Christopher Manacci, MSN, ACNP, CCRN Acute Care Nurse Practitioner Critical Care Transport Services...
-
Upload
hector-bridges -
Category
Documents
-
view
220 -
download
1
Transcript of Christopher Manacci, MSN, ACNP, CCRN Acute Care Nurse Practitioner Critical Care Transport Services...
Christopher Manacci, MSN, ACNP, CCRNAcute Care Nurse Practitioner
Critical Care Transport ServicesThe Cleveland Clinic
Director, ACNP Flight Nursing ProgramThe National Flight Nurse Academy
Case Western Reserve University
Define EBP Discuss the process for developing EBP Identify levels of evidence Discuss how to evaluate evidence List strategies for making EBP changes
Integration of best research evidence with clinical expertise and patient values
◦ Identify a clinical problem◦ Asking an answerable question◦ Searching for evidence◦ Evaluating evidence
Clinical practice – high volume, high cost patient populations
Quality assurance indicators Regulatory requirements, accreditation
standards
Strong questions have 4 components:• Problem of interest• Main intervention• Comparison intervention, if relevant• Outcome of interest
Searching for evidence Start with Systematic Reviews Clinical trials Experimental studies Quasi experimental studies Descriptive or Qualitative Case Studies
Systematic review is a summary of research literature that uses explicit methods to systematically search, critically appraise, and synthesize the literature on a specific issue.
◦ Meta-analysis – a type of systematic review that uses quantitative methods to summarize the results.
Clinical Trial:◦ random assignment of subjects◦ double blinded◦ prospective ◦ one or more interventions are tested in an
experimental group and compared to a control group
Experimental study has:◦ Random assignment of subjects to an
experimental and control group◦ An independent variable that the investigator
manipulates (intervention)◦ A dependent (outcome) variable
Quasi-experimental has:◦No Random assignment of subjects to an
experimental and control group◦ An independent variable that the investigator
manipulates (intervention)◦ A dependent (outcome) variable
Descriptive, Correlational, Survey:◦ Main objective is to understand the characteristics
of persons, situations, or groups; and/or the frequency with which certain phenomena occur.
Qualitative:◦ Main objective is to describe a phenomenon or
understand an experience◦ Data is collected in narrative (nonnumeric) form
Case Study:◦ An in-depth analysis of an individual, group,
institution or other social unit
National Guideline Clearinghouse◦ www.ngc.gov
The Cochrane Library◦ www.chchrane.de
Evidence Based Journals◦ e.g. www.evidencebasednursing.com
Professional Organization Guidelines PubMed
◦ www.ncbi.nlm.nih.gov/PubMed
Systematic Reviews (SR): Are the results of the SR valid? Are the results important? Can you apply this evidence in caring for
your patients? What is the clinical bottom line?
The Association of Air Medical Services Research Committee developed several surveys
Identify the restraining forces related to the lack of research
Identify the priorities in air medical research Develop a cohort of member programs to
create, encourage and promote research
Auto Launch Early Activation Appropriate use of air medical services Criteria for waiting on scene for air
medical services Relationship of number and type of
missions and patient outcomes Is there a difference in outcome utilizing
different team configurations, e.g. Advanced Practice v. Traditional
What is auto launch and do we all define it the same way?
Is auto launch different than early activation?
Is auto launch cost effective? Does auto launch improve outcomes in the
trauma population?