Evidence-Based Practice for Nursing and Healthcare Quality Improvement

CONTENTS
EVIDENCE-BASED PRACTICE for NURSING and HEALTHCARE QUALITY IMPROVEMENT
EVIDENCE-BASED PRACTICE for NURSING and HEALTHCARE QUALITY IMPROVEMENT
Copyright
ABOUT THE AUTHORS
CONTRIBUTORS
REVIEWERS
TO THE FACULTY
TO THE STUDENT
ACKNOWLEDGMENTS
CONTENTS
I - Introduction
	1 - Overview of Evidence-Based Practice
		HISTORICAL OVERVIEW
		DEFINITION OF TERMS
		THE NATIONAL AGENDA FOR EVIDENCE-BASED PRACTICE
		STEPS OF EVIDENCE-BASED PRACTICE
		THE EVIDENCE-BASED PRACTICE TEAM
		ENGAGING CONSUMERS IN EVIDENCE-BASED PRACTICE
		CALL TO ACTION
		SYNTHESIS
		REFERENCES
	2 - Models and Evidence
		COMPARING RESEARCH, EVIDENCE-BASED PRACTICE, AND QUALITY IMPROVEMENT
			Models of Evidence-Based Practice
		THE IOWA MODEL OF EVIDENCE-BASED PRACTICE
			Selection of a Topic
			Forming a Team
			Evidence Retrieval
			Grading the Evidence
			Critical Appraisal and Synthesis of Evidence
			Proposing Evidence-Based Practice Recommendations
			Development of the Evidence-Based Practice
			Implementation and Dissemination of the Practice Change
			Evaluation of the Practice Change
		SYNTHESIS
		KEY POINTS
		REFERENCES
II - Processes of Developing EBP and Questions inVarious Clinical Settings
	3 - Developing Compelling Clinical Questions
		INTRODUCTION
		WHAT IS A CLINICAL QUESTION?
		WHY ARE CLINICAL QUESTIONS IMPORTANT?
		SOURCES OF CLINICAL QUESTIONS
		TYPES OF CLINICAL/PICO QUESTIONS
		CLINICAL QUESTIONS DIFFER FROM RESEARCH QUESTIONS AND HYPOTHESES
		SYNTHESIS
		REFERENCES
	4 - Search and Critical Appraisal of the Literature
		EVIDENCE IS HIERARCHICAL
		METALITERACY
		WHERE TO START
		BEYOND THE PUBLISHED EVIDENCE
			ASK a Background Question
		ASK A “PICO” QUESTION
			A Simple Search, Translating a PICO Question
			An Advanced Search: Expanding the Quest for Evidence
			Narrowing Search Results: Filtering
			Organizing, Evaluating, and Sharing the Evidence
		ASSESS/APPRAISE/SYNTHESIZE
		SYNTHESIS
		REFERENCES
	5 - Principles of Assessing Research Quality
		ISSUES RELATING TO MAXIMIZING APPLICABILITY OF FINDINGS TO PRACTICE
		AN OBJECTIVELY CONCEPTUALIZED RESEARCH QUESTION
		HOMOGENOUS SAMPLE
		DATA COLLECTION CONSTANCY
		INTERVENTION FIDELITY
		INTERNAL VALIDITY
		EXTERNAL VALIDITY
			Selection Effects
			Reactive Effects
			Measurement Effects
		SYNTHESIS
			Quantitative Research
		REFERENCES
	6 - Intervention Studies
		INTRODUCTION
		PURPOSE OF INTERVENTION STUDIES
		TYPES OF INTERVENTION STUDIES
		TYPES OF DATA IN INTERVENTION STUDIES
		CRITICALLY APPRAISING INTERVENTION RESEARCH
		SYNTHESIS
		KEY POINTS
		REFERENCES
	7 - Observational Studies
		INTRODUCTION
		OBSERVATIONAL STUDIES
		Observational Studies
		PURPOSE OF OBSERVATIONAL STUDIES
		TYPES OF OBSERVATIONAL STUDIES
			Cohort Studies
			Case Control Studies
			Case Series
			Survey Studies
		TYPES OF DATA AND DATA ANALYSES IN OBSERVATIONAL STUDIES
		CRITICALLY APPRAISING OBSERVATIONAL STUDIES
		SYNTHESIS
		KEY POINTS
		REFERENCES
	8 - Systematic Reviews and Clinical Practice Guidelines
		TYPES OF REVIEWS
			Integrative Reviews
			Critically Appraising Systematic Reviews
		CLINICAL PRACTICE GUIDELINES
		IMPLEMENTING CLINICAL PRACTICE GUIDELINES IN CLINICAL PRACTICE
		CRITICAL APPRAISAL OF CLINICAL PRACTICE GUIDELINES
			Appraising Clinical Practice Guidelines
		SYNTHESIS
		KEY POINTS
		REFERENCES
	9 - Qualitative Studies
		INTRODUCTION
		QUALITATIVE METHODOLOGIES AND WORLDVIEW
		PHENOMENOLOGY
		GROUNDED THEORY
		ETHNOGRAPHY
		CASE STUDY
		METASYNTHESIS
		KEY DIFFERENCES IN QUALITATIVE METHODOLOGIES
		DATA ANALYSIS
		SCIENTIFIC RIGOR IN QUALITATIVE RESEARCH
		SYNTHESIS
		KEY POINTS
		REFERENCES
	10 - Understanding Statistics for Evidence-Based Practice
		INTRODUCTION
		BASIC CONCEPTS APPLIED TO AN EVIDENCE-BASED PROJECT: DATA
			Levels of Measurement
		DESCRIPTIVE AND INFERENTIAL CONCEPTS APPLIED TO EVIDENCE-BASED PROJECTS
			Descriptive Statistics: Frequencies, Measures of Central Tendency, and Distribution of Data
		CENTRAL LIMIT THEOREM IN PRACTICE
		INFERENTIAL STATISTICS
			Testing for Significance or Hypothesis Testing Framework
				Confidence Interval Framework
		READ, INTERPRET, AND UNDERSTAND EVIDENCE-BASED LITERATURE STATISTICS
			Intervention Studies
				Statistics Common to Intervention Studies
		OBSERVATIONAL STUDIES
			Statistics Common to Diagnosis Studies
			Statistics Common to Prognosis Articles
			Statistics Common to Harm Articles
		META-ANALYSIS
			Statistics Common to Meta-Analysis
		SYNTHESIS-STATISTICAL ANALYSES
		KEY POINTS
		REFERENCES
III - Implementation
	11 - Evidence-Based Approaches for Improving Healthcare Quality
		THE CLINICAL LEADER’S ROLE IN HEALTH CARE QUALITY IMPROVEMENT
		NATIONAL GOALS AND STRATEGIES FOR HEALTH CARE QUALITY IMPROVEMENT
		QUALITY STRATEGY LEVERS
			Measuring Health Care Quality
			Benchmarking
		COMMON QUALITY IMPROVEMENT PERSPECTIVES AND MODELS
		QUALITY IMPROVEMENT STEPS AND TOOLS
			Leading a Quality Improvement Team
			Improvement Process Step 1: Assessment
			Improvement Process Step 2: Analysis
				Trending Variation in System Performance with Run and Control Charts
				Graphs
				Cause and Effect Diagrams
				Flowcharting
			Improvement Process Step 3: Develop a Plan for Improvement
			Improvement Process Step 4: Test and Implement the Improvement Plan
		TAKING ON THE QUALITY IMPROVEMENT CHALLENGE AND LEADING THE WAY
		SYNTHESIS
		KEY POINTS
		REFERENCES
	12 - Planning for Success
		INTRODUCTION
		OVERVIEW OF AN IMPLEMENTATION MODEL
		THE EVIDENCE-BASED PRACTICE TOPIC
			The Team
		QUALITY IMPROVEMENT AS A FOUNDATION FOR IMPLEMENTATION
		PRINCIPLES OF IMPLEMENTATION
		ACTION PLANS
		ETHICAL CONSIDERATIONS FOR EVIDENCE-BASED PRACTICE
		SYNTHESIS
		KEY POINTS
		REFERENCES
	13 - Launching Implementation
		INTRODUCTION
		IMPLEMENTATION STRATEGIES THAT ADDRESS CHARACTERISTICS OF THE CLINICAL TOPIC
		IMPLEMENTATION STRATEGIES THAT ADDRESS COMMUNICATION
		SUSTAINABILITY
		SYNTHESIS
		KEY POINTS
	14 - Implementation Strategies for Stakeholders
		USERS OF EVIDENCE-BASED PRACTICE
			Performance Gap Assessment
			Audit and Feedback
			Piloting the Change
			Meetings
		SOCIAL SYSTEM (CONTEXT)
			Overview
				Organizational Capacity
				Leadership
			Implementation Strategies to Address the Social System/Practice Context
				Environmental Scan
				Meetings with Key Leadership Stakeholders
				Standards of Practice and Documentation Systems
				Recognition and Rewards
		SYNTHESIS
		KEY POINTS
		REFERENCES
	15 - Patient-Centered Evidence-Based Practices
		INTRODUCTION
		CLINICAL SCENARIO
		PATIENT EMPOWERMENT THROUGH SHARED DECISION MAKING
		EVIDENCE TO SUPPORT SHARED DECISION MAKING
		SHARED DECISION-MAKING AIDS
		EVIDENCE-BASED METHODS TO DEVELOP PATIENT ENGAGEMENT TOOLS
		PATIENT ACTIVATION
		HEALTH LITERACY AND NUMERACY
		STRATEGIES TO IMPROVE HEALTH LITERACY AND NUMERACY
		PATIENT ENGAGEMENT STRATEGIES FOR CLINICAL PRACTICE
		INDIVIDUAL BARRIERS AGAINST PATIENT ENGAGEMENT
		CONTEXTUAL BARRIERS AGAINST PATIENT ENGAGEMENT
		SYNTHESIS
		KEY POINTS
		REFERENCES
IV - Evaluation and Dissemination
	16 - Evaluation of Evidence-Based Practice
		INTRODUCTION
		METHODS FOR EVALUATION
		WHAT TO MEASURE
		FISCAL OUTCOMES
		DATA SOURCES
		ANALYSIS AND DISPLAY OF DATA
		EVALUATION SUMMARY FOR KEY STAKEHOLDERS
		SYNTHESIS
		KEY POINTS
		REFERENCES
	17 - Dissemination
		INTRODUCTION
		PRINCIPLES OF DISSEMINATION
		INTENDED AUDIENCE
		PRIMARY OBJECTIVE(S) OF DISSEMINATION
		TYPES OF DISSEMINATION
		DISSEMINATION VENUES
		TRADITIONAL METHODS
		SOCIAL MEDIA
		ESSENTIAL ELEMENTS IN DISSEMINATION OF EVIDENCE-BASED PRACTICE PROJECTS
		SYNTHESIS
		KEY POINTS
		REFERENCES
Appendix A
B APPENDIX
APPENDIX C
Appendix D
E Appendix
F Appendix
Appendix G
Appendix H
GLOSSARY
INDEX
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	B
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	D
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	Q
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	Y
SPECIAL FEATURES