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Doctor of Nursing Practice (DNP) Guide

Evidence Based Practice Research

What is Evidence-Based Practice (EBP)?

 
Evidence Based Practice:

A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.

Year introduced: 2009  
(PubMed MeSH)


Evidence Based Nursing Practice:
Nursing practice that bases clinical decisions on research, clinical expertise, patient choices, and critical evaluation of the literature.

(CINAHL Complete - CINAHL Headings)

Evidence Based Practice: The Basics

3 Pillars of Evidence-Based Practice

    1. EVIDENCE derived from rigorous scientific research found in literature.

    2. EXPERTISE derived from clinical experience and skill.

    3. PATIENT PREFERENCE concerning personal health decisions.


Steps in the EBP Process

Steps in the EBP process         

Asking for and locating evidence depends upon asking an focused clinical question.
 

Use the PICO mnemonic to build that question and to focus your searches.
 

P =   Patient     Population  *  Problem  (includes demographic information)

I   Intervention   Treatment  * Therapy  *  Prognostic Factor  *  Exposure

C  =  Comparison  Competing Intervention    (could be placebo or no treatment)

O  =  Outcome     Desired result     (what you hope to accomplish; measurable)

P I C O

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome


P I C O T

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- time


P I C O (T)

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- type of studies or questions


P I C O T T

     P -- patient, population, participant, problem (diagnosis)
     I -- intervention, therapy, treatment
     C -- comparison  (not always required)
     O -- outcome

     T  -- type of question 
              (therapy/treatment, diagnosis, prognosis, harm/etiology)

     T  -- type of study 
              (research method/design)

 5 Types of PICO Questions

     1. Diagnosis
     2. Therapy (treatment / intervention)
     3. Etiology (cause)
     4. Prognosis (future / forecast)
     5. Prevention

Diagnosis PICO:
In children with respiratory infection, is the respiratory rate as effective as chest x-ray in detecting pneumonia?

Prognosis PICO
:
In premature infants (compared to full-term infants), what is the lifetime prevalence of hearing deficit?
 

Therapy PICO:
In patients with recurrent infection, do antibiotics, compared to no treatment, reduce recurrence rate?
 

Etiology PICO:
In post-menopausal women, does hormone replacement therapy increase the risk of breast cancer?

EBP Video - Entertaining

The video was produced from the perspective of Doctors of Pharmacy, but it's great!  Set to the music of Coldplay.