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Chapter 2
Translating Research Evidence Into Nursing Practice:
Evidence-Based Nursing
Chapter 2
Translating Research Evidence Into Nursing Practice:
Evidence-Based Nursing
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Research Utilization (RU) Versus Evidence-Based Practice (EBP)
Research Utilization (RU) Versus Evidence-Based Practice (EBP)
Research utilization (RU)
The use of study findings in a practical application unrelated to the original research
Evidence-based practice (EBP)
Basing clinical decisions on best possible evidence—especially high-quality research
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Resources for Evidence-Based PracticeResources for Evidence-Based Practice
• Systematic reviews
• Clinical practice guidelines
• Other preappraised evidence
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Research Integration and SynthesisResearch Integration and Synthesis
Forms of integrative reviews:
• Narrative, qualitative integration (traditional review of quantitative or qualitative results)
• Meta-analysis (statistical integration of results)
• Metasynthesis (theoretical integration of qualitative findings)
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Barriers to Using Research in Nursing Practice
Barriers to Using Research in Nursing Practice
• Research-related barriers
• Nurse-related barriers
• Organizational barriers
• Barriers related to the nursing profession
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Steps of Individual EBPSteps of Individual EBP
1. Framing an answerable clinical question
2. Searching for relevant research-based evidence
3. Appraising and synthesizing the evidence
4. Integrating evidence with other factors
5. Assessing effectiveness
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Appraisal of EvidenceAppraisal of Evidence
• Validity of study findings
• Clinical importance of findings
• Precision of estimates of effects
• Associated costs and risks
• Utility in a particular clinical situation
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
EBP in Organizational ContextEBP in Organizational Context
• More formalized than individual EBP
• Must take organizational and interpersonal factors into account
• “Triggers” include both pressing clinical problems and existing knowledge
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Organizational (Team-Based) EBP Projects
Organizational (Team-Based) EBP Projects
• Involve the development or adaptation of clinical practice guidelines or clinical protocols
• Assessment of implementation potential of the innovation
Transferability
Feasibility
Cost/benefit ratio
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Criteria for Evaluating the Implementation Potential of an Innovation Under Scrutiny Criteria for Evaluating the Implementation Potential of an Innovation Under Scrutiny
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Implementing and Evaluating the Innovation
Implementing and Evaluating the Innovation
Pilot Test
• Develop an evaluation plan
• Collect information on outcomes
• Train staff in the use of the new guideline and, if necessary, “market” the innovation
• Try the guideline out on one or more units or with a group of clients
• Evaluate the pilot project
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nurses’ Role in Using Research EvidenceNurses’ Role in Using Research Evidence
• 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