Evidence Based Practice

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Evidence Based Nursing Practice in Nursing

• "Doing the right things right" (Craig & Smyth, 2002, p.4)
• Used to improve the experiences associated with health care and illness
• Early examples o Infection control (aseptic technique) o DVT (deep vein thrombosis) prevention

Development of the EBP Concept
• Began with medicine o Archie Cochran, a British epidemiologist in 1972 published a book criticizing the medical profession for not reviewing medical research studies o Believed that the strongest evidence came from RCT (randomized clinical trials). RCT are the most strict kind of research design.
• A RCT has to have three things:
• Control group
• Placebo group
• Experimental group o Founded the Cochran Foundation in 1992 after his death
• Defined as "the conscientious, explicit and judicious use of current best evidence in making decisions about the health care of patients" (Sackett, et al)
• Focused on findings of randomized clinical trials only
• New definition: "the integration of best research evidence with clinical expertise and patient values (Sackett, et. al.)

Current Definition in Nursing
• "Evidence-based practice (EBP) is a problem solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician's expertise as well as patient preferences and values to make decisions about the type of care that is provided" (Melnyk, 2004)

Definition of Terms
• Best research evidence is patient centered research that is clinically relevant
• Clinical expertise: the ability to use clinical skills and clinical decision-making to identify patients' health states and risks and benefits of interventions.
• Patient Values: preferences, concerns and expectations that must be integrated into patients' health care.

Why Evidence-Based Practice?
• Despite an aggressive research movement, the majority of findings from research often are not integrated into practice.
• It take approximately

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