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DNP in Practice: EBP Review

Defining EBP

Evidence-Based Practice (EBP) is the framework for your clinical decision-making process. It is the integration of

  • Clinical Expertise: your knowledge, skills, and past experience
  • Patient Characteristics: the unique preferences, concerns and expectations of your patient
  • Best Evidence: valid and clinically relevant research   

 

Types of Clinical Questions

Therapy - What is the treatment for a disease?

Diagnosis - power of a test to differentiate between those with and without a disease?

Prognosis - a patient’s likely course over time due to factors other than interventions?

Etiology/Harm - effects of potentially harmful agents on the patient?

Study Design

 

Type of Question Suggested Best Type of Study
Therapy RCT > prospective cohort
Diagnosis Prospective, blind comparison to a gold standard
Etiology/Harm RCT > cohort > case control > case series
Prognosis cohort study > case control > case series
Prevention RCT > cohort study > case control > case series
Clinical Exam prospective, blind comparison to gold standard
Cost economic analysis

5 A's - Steps for Acquiring Information

                    

               - Review the Situation (Assess)

             - Define the clinical problem as a question (Ask)

             - Select resources, design a strategy, and search for the

               answer (Acquire)

             - Summarize the evidence yield (Appraise)

             - Apply the evidence (Apply)

Hierarchy of the Evidence

Research design and evidence

By CFCF (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

AACN Levels of Evidence

AACN new levels of evidence

AACN Levels of evidence citation