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The Clinical Inquiry Process Resource Guide

The goal of this guide is to provide nurses a resource to understand and carryout the steps of performing an evidence-based practice (EBP) project.

Importance of Non-Research Evidence

The Importance and Purpose of Non-Research Evidence 

 

Non-research evidence is crucial in Evidence-Based Practice (EBP). It complements research studies related to clinical questions and guides clinical decision-making, especially when research is limited or absent. Here's how non-research evidence contributes to EBP:

  • Enhances Clinical Relevance: Expert opinions, clinical guidelines, and case reports help contextualize research findings for specific patient populations or settings, ensuring that the evidence used in practice meets real-world patient needs.
  • Guides Practice in Absence of Strong Research: When high-quality research is unavailable, non-research evidence, such as expert opinions or patient preferences, can guide decision-making, particularly when research studies don't provide clear answers.
  • Informs Patient-Centered Care: Patient preferences and values are integral to EBP. Non-research evidence allows practitioners to incorporate individual patient perspectives, ensuring care decisions respect their personal choices and priorities.
  • Supports a Holistic Approach: EBP includes the best available research, clinical expertise, and the unique needs of patients. Non-research evidence integrates these dimensions into practice, creating a more comprehensive approach to care.
  • Fills Gaps in Knowledge: Non-research evidence provides insights when formal research is lacking, especially for rare conditions or emergent situations, enabling clinicians to make informed decisions when research evidence is insufficient or evolving.

Universal Appraisal Considerations

Non-Research Evidence - Appraisal and Evaluation

Non-Research Evidence:  Appraisal / Evaluation Criteria 

Publication Type

Key Appraisal Questions

Primary Evaluation Criteria

Potential Limitations

Case Report

  • Is the case description comprehensive?
  • Are unique or important aspects highlighted?
  • What is the potential broader significance?
  • Are ethical considerations addressed?
  • How unusual or informative is the case?
  • Detailed description
  • Clinical relevance
  • Potential learning value
  • Ethical considerations
  • Cannot generalize
  • Limited scientific value
  • Potential reporting bias

Case Study

  • Was the study methodology rigorous?
  • How were data collected and analyzed?
  • What contextual factors were considered?
  • Are findings potentially transferable?
  •  What are the study's limitations?
  • Depth of analysis
  • Contextual understanding
  • Methodological rigor
  •  Potential insights
  • Limited generalizability
  • Potential researcher bias
  • Narrow scope

Clinical Practice Guideline

  • Was the guideline developed systematically?
  • Are recommendations based on best available evidence?
  • How recently was the guideline updated?
  • Are conflicts of interest disclosed?
  • Does it address multiple clinical scenarios?
  • Evidence quality
  • Comprehensive approach
  • Clarity of recommendations
  • Professional consensus
  • May become outdated
  • Potential funding bias
  • Limited individual patient variation

Clinical Protocol

  • Are steps clearly defined and sequenced?
  • Is the protocol based on current evidence?
  • Does it provide decision-making guidance?
  • Are potential variations addressed?
  • How flexible is the implementation?
  • Procedural clarity
  • Evidence-based approach
  • Practical applicability
  • Safety considerations
  • May not fit all scenarios
  • Potential oversimplification
  • Limited individual adaptation

Consensus/Position Statement

  • Who developed the statement?
  • What evidence supports the consensus?
  • How representative are the contributors?
  • Are minority opinions acknowledged?
  • What is the level of agreement?
  • Expert credibility
  • Transparency
  • Breadth of perspective
  • Scientific backing
  • Potential expert bias
  • Limited empirical evidence
  • May reflect opinion over research

Financial/Economic Impact Report

  • What methodology was used for analysis?
  • Are all relevant costs considered?
  • What are the long-term financial implications?
  • Are assumptions clearly stated?
  • How sensitive are the findings to variations?
  • Comprehensive cost analysis
  • Methodological rigor
  • Transparency of assumptions
  • Long-term perspective
  • Complex modeling
  • Potential predictive limitations
  • Sensitivity to input variables

Literature Review

  • Was the search strategy comprehensive?
  • How were studies selected and evaluated?
  • Are contradictory findings discussed?
  • Is the review critically analytical?
  • Are gaps in current research identified?

  • Search comprehensiveness
  • Critical analysis
  • Synthesis quality
  • Research gap identification
  • Potential selection bias
  • May not be systematic
  • Dependent on available literature

Quality Improvement Report

  • What was the specific improvement goal?
  • How was progress measured?
  • What interventions were implemented?
  • Are results statistically significant?
  • Are sustainability and scalability addressed?

  • Measurable outcomes
  • Intervention clarity
  • Statistical validity
  • Potential for broader application
  • May be context-specific
  • Potential implementation challenges
  • Limited long-term data