The Evidence-based Practice Manual for Nurses

by Craig, Jean V.

• ISBN13: 9780443102301
• ISBN10: 0443102309
• Edition: 2nd
• Format: Paperback
• Copyright: 2007-01-18
• Publisher: Elsevier Science Health Science div

Summary

This manual examines the core skills relating to evidence-based practice: translating clinical information needs into clearly defined, focused questions; effectively searching for scientific evidence that addresses these questions; evaluating the validity of retrieved evidence and assessing its applicability to the nurse's own clinical setting and patients; using the best research evidence, along with clinical expertise and patient's preferences, to reach clinical decisions.

Table of Contents

Contributors	p. xi
Foreword to second edition	p. xiii
Foreword to first edition	p. xv
Preface	p. xvii
The Context for Evidence-Based Practice
Evidence-based practice in nursing	p. 3
Introduction	p. 4
Evidence-based health care: what is it and why do we need it?	p. 4
The evidence-based movement across health care	p. 8
Challenges	p. 10
A wide range of evidence bases relevant to nursing practice	p. 12
The problem of generalisability	p. 15
When will we get there?	p. 16
Skills for Evidence-based Practice
How to ask the right question	p. 25
Introduction	p. 26
Information for effective nursing care	p. 26
Turning Information needs into focused questions	p. 29
A framework for formulating questions	p. 32
Becoming proficient in asking questions	p. 40
Specific prompts for accessing research evidence	p. 42
Prioritising questions	p. 43
Questions for research	p. 43
Questions and research evidence aren't enough	p. 44
Summary	p. 45
Searching the literature	p. 51
Introduction	p. 52
Where is research information found?	p. 52
Getting help	p. 53
Basic search principles	p. 53
Where to search first	p. 60
Where to search next	p. 65
An example search on the MEDLINE database (PubMed version)	p. 66
Common queries regarding searching	p. 73
Tips for more advanced users	p. 75
Searching for a systematic review	p. 80
The internet	p. 83
Critical appraisal of quantitative studies I: Is the quality of the study good enough for you to use the findings?	p. 95
Introduction	p. 96
Is the quality of the study good enough for me to use the results?	p. 98
Assessing the quality of a study that asks a question about the effectiveness of a therapy or intervention	p. 104
Assessing the quality of a study that asks a question about the performance or accuracy of a particular diagnostic test or method of assessment	p. 110
Assessing the quality of a study that asks a question about the likely pattern and/or outcome of a particular health problem/disease	p. 116
Critical appraisal in practice	p. 120
Summary	p. 122
Critical appraisal of quantitative studies 2: Can the evidence be applied in your clinical setting?	p. 127
Introduction	p. 128
Deciding whether the results can be applied in your clinical setting	p. 129
What do the results of this study mean in my context/for my patients?	p. 131
Interpreting the results of studies about the effectiveness of a particular therapy or intervention	p. 136
Interpreting the results of studies that investigate the performance or accuracy of a particular diagnostic test/method of assessment	p. 141
Interpreting the results of studies about prognosis or outcome of a particular condition and/or harm	p. 146
Summary	p. 149
Qualitative research: critical appraisal	p. 153
Introduction	p. 154
What is qualitative research?	p. 154
Types of qualitative methods	p. 156
Appraising qualitative research	p. 162
How can qualitative research inform clinical practice?	p. 175
Conclusions	p. 178
Summary	p. 178
Systematic reviews: what are they and how can they be used?	p. 185
What are systematic reviews?	p. 186
Cochrane Systematic Reviews	p. 192
Critical appraisal of systematic reviews	p. 193
Understanding meta-analysis	p. 194
How can systematic reviews inform practice?	p. 201
Integrating research evidence into clinical decisions	p. 209
Introduction	p. 210
More than research is needed	p. 210
Clinical expertise	p. 212
Patient preferences, values and beliefs	p. 217
Limited resources for health care	p. 227
Conclusion	p. 227
The Process of Changing Practice
Evidence-based guidelines	p. 237
Introduction	p. 238
Guideline characteristics	p. 238
National or local guideline development	p. 239
Prioritising topic areas for guideline development	p. 240
How are guidelines developed?	p. 241
Consensus guidelines	p. 246
Example of an evidence-based guideline	p. 249
Appraising published guidelines	p. 249
Adapting nationally developed guidelines for local use	p. 255
Patient versions of guidelines	p. 256
Introducing the guideline into practice	p. 256
Evaluating the effectiveness of clinical guidelines in nursing and allied health professions	p. 257
Benefits and disbenefits of clinical guidelines	p. 259
Conclusion	p. 260
Implementing best evidence in clinical practice	p. 267
Introduction	p. 268
How is this relevant to me?	p. 268
Implementing best evidence - where to start?	p. 269
First steps	p. 274
What changes are needed?	p. 285
How to implement the changes	p. 291
Evaluating the progress and effects of the changes	p. 297
Conclusion	p. 299
How can we develop an evidence-based culture?	p. 305
Introduction	p. 306
National imperatives	p. 306
What does an evidence-based culture look like?	p. 307
Diagnosing the challenges to changing practice - understanding complexity	p. 310
How can evidence-based innovation and culture be encouraged?	p. 312
How can change happen?	p. 316
Real-life examples of changing practice and culture	p. 325
Conclusion: culture, practice change and evidence-based health care	p. 331
Glossary	p. 339
Index	p. 347
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