Article

Evidence-based practice: step by step: the seven steps of evidence-based practice.

Arizona State University in Phoenix, AZ, USA.
The American journal of nursing (Impact Factor: 0.69). 01/2010; 110(1):51-3. DOI: 10.1097/01.NAJ.0000366056.06605.d2
Source: PubMed

ABSTRACT This is the second article in a new series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Ask the Authors" calls every few months to provide a direct line to the experts to help you resolve questions. See details below.

6 Bookmarks
 · 
972 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making - integrated with evidence-based practice - can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence-based practice to deliver patient-centred care.
    International journal of nursing studies. 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: This column shares the best evidence-based strategies and innovative ideas on how to facilitate the implementing of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.
    Worldviews on Evidence-Based Nursing 08/2014; · 1.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although evidence-based clinical practice constitutes a priority for healthcare services in many countries within the last few years, there is a general lack of implementation of evidence-based clinical practice in nursing care, especially in primary health care. Few qualitative studies concerning the influencing factors on evidence-based clinical practice for community nurses have been carried out. This study examined the perception of nurses in Spanish primary health care with regard to the knowledge, advantages and barriers within the application process with evidence-based clinical practice. We used a descriptive qualitative study with focus groups to collect data. Forty-six primary care nurses took part in this study and they were distributed into five focus groups. Five main topics arose from the results achieved: knowledge and development of evidence-based clinical practice, evidence searching, evidence dissemination, advantages of use of evidence-based clinical practice, and barriers for its application and implementation. Participants had a positive attitude towards evidence-based practice, although they used this infrequently because of lack of competence and organizational support for its application. Our participants are increasingly determined to take into account evidence within the decision-making processes in their usual clinical practice. We consider it advisable to develop specialized training strategies as well as provide necessary resources for the implementation of evidence-based clinical practice duly adapted to the field of primary health care. This study highlights the existing gap in translating knowledge to practice and its potential implications in the effectiveness of nursing interventions and decision making in primary health care, and thus its implications for education policy.
    International Nursing Review 01/2014; · 0.94 Impact Factor

Full-text (2 Sources)

Download
104 Downloads
Available from
May 27, 2014

Similar Publications