The Evidence-Based Practice Manual for Nurses

by Craig & Smyth

• ISBN13: 9780443070648
• ISBN10: 0443070644
• Format: Paperback
• Copyright: 2002-07-01
• Publisher: Churchill Livingstone

Summary

This practical, user-friendly guide offers straightforward explanations of evidence-based practice (EBP) and how nurses in all areas of specialization can apply these concepts to their work in any clinical setting. Provides step-by-step demonstrations of how to ask useful clinical questions that direct the investigation, as well as how to access and utilize the many valuable sources of evidence and information available. Describes and explains essential components of EBP, including critical appraisal, systematic reviews, qualitative research, formulating evidence-based guidelines, and more.

Table of Contents

Contributors	xi
Foreword	xiii
Preface	xv
Section 1 The context for evidence-based practice	1	(20)
Evidence-based practice in nursing	3	(18)
Maggie Pearson
Jean V Craig
Introduction	3	(1)
Evidence-based health care: what is it and why do we need it?	4	(4)
The evidence-based movement across health care	8	(2)
Challenges	10	(2)
A wide range of evidence bases relevant to nursing practice	12	(3)
The problem of generalisability	15	(1)
When will we get there?	16	(2)
Acknowledgement	18	(1)
References	18	(3)
Section 2 Skills for evidence-based practice	21	(164)
How to ask the right question	23	(22)
Jean V Craig
Introduction	23	(1)
Decision-making in clinical practice	24	(2)
Turning information needs into focused questions	26	(3)
A framework for formulating questions	29	(1)
Case study 2.1	30	(3)
Case study 2.2	33	(3)
Case study 2.3	36	(1)
Becoming proficient in asking questions	37	(1)
Exercises	38	(1)
Specific prompts for accessing research evidence	39	(1)
Prioritizing questions	40	(1)
Questions for research	41	(1)
Summary	41	(1)
References	42	(1)
Appendix 2.1 Possible solutions to exercises	43	(2)
Searching the literature	45	(41)
Olwen Beaven
Introduction	45	(1)
Where is research information found?	45	(2)
Getting help	47	(1)
Basic search principles	47	(5)
Where to search first	52	(3)
Where to search next	55	(1)
An example search on the MEDLINE database	56	(7)
Common queries regarding searching	63	(1)
Tips for more advanced users	64	(5)
Searching for a systematic review	69	(4)
The internet	73	(6)
Further reading	79	(2)
Appendix 3.1 Electronic databases	81	(3)
Appendix 3.2 Useful websites	84	(2)
Critical appraisal 1: is the quality of the study good enough for you to use the findings?	86	(28)
Mark Newman
Tony Roberts
Introduction	86	(2)
Is the quality of the study good enough for me to use the results?	88	(6)
Worked example 4.1: Assessing the quality of studies, answering questions about the effectiveness of therapy or interventions	94	(5)
Worked example 4.2: Assessing the quality of a study that asks a question about whether a particular diagnostic test or method of assessment works	99	(4)
Worked example 4.3: Assessing the quality of a study that asks questions about finding out the likely pattern and/or outcome of a particular health problem/disease	103	(5)
Critical appraisal in practice	108	(1)
Summary	109	(1)
Acknowledgement	110	(1)
References	110	(2)
Further reading	112	(2)
Critical appraisal 2: can the evidence be applied in your context?	114	(22)
Mark Newman
Tony Roberts
Introduction	114	(1)
Deciding whether the results can be applied in your setting	115	(3)
What do the results of this study mean in my context/for my patients?	118	(3)
Interpreting the results of studies about the effectiveness of a particular therapy or intervention	121	(4)
Interpreting the results of studies about whether a particular diagnostic test or method of assessment works	125	(5)
Interpreting the results of studies about prognosis or outcome of a particular condition and/or harm	130	(4)
Summary	134	(1)
Acknowledgement	135	(1)
References	135	(1)
Further reading	135	(1)
Qualitative methods and evidence-based practice	136	(28)
Andrea Litva
Ann Jacoby
Introduction	136	(1)
What is qualitative research	137	(2)
Types of qualitative methods	139	(6)
Appraising qualitative research	145	(11)
How can qualitative research inform clinical practice?	156	(3)
Conclusions	159	(1)
Summary	159	(1)
References	160	(3)
Further reading	163	(1)
Systematic reviews: what are they and how can the be used?	164	(21)
Rosalind L Smyth
What are systematic reviews?	164	(6)
Cochrane Systematic Reviews	170	(2)
Critical appraisal of systematic reviews	172	(1)
Understanding meta-analysis	173	(6)
How can systematic reviews inform practice?	179	(4)
References	183	(2)
Section 3 The process of changing practice	185	(108)
Evidence-based guidelines	187	(24)
Lois Thomas
Rhona Hotchkiss
Introduction	187	(1)
Guideline characteristics	188	(1)
National or local guideline development	188	(2)
Prioritising topic areas for guideline development	190	(1)
How are guidelines developed?	191	(5)
Consensus guidelines	196	(1)
Example of an evidence-based guideline	197	(1)
Appraising published guidelines	198	(1)
Adapting nationally developed guidelines for Local use	198	(3)
Patient versions of guidelines	201	(1)
Introducing the guideline into practice	202	(1)
Evaluating the effectiveness of clinical guidelines in nursing and professions allied to medicine	203	(1)
Benefits and disbenefits of clinical guidelines	204	(2)
Conclusion	206	(1)
References	206	(3)
Further reading	209	(1)
Appendix 8.1 Useful websites	210	(1)
How can we develop an evidence-based culture?	211	(29)
Carl Thompson
Mark Learmonth
Introduction	211	(1)
The national picture	211	(1)
What does an evidence-based culture look like?	212	(2)
Diagnosing the challenges to changing practice	214	(2)
Common complexities associated with nursing and research use	216	(15)
Planning for and managing resistance and change	220	(3)
An evidence-based toolkit for change?	223	(8)
Real life examples of changing practice and culture	231	(3)
Conclusion: culture, practice change and evidence-based health care	234	(1)
Summary	235	(1)
References	236	(4)
Implementing best evidence in clinical practice	240	(34)
Lin Perry
Introduction	240	(1)
Background to the STEP project	241	(1)
How is this relevant to me?	242	(1)
Where to start?	242	(4)
First steps	246	(9)
What changes are needed?	255	(7)
How to implement the changes	262	(5)
Evaluating the progress and effects of the changes	267	(2)
In conclusion	269	(2)
References	271	(2)
Further reading	273	(1)
How clinical evidence can change nursing policies	274	(19)
Rhona Hotchkiss
Mandie Sunderland
Introduction	274	(2)
Evidence-based policy at a regional level: the UK model	276	(1)
Clinical Governance	277	(2)
Policies designed to ensure comparable standards of health care across the four United Kingdom countries	279	(4)
Standard setting and monitoring for quality	283	(4)
Policy specific to nursing practice	287	(4)
Conclusion	291	(1)
References	292	(1)
Glossary	293	(6)
Index	299