Get documents about "Evaluation of Primary Health Care NP Initiative
Shared by: HC12073017828
-
Stats
- views:
- 0
- posted:
- 7/30/2012
- language:
- pages:
- 51
Document Sample
Developing Research
Inspire.
Questions & Searching for the
Evidence
Engage.
Laura Banfield, Nursing Librarian
Health Sciences Library
Lead.
September 2009
Learning Objectives
Review the definition of Evidence (Informed) Based
Inspire.
Practice and the steps in the process
Formulate questions using PICO and PS models
Introduce the concept of preprocessed evidence and
Engage.
the hierarchy of evidence
Identify databases and sources for locating pre-
processed evidence
Lead.
Evidence-Based Practice (EBP)
Inspire.
“The integration of best research evidence with
clinical expertise and patient values to facilitate
clinical decision making”
Engage.
(Sackett et al., 2000)
Lead.
Clinical Decisions
Clinical state, Patient
Inspire.
setting, and preferences
circumstances and actions
Engage.
Clinical Expertise
Clinical Expertise
Health care
Research
resources
Lead.
evidence
Steps of EBP
1. Construct a relevant, answerable question from
Inspire.
a clinical case.
2. Search the literature to retrieve the best
evidence.
Engage.
3. Critically appraise the literature (evidence) for
validity and applicability.
4. Apply the evidence to your clinical practice.
Lead.
5. Evaluate the outcome or performance.
*From: Flemming, K. (1998). Asking answerable questions. Evidence-Based Nursing, 1(2),
36-7.
Steps of EBP
1. Construct a relevant, answerable question
Inspire.
from a clinical case.
2. Search the literature to retrieve the best
evidence.
Engage.
3. Critically appraise the literature (evidence) for
validity and applicability.
4. Apply the evidence to your clinical practice.
Lead.
5. Evaluate the outcome or performance.
*From: Flemming, K. (1998). Asking answerable questions. Evidence-Based Nursing, 1(2),
36-7.
Inspire.
What Type of Question is it?
Engage.
Lead.
Formulating the Question
(Quantitative)
Inspire.
P -- Population/Situation
I -- Intervention/Exposure
Engage.
C -- Comparison/Counter Exposure
O -- Outcome
Lead.
Question
Inspire.
Intervention
Is exercise more effective than rest
for relieving chronic back pain?
Engage.
Lead.
Question
Inspire.
Population People with back pain
Intervention Exercise
Engage.
Comparison Bed rest
Outcome Reduced pain
Lead.
Question
Inspire.
Causation
Does the presence of hand sanitizer
stations in nursing homes reduce the
Engage.
number of infections transferred to
residents?
Lead.
Question
Inspire.
Population Nursing home residents
Exposure Hand sanitizer stations
Engage.
Comparison No hand sanitizer
Outcome Reduced infection
Lead.
Formulating the Question
(Qualitative)
Inspire.
P -- Population
S -- Situation
Engage.
Lead.
Question
Inspire.
How do people with HIV/AIDS living in a rural
community feel about disclosing their status to
Engage.
their health care provider?
Lead.
Question
Inspire.
Population People with HIV/AIDS
Engage.
Situation Disclosing their status
to their health care
providers
Lead.
Hierarchy of
Pre-processed Evidence
Inspire.
Engage.
Lead.
(Haynes, 2007)
Systems
Inspire.
Support clinical decision making through linking all
relevant best research evidence about a clinical
situation directly to a patient’s record.
Engage.
(Haynes 2008)
Sources of Systems
Integrative Electronic Patient Records
Lead.
Summaries
“Summaries integrate best available evidence from
Inspire.
lower layers … to provide a full range of evidence
concerning management options for a given health
problem.”
(Haynes, 2007)
Engage.
Sources of Summaries
Clinical Practice Guidelines
Lead.
Evidence Based Texts
http://www.rnao.org/bestpractices/
Nursing Best Practice Guidelines
Inspire.
Engage.
Lead.
http://www.guideline.gov/
National Guideline Clearinghouse
Inspire.
Engage.
Lead.
BMJ Clinical Evidence
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
ACP PIER
(Physicians’ Information and Education Resource)
Available through STAT!Ref
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
ACP PIER
Lead. Engage. Inspire.
ACP PIER
Lead. Engage. Inspire.
FirstCONSULT
Lead. Engage. Inspire.
FirstCONSULT
Syntheses:
Systematic Reviews
Consolidate the literature on a specific topic:
Inspire.
• comprehensive identification of studies
• review of study relevance
• evaluate methodologic quality
Engage.
• extraction and analysis of data
• draw of conclusions
Sources of Synthesis
The Cochrane Library
Lead.
Health Care journals
Cochrane Library
http://www.thecochranelibrary.com
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
Lead. Engage. Inspire.
Lead. Engage. Inspire.
Lead. Engage. Inspire.
Synopses
Inspire.
“Synopses of individual studies or systematic
reviews encapsulate the key methodologic
details and results required to apply the
evidence to individual patient care.”
Engage.
(Haynes, 2001)
Sources of Synopses
• Database of Abstracts of Reviews of Effects (DARE)
• health-evidence.ca
Lead.
• Evidence-based abstraction journals
DARE
Database of Abstracts of Reviews of Effects
http://www.crd.york.ac.uk/crdweb/
Inspire.
Engage.
Lead.
DARE – Synopses of Syntheses
Inspire.
Engage.
Lead.
Evidence Based Nursing
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
Single Studies
Inspire.
• To keep up with the literature
• To update summaries and systematic
reviews
Engage.
• To contribute to clinical decisions if no
higher preprocessed level is available
Lead.
PubMed
Inspire.
Clinical Queries
Engage.
Lead.
Special Queries
PubMed Clinical Queries
Inspire.
Engage.
Lead.
PubMed – Special Queries
Inspire.
Engage.
Lead.
CINAHL – Clinical Queries
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
CINAHL - Clinical Queries
Inspire.
Engage.
Lead.
TRIP (Turning Research into Practice)
Inspire.
Engage.
http://www.tripdatabase.com
Lead.
TRIP – Searching across the Hierarchy
Inspire.
Engage.
Lead.
Lead. Engage. Inspire.
EBN Resources Page
Inspire.
http://hsl.mcmaster.ca/resources
Engage.
/topic/eb/nurse.html
Lead.
Library Sessions
Inspire.
Wednesday September 30 12:30 pm - 2:00 pm
2:00 pm - 3:30 pm
3:30 pm - 5:00 pm
Engage.
Lead.
Questions??
Inspire.
Laura Banfield
Nursing Librarian
Engage.
banfie@mcmaster.ca
Ext. 20239
Lead.
