BATAAN PENINSULA STATE UNIVERSITY

MAIN CAMPUS

College of Nursing and Midwifery

APPLY disseminate findings review and local application

EVIDENCE BASED PRACTICE AUDIT/ASSESS
→ During 1980s the term “evidence-based medicine” emerged to
describe the approach that used scientific evidence to SOURCES OF EVIDENCE
determine the best the best practice. Evidence based practice RESEARCH has assumed priority over other sources of
movement started in England in early 1990s. EVIDENCE evidence in the delivery of evidence based
→ Evidence-Based Medicine (Ebm) Or Evidence Based Practice health care
(Ebp), is the judicious use of the best current evidence in FILTERED RESOURES clinical experts and subject specialist pose
making decisions about the care of the individual patient. a question and then synthesize evidence to
→ Evidence-based practice represents both an ideology and a state conclusion based on available
research. These sources are helpful
method. The ideology springs from ethical principle that the
because the literature has been searched
client deserve to be provided with most effective interventions
and results evaluated to provide an answer
possible. The Method Of Ebp is the way we go about finding to clinical question.
and then implementing those interventions.
UNFILTERED it provides most recent information. E.g.
DEFINITION RESOURCES medline, cinhal etc. provides primary and
it is something that furnishes proof or (PRIMARY secondary literature for medicine.
EVIDENCE testimony or something legally submitted
LITERATURE)
to ascertain in the truth of matter.
CLINICAL knowledge through professional practice
it is systemic inter connecting of
EXPERIENCES and life experiences makes up the second
scientifically generated evidence with the
part in the evidenced based, person-
tacit knowledge of the expert practitioner
EVIDENCE BASED centered care.
to achieve a change in a particular
PRACTICE KNOWLEDGE FROM evidence delivered from patients
practice for the benefit of a well-defined
PATIENT knowledge of themselves, their bodies and
client/ patient group (French 1999)
social lives
it is a process by which nurses make
KNOWLEDGE FROM → Audit and performance data
EVIDENCE BASED clinical decisions using the best available
LOCAL CONTEXT → Patients stories and narratives
research evidence, their clinical expertise
NURSING → Knowledge about the culture of the
and patient preferences (mulhall, 1998)
organization and individuals with in it
the conscientious, explicit and judicious
→ social and professional networks
EVIDENCE BASED use of current best evidence in making
→ Information from feedback
decision about the care of individual
MEDICINE/PRACTICE → Local and national policy
patient. (dr. david sackett, Rosenberg,
1996) HIERARCHY OF EVIDENCE
is a way of providing nursing care that is
guided by the integration of the best
available scientific knowledge with
nursing expertise. This approach requires
EBP IN NURSING nurses to critically assess relevant
scientific data or research evidence and
to implement high quality interventions for
their nursing practice. (NLM pubmed)
NEED FOR EBP
→ For making sure that each client get the best possible
services.
→ Update knowledge and is essential for lifelong learning
→ Provide clinical judgment
→ Improvement care provided and save lives
GOAL OF EBP
→ Provide practicing nurses the evidence based data to deliver MODELS OF EBP
effective care. JOHN-HOPKINS used as a framework to guide the
→ Resolve problem in clinical setting. synthesis and translation of evidence
NURSING EBP
→ Achieve excellence in care delivery. into practice.
MODEL
→ Reduces the variations in nursing care and assist with efficient
and effective decision making There are three phases to the jhnebp model
STEP IN EBP 1. The identification of an answerable question.
ASK frame focused questions to be answered by the
evidence review 2. A systematic review of the synthesis of both research and
ACQUIRE identify sources and collect potentially relevant non-research evidence
studies
create an evidence base by applying screening 3. Translation includes implementation of the practice change
APPRAISE
criteria related to topic, questions, practices, and as a pilot study, measurement of outcomes, and
outcomes
standardize, summarize and rate strength of body dissemination of findings.
ANALYZE
of evidence (study, characteristic, quality, effect
size, and consistency)

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 BATAAN PENINSULA STATE UNIVERSITY
MAIN CAMPUS

College of Nursing and Midwifery

The Stetler model of evidence-based practice consists of five

phases (Stetler, 1994; Stetler, 2001; Stetler, 2010).
Each phase is designed to:

1. facilitate critical thinking about the practical application of

research findings;
2. result in the use of evidence in the context of daily practice; and
3. mitigate some of the human errors made in decision making.

focuses in organization and collaboration

IOWA MODEL incorporating conduct and uses of research,
along with other types of evidence. (titler et al,
2001). It was originated in 1994
The star point in the model can either be
1. A knowledge focus trigger (the emerges from awareness of
innovative research findings)
2. A problem- focus trigger (that has its root in a clinical
organizational problem) BARRIERS IN EBP
→ Lack of value for research in practice
→ Difficulty in bringing change
→ Lack of administrative support
→ Lack of knowledge mentors
→ Lack of time for research
→ Lack of knowledge about research
→ Research reports not easily available
→ Complexity of research reports
→ Lack of knowledge about ebp
ADVANTAGES OF EBP
→ Provide better information to practitioner
→ Enable consistency of care
→ Better patient outcome
→ Provide client focused care
→ Structured process
→ Increases confidence in decision-making
→ Generalize information
→ Contribute to science of nursing
→ Provide guidelines for further research
→ Helps nurses to provide high quality patient care
This model examines how to use evidence to DISADVANTAGES OF EBP
create formal change within organizations, as → Not enough evidence for ebp
STETLER MODEL well how individual practitioners can use → Time consuming
research on an informal basis as part of → Reduce client choice
critical thinking and reflective practice. → Reduced professional judgment/ autonomy
→ Suppress creativity
The settler model of evidence-based practice based on the → Influence legal proceedings
following: → Publication bias
CONCLUSION
1. Use may be instrumental, conceptual and/or
Evidence-based nursing care is a lifelong approach to clinical
symbolic/strategic.
decision making and excellence in practice. Evidence-based
2. Other types of evidence and/or non-research-related
nursing care is informed by research findings, clinical expertise,
information are likely to be combined with research findings to
and patient’s values and its use can improve patients outcome.
facilitate decision making or problem solving.
Use of research evidence in clinical practice is an expected
3. Internal or external factors can influence an individual's or
standard of practice for nurses and health care organizations, but
group's review and use of evidence.
numerous barriers exist that create a gap between new
4. Research and evaluation provide probabilistic information, not
knowledge and implementation of that knowledge to improve
absolutes.
patient care. Using the levels of evidence, nurses can determine
5. Lack of knowledge and skills pertaining to research use and
the strength of research studies, assess the findings, and evaluate
evidence-informed practice can inhibit appropriate and effective
the evidence for potential implementation into best practice.
use.

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