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Lecture 4

NSG 2113 Lecture Notes - Lecture 4: Causative, Nanda, Family Process

Course Code
NSG 2113
Jacques Barbier

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Evidence Based Nursing
Process to Practice
Evidence-Based Practice: An approach to clinical practice + way to keep current with new developments
- Continuous interactive process of consideration of best available evidence to provide care
Evidence-informed practice: integration of most informative research evidence with evidence from
expert clinical practice, client references, pro clinical judgement and other sources
Evidence-informed decision making: provide safety net and enable to make accurate timely and
appropriate clinical decisions
Evidence-Based Practice:
1. Involves life-long, self-directed, problem-based learning
2. Involves exploring the relationship between clinical reasoning and research evidence
3. Involves practice
Five Steps of Evidence-Based Practice
1. Define the Question
2. Collect the Evidence
3. Critically Appraise the Evidence
4. Integrate the Evidence and Patient Factors
5. Evaluate the Process
Evidence Based Nursing Practice
Knowledge Standard
Each nurse possesses, through basic education and continuing learning, knowledge relevant to
her/his professional practice
Knowledge Standard Indicators
Providing a theoretical and/or evidence-based rationale for all decisions
Understanding the knowledge required to meet the needs of complex clients
Knowing where/how to access learning resources when necessary
Seeking and reviewing research in nursing, health sciences and related disciplines
Using research to inform practice/professional service
Knowledge Application Standard
Each nurse continually improves the application of professional knowledge
Knowledge Application Standard Indicators
Ensuring practice is based in theory and evidence and meets all relevant standards/guidelines
Assessing/describing the client situation using a theory, framework or evidence-based tool
Managing multiple nursing interventions simultaneously
Evaluating/describing the outcome of specific interventions and modifying the plan/approach
Integrating research findings into professional service and practice
Clincal question: focus on relevant components of issue & use 3 elements from PICO format
P: patient population of interest
o Age, sex, ethnicity, disease/health problem of patient
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find more resources at

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I: intervention of interest
o Education, diagnostics, treatment plan, self care
C: Comparison of interest:
o What is usual standard of care or current intervention used now in practice?
O: Outcome
o Change in patient behavior, physical finding
Evidence Pyramid
Evidence Pyramid
- Important medical questions are typically studied more than once, often by different research teams
in different locations. A meta-analysis combines results from different studies, hopefully averaging out
any differences caused by random change or local variation and getting at something close to the real
truth. In general a meta-analysis, if you can find one, will be a better guide to practice than an individual
Evidence Based Resources Models:
Usefulness = Relevance x Validity
Complex situations require critical thinking
Look beyond the obvious
Avoids routine
Evidence based
Requires self awareness
Willing to reconsider
Model of CT for nursing judgment
- Three levels of CT
Basic, complex and commitment
- Five components of CT
1. Knowledge base
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find more resources at
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