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Evidence-Based Practice for Nurses

This course is offered by the VCU Health System Department of Education and Professional Development.

Agenda

  • Introduction to Evidence-Based Practice Resources Available at VCU.
  • Introduction to the Johns Hopkins Model of Evidence-Based Practice.
  • Types of Clinical Questions and How to Formulate a Searchable Question.

PICO Model

Evidence-based practice uses the PICO model to help create a searchable clinical question. 

PICO is describes four components of a useful clinical question:

 

Examples of applications of the PICO model can be found under Introduction to EBP.

Clinical Questions

Why Ask a Searchable, Answerable Clinical Question?

  • Too much information but too little time
  • Build good habits into everyday practice
  • Clear communication with colleagues
  • Further clinical practice
  • Saves time in the long run

What Are the Types of Clinical Questions?

Background

Focuses on the big picture and provides basic, general knowledge in reference to a specific condition, situation or topic.  

  • Provides general information that enables one to gain a greater understanding and allows one to understand the options or possibilities when it comes to addressing a topic.
  • Tend to have two components.
    • A question root (who, what, when, etc.) with a verb
    • A disorder, test, treatment, or other aspect of healthcare
  • Background Question Resources:  Reference Books, Textbooks, Review Articles

Examples:

What is the best practice for preventing nosocomial infections?

What types of patients are most at risk for falls in the inpatient setting?

What are the best interventions to encourage sleep in the inpatient setting?

When is the best time to discuss end of life care decisions with terminal patients?

 

 Foreground 

Focused question that asks something specific in order to make an informed clinical decision or action.

  • Specific knowledge about managing a patient with a condition.
  • Requires a grasp of basic concepts
  • Foreground Question Resources -   Research findings, journal articles, conference proceedings, synthesis of findings
  • Question can be broken down into parts into parts -  PICO

P - (Patient, Population or Problem) 

I - (Intervention) 

C - (Comparison with other treatments, if applicable) 

O - (Outcome) 

Examples:

Is therapeutic touch or guided imagery more effective when treating a patient with fibromyalgia?

In elderly patients requiring wound care, does the use of tap water as compared to normal saline reduce the incidence of infection? 

 

Type of Question = Type of Study

  • Always looking for a Clinical Practice Guideline, Systematic Review or Meta-Analysis