase process. The path initiates with a clinical “trigger” that identifies a clinical problem and includes decision points with evaluative feedback loops when recommending and implementing practice change. The model phases are interprofessional team formation; evidence review, critique, and synthesis; change implementation through piloting; ongoing evaluation; and outcomes dissemination.

The Advancing Research and Clinical Practice Through Close Collaboration Model is for building resources and training mentors who play a central role in facilitating and sustaining EBP at the point-of-care and throughout the organization. The model has seven steps: cultivating a spirit of inquiry; asking a PICOT-formatted clinical question; collecting, critically appraising, and integrating the best evidence with clinical expertise and patient preferences; and evaluating and disseminating practice change outcomes.

The Johns Hopkins Nursing Evidence-Based Practice Model is clinician-focused, allowing rapid and appropriate application of current research and best practices. It simplifies the EBP process and cultivates a culture of care based on evidence. It has three overall steps: practice question, evidence, and translation. Its directive tools are intended for practicing clinicians working individually or in a group to address clinical inquiries.

The Promoting Action on Research Implementation in Health Services (PARIHS) Framework has been revised into the integrated or i-PARIHS framework. The framework refers to evidence-based change as practice innovation. It contends the core elements of successful implementation of practice innovation is dependent on the type of evidence available, context of the care setting, and how the process is facilitated. The framework emphasizes the importance of taking into consideration the perspectives of all recipients of the intended change.

Although these are just a few models for translating evidence into practice, each outlines and promotes the need for a systematic approach to evidence-based change. Each addresses the sustainability of EBP through organizational culture change, stakeholder engagement, comprehensive literature review and appraisal, barrier identification, impact evaluation, and outcomes dissemination. Regardless of the preferred model, the EBP process should tell the story of how a problem was recognized, addressed, and improved, and that story should be shared.

What are the six steps of evidence informed practice in chronological order?

Steps in the Process.

ASSESS the patient. Start with the patient; determine a clinical problem or question that arises from the care of the patient..

ASK a focused clinical question. ... .

ACQUIRE evidence to answer the question. ... .

APPRAISE the quality of the evidence. ... .

APPLY the evidence to patient care. ... .

EVALUATE..

What are the 5 stages of the nursing process?

The common thread uniting different types of nurses who work in varied areas is the nursing process—the essential core of practice for the registered nurse to deliver holistic, patient-focused care. Assessment. ... .

Diagnosis. ... .

Outcomes / Planning. ... .

Implementation. ... .

Evaluation..

Which of the following should occur first in the steps of EBP?

The first step in the EBP process is to phrase your scenario as a specific, answerable question: Ask a well-built clinical question. This will help you to focus on the key issues and identify what evidence you need to answer your question.