Teaching EBP: Asking Searchable, Answerable Clinical Questions
Center for the Advancement of Evidence-Based Practice, Arizona State University, Tempe, Arizona 85287-2602, USA.Worldviews on Evidence-Based Nursing (Impact Factor: 2.38). 02/2005; 2(3):157-60. DOI: 10.1111/j.1741-6787.2005.00032.x
Asking a searchable, answerable question is a basic step in the EBP process. Sackett and colleagues (2000) referred to this step as the most challenging step in the EBP process. One could assume that the skill of asking a searchable, answerable clinical question is already developed in clinicians, since they are practicing. As well, one may assume it is easily developed in pre-licensure students; however, when attempting to ask the question using a standardized format, the challenge and thought required increases. Keeping these factors in mind will assist educators in designing curricula in which objectives are dedicated to assisting learners in how to ask the question in a searchable, answerable format, and to understanding the subsequent implications of this endeavor.
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ABSTRACT: Introduction: Medical libraries very often base the decisions they make about library services on information gathered from user surveys. Is the quality of information obtained in this way sufficient to enable evidence-based practice? Aim: To determine what aspects of user survey design and presentation obtain the best response rates and therefore high external validity. Also to provide guidance for medical librarians who may wish to carry out user surveys. Methods: Library and information studies databases and Medline were searched to identify studies that reported the results of library user surveys that measured user perceptions of an existing library service or potential service. Studies that evaluated information skills training or clinical librarianship interventions were excluded as they have been looked in separate systematic reviews. Also studies that reported the results of LibQUAL or SERVQUAL were excluded. Results: 54 studies were included. The quality of the majority of the surveys was not clear as the reporting of the methodology of the user surveys was poor. However, it was determined that, as demonstrated in previous research, paper format surveys reported higher response rates than online-only surveys. It was not possible to extract any relevant data from the identified studies to draw any conclusions relating to presentation of the survey instrument. Conclusions: Unless survey methodology is reported in detail it is not possible to judge the quality of the evidence surveys contain. Good survey design is key to obtaining a good response rate and a good response rate means the results can be used for evidence-based practice. A Reporting Survey results Guideline (Resurge) is recommended to help improve the reporting quality of medical library survey research.
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ABSTRACT: As pay-for-performance programs gain momentum, hospital administrators and clinical leaders will need to consider the organization's infrastructure and measures that promote quality management initiatives. Many hospital performance measures by the Centers for Medicare & Medicaid Services involve chronic diseases that may be best managed by an interdisciplinary team-based approach, of which nurses are significant members. While the primary focus of pay-for-performance has been concentrated on physicians, comparatively less attention has been given to the potential impact on nurses and nursing care. Moreover, the impact of the pay-for-performance measures on nursing labor and processes has not been well studied. Within acute care settings, increasing attention has focused on the structure of nursing, such as number and skill mix of nursing personnel, processes of care, and influence on patient outcomes. As pay-for-performance standards evolve and encompass patient outcomes, attention to nursing's contribution will follow. Nursing leadership will need to address a number of strategies to (a) address the impact of pay-for-performance on nursing performance measures as well as (b) on staff nurses' ability to contribute to the organization's efforts in achieving pay-for-performance standards, including education, documentation, team collaboration, and patterns of care.
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