Evidence-Based Clinical Practice in Nursing

Evidence-Based Clinical Practice in Nursing and Healthcare examines the Joanna Briggs Institute model for evidence-based practice which recognises research, theory and practice as sources of evidence and takes a practical approach to developing, implementing and evaluating practice, based on 'evidence' in its broadest sense. Evidence-based Clinical Practice in Nursing and Healthcare addresses the nature of evidence in clinical practice, generating and synthesising evidence, and transferring and utilising evidence in clinical practice. It describes the development of practice information sheets and clinical guidelines and provides practical guidance on the implementation of evidence-based practice and its evaluation using clinical audit.

Alan Pearson and Zoe Jordan are based at the Joanna Briggs Institute, Adelaide, Australia. John Field is based as James Cook University.

Preface

ix

About the authors

xi

The Evolution of Evidence-Based Practice

1

(15)

Introduction

1

(3)

Evidence-based health care (EBHC)

4

(1)

Evidence-based medicine

5

(1)

Evidence-based practice around the world

6

(2)

Evidence-based practice: beyond medicine

8

(1)

A multidisciplinary affair

9

(1)

The roles of consumers

10

(1)

Criticisms of the evidence-based approach

11

(3)

Conclusion

14

(2)

A Comprehensive Approach to Evidence-Based Health Care: The JBI Model

16

(11)

Introduction

16

(2)

Health care evidence generation

18

(3)

Evidence synthesis

21

(3)

Evidence (knowledge) transfer

24

(1)

Evidence utilisation

25

(1)

Conclusion

25

(2)

What is Evidence for Practice?

27

(9)

Introduction

27

(1)

Feasibility, appropriateness, meaningfulness and effectiveness

28

(2)

Achieving a balance between evidence of effectiveness and other evidence interests for clinicians and consumers

30

(1)

The nature of evidence

31

(1)

Evidence for health professionals

32

(2)

Evidence for health consumers

34

(1)

Conclusion

35

(1)

Health Care Evidence Generation

36

(16)

Introduction

37

(1)

Guiding paradigms in research

38

(4)

The qualitative/quantitative debate

42

(1)

Paradigm, methodology and method

43

(1)

The quantitative research approach

43

(1)

The interpretive research approach

44

(1)

The critical research approach

45

(4)

Sources for evidence of feasibility

49

(1)

Sources for evidence of appropriateness

49

(1)

Sources for evidence of meaningfulness

50

(1)

Sources for evidence of effectiveness

50

(1)

Conclusion

50

(2)

Evidence Synthesis: The Systematic Review

52

(20)

Introduction

53

(1)

Overview of the systematic review process

54

(9)

The importance of systematic reviews of evidence

63

(1)

Finding the evidence

64

(5)

Study selection

69

(1)

Conclusion

70

(2)

Evidence Synthesis: Critical Appraisal, Data Extraction and the Synthesis of Findings

72

(27)

Introduction

73

(1)

Critical appraisal of evidence

74

(14)

The limitations of critical appraisal

88

(1)

Data extraction

89

(3)

Data analysis and synthesis

92

(4)

Practical tools for systematic reviews

96

(1)

Conclusion

97

(2)

Evidence Transfer: Writing Up a Systematic Review Report and Developing Clinical Guidelines

99

(19)

Introduction

100

(1)

The purpose of the systematic review report

101

(1)

Writing the report

102

(1)

What is a clinical guideline?

103

(1)

Medicine-specific guidelines

104

(1)

Nursing-specific clinical guidelines

104

(1)

Allied-health-specific guidelines

104

(1)

`Consensus' versus `evidence'

105

(1)

Strategies for guideline development

105

(2)

The quality of the evidence

107

(1)

Grades of recommendation

108

(4)

Consumer involvement in guideline development

112

(1)

Guideline appraisal

113

(1)

The role of guidelines in practice

114

(1)

Practical tools for guideline development

115

(1)

Conclusion

116

(2)

Evidence Utilisation: Implementing Evidence-Based Guidelines

118

(19)

Introduction

119

(1)

Barriers to change

120

(2)

Changing practice

122

(2)

Evidence-based health care and practice change

124

(1)

The theory behind change

125

(1)

A process for change

125

(2)

Tools and strategies

127

(3)

Models for change

130

(3)

Knowledge translation

133

(1)

Evaluation

133

(2)

Conclusion

135

(2)

Evidence Utilisation: Clinical Audit

137

(17)

Introduction

138

(1)

Clinical effectiveness

139

(1)

Clinical audit

139

(9)

Strategies to promote successful auditing

148

(1)

Writing an audit report

148

(1)

Practical tools for clinical audit

149

(2)

Clinical audit and research

151

(1)

Conclusion

152

(2)

Evidence-Based Practice: Issues and Challenges

154

(14)

Introduction

156

(1)

Evidence-based practice and the role of organisations

156

(2)

Legal and policy implications of evidence-based practice

158

(4)

Health care takes the lead . . . and others follow

162

(1)

Consumer participation

163

(1)

The rise and rise of information technology

164

(2)

Conclusion

166

(2)

References

168

(4)

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Evidence-Based Clinical Practice in Nursing and Health Care Assimilating Research, Experience and Expertise

Summary

Author Biography

Table of Contents

Supplemental Materials