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Nursing 122 (Benetti)

Nursing 122 (Benetti)

What is Evidence-Based Practice (EBP)? 

The most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)

EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.

Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature.

"Introduction to Evidence-Based Practice - Tutorial" by Duke University Medical Center Library and the Health Sciences Library at the  University of North Carolina at Chapel Hill (http://guides.mclibrary.duke.edu/content.php?pid=431451&sid=3529499) available under a  Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License   

The Steps in the EBP Process:

ASSESS the patient

 1. Start with the patient - a clinical problem or question arises from the care of the patient

ASK the question

 2. Construct a well built clinical question derived from the case

ACQUIRE the evidence

 3. Select the appropriate resource (s) and conduct a search

APPRAISE the evidence

 4. Appraise that evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice) 

APPLY: talk with the patient

 5. Return to the patient - integrate that evidence with clinical expertise, patient preferences and apply to the practice

Self-evaluation

 6. Evaluate your performance with this patient

 

To access the entire six-step Interactive EBP tutorial developed by Duke University and the University of Carolina at Chapel Hill, select the link Introduction to Evidence-Based Practice

"Introduction to Evidence-Based Practice - Tutorial" by Duke University Medical Center Library and the Health Sciences Library at the  University of North Carolina at Chapel Hill (http://guides.mclibrary.duke.edu/content.php?pid=431451&sid=3529499) available under a  Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License      

Your instructor has asked you to use peer-reviewed sources for your research paper. What is "peer-review" in the scholarly world and how do you know if your source is peer-reviewed? Let's explore this by first watching a video on credibility:

Now that we understand the characteristics of a credible source, let's look at what makes a source "peer-reviewed:"


Common Elements of a Peer-Reviewed Research Article 

A peer-reviewed research article generally includes the following sections:

Abstract - includes a brief summary of the research and is typically followed by author credentials.

Introduction - the introduction will contain information about the authors' intentions for the article, why they did the research, and it will include the hypothesis or research objectives. 

Methods - a description of the research methods used (survey, focus groups, statistical analysis, regression analysis, etc.); may also describe limitations with the selected method.

Results - scientific description of the findings.

Discussion - discusses the research in detail.

Conclusion - summarizes the findings and makes suggestions for future use of research. 

Appendix/Appendices - may or may not be part of the article

References and/or bibliography


To summarize:

Scholarly articles are written by an expert in the subject matter, are research focused, contain original research, and the audience is geared towards other experts. Scholarly articles are often, but not always, peer-reviewed.


Peer-reviewed articles are scholarly articles that also go through a rigorous review process by other experts in the same field before publication. How does the process work?

  • After conducting research (often but not always original research) an expert in a field writes an article and submits it to a journal for publication.
  • If the editor(s) believe the article is a good fit, the article is sent to other subject matter experts (in the author's field) who review it for quality indicators such as appropriate scientific methodologies, consideration of previous scholarship, logical conclusions, etc. To avoid bias, reviewers usually do not know the name of the article’s author.
  • Once the review process is complete, the article is returned to the journal editors (with feedback and recommendations for any changes) and either rejected or approved for publication in the journal (pending any required changes the editors require--based on the peer reviewed feedback).

Popular articles are articles that appear in magazines or newspapers, are not scholarly or peer-reviewed, and are written by journalists or staff members who are not subject matter experts. That is not to say that these types of articles are not credible, but they need do need to be evaluated for credibility more so than their counterparts. Examples:

  • New York Times and other newspapers
  • Newsweek
  • National Geographic
  • Psychology Today

There are several ways to check and see if the article you are looking at is peer-reviewed:

  • If you obtain the journal from one of the databases MCC Libraries has access to you can filter you search results to show you only peer reviewed articles.
  • Check the electronic record. In EBSCO and Gale databases, the electronic record will tell you if the article has been peer-reviewed (sometimes called "refereed").
  • Go to the website of the journal the article appears in (many journals only publish peer reviewed articles) to see if it is a peer reviewed publication.
  • Ask a librarian for help!

Find Peer-Reviewed Articles

TRY:

<your topic here> AND pathophysiology

<your topic here> AND assessment

<your topic here> AND intervention

Examples:

myocardial infarction AND pathophysiology

diabetes AND assessment NOT type 2 

pneumonia AND (geriatric OR elderly) AND intervention


CINAHL: How to Find Peer-Reviewed, Evidenced-Based Practice Articles

If you need more information or sources, try the following:


eBooks

Formatting Your Paper

Your paper must include APA formatting and citations. Citation styles require very specific order, punctuation, formatting and capitalization - there is no room for creativity! To see APA rules and examples, visit the APA Citation Guidelines.


Avoiding Plagiarism

Citations are vital to avoiding plagiarism in a research paper, but they are only one part. One of the most difficult aspects of writing a research paper is paraphrasing correctly. Many students who would never intentionally cheat or plagiarize will accidentally plagiarize through improper paraphrasing. Closely examine the paraphrasing examples below and see the Avoiding Plagiarism tutorial for more information. 

Examples of Acceptable and Unacceptable Paraphrasing  

The examples below will show you how paraphrase correctly. They're adapted from Paraphrasing by University Libraries, University of Arizona with its gracious permission.

Here's the original text, from page 1 of Lizzie Borden: A Case Book of Family and Crime in the 1890s by Joyce Williams et al.:

The rise of industry, the growth of cities, and the expansion of the population were the three great developments of late nineteenth century American history. As new, larger, steam-powered factories became a feature of the American landscape in the East, they transformed farm hands into industrial laborers, and provided jobs for a rising tide of immigrants. With industry came urbanization the growth of large cities (like Fall River, Massachusetts, where the Bordens lived) which became the centers of production as well as of commerce and trade.

Here's an unacceptable paraphrase:

The increase of industry, the growth of cities, and the explosion of the population were three large factors of nineteenth century America. As steam-driven companies became more visible in the eastern part of the country, they changed farm hands into factory workers and provided jobs for the large wave of immigrants. With industry came the growth of large cities like Fall River where the Bordens lived which turned into centers of commerce and trade as well as production.

What makes this passage plagiarism?

This is unacceptable paraphrasing because the writer has:

  • only changed a few words and phrases
  • only changed the order of the original's sentences
  • failed to cite a source for any of the ideas or facts
Here's an acceptable paraphrase:

Fall River, where the Borden family lived, was typical of northeastern industrial cities of the nineteenth century. Steam-powered production had shifted labor from agriculture to manufacturing, and as immigrants arrived in the U.S., they found work in these new factories. As a result, populations grew and large urban areas arose. Fall River was one of these manufacturing and commercial centers (Williams 1).

Why is this passage acceptable?
  • accurately relays the information in the original using his/her own words
  • lets the reader know the source of information
Here's an another acceptable paraphrase, using a quotation and paraphrase together:

Fall River, where the Borden family lived, was typical of northeastern industrial cities of the nineteenth century. As steam-powered production shifted labor from agriculture to manufacturing, the demand for workers "transformed farm hands into factory workers" and created jobs for immigrants. In turn, growing populations increased the size of urban areas. Fall River was one of these manufacturing hubs that were also "centers of commerce and trade" (Williams 1).

Why is this passage acceptable?
  • accurately records the information in the original passage
  • gives credit for the ideas in this passage
  • indicated which part is taken directly from the source by putting the passage in quotation marks and citing the page number
 Strategies for avoiding plagiarism

1. Put quotation marks around everything that comes directly from the text, especially when taking notes.

2. When you paraphrase, be sure you're not just rearranging or replacing a few words. Instead, read over what you want to paraphrase carefully; cover up the text with your hand, or close the text so you can't see any of it (and so aren't tempted to use the text as a "guide"). Write out the idea in your own words without peeking.

3. Check your paraphrase against the original text to be sure you haven't accidentally used the same phrases or words, and that the information is accurate.


Revising vs. Editing

Students often confuse proofreading/editing for revision. The following video explains how these two parts of the writing process are both very necessary and very different from each other:

Successful students ask for help early and often!

Here's a few options to get help:


Visit the University of North Carolina's Writing Lab for more writing help. They have many excellent worksheets and tutorials.


Contact the MCC Library if you need help finding or evaluating sources.

During fall and spring semesters, the library is open Monday - Thursday from 8:00 A.M. to 8:00 P.M., and Friday from 8:00 A.M. to 5:00 P.M. for in-person help:

Neal Campus Kingman Library 

1971 E Jagerson Avenue

Building 300

Kingman, AZ 86409

928-757-0856

Virtual help is available at the same hours through the website chat at mohave.libguides.com, text at 928-232-4430, email at askalibrarian@mohave.edu, or on Zoom. Contact the library to set up a Zoom session. 


Contact the Student Success Center if you need help writing, editing or formatting your paper. They are located next to the library.

During fall and spring semesters, tutors are available Monday - Thursday from 9:00 A.M. to 8:00 P.M. and Friday from 10:00 A.M. to 2:00 P.M. 

SmartThinking online tutoring also has tutors who will review your paper. You can access SmartThinking through Schoology at the bottom of the lefthand toolbar.


MCC Connect can transfer your call to the Library, Student Success Center or your professor. Call 866-664-2832.