DNP 810 Module Critical Appraisal of the Evidence Part III
In September’s evidence- based practice (EBP) article, Rebecca R., our hypotheti cal staff nurse, Carlos A., her hospi- tal’s expert EBP mentor, and Chen M., Rebecca’s nurse colleague, ra- pidly critically appraised the 15 articles they found to answer their clinical question—“In hospital- ized adults (P), how does a rapid response team (I) compared with no rapid response team (C) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a three-month period (T)?”—and determined that they were all “keepers.” The team now begins the process of evaluation and syn thesis of the articles to see what the evidence says about initiating a rapid re- sponse team (RRT) in their hos- pital. Carlos reminds them that evaluation and synthesis are syn- ergistic processes and don’t neces- sarily happen one after the other. Nevertheless, to help them learn, he will guide them through the EBP process one step at a time. DNP 810 Module Critical Appraisal of the Evidence Part III
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STARTING THE EVALUATION Rebecca, Carlos, and Chen begin to work with the evaluation table
they created earlier in this process when they found and filled in the essential elements of the 15 stud- ies and projects (see “Critical Ap – praisal of the Evidence: Part I,” July). Now each takes a stack of the “keeper” studies and system- atically begins adding to the table any remaining data that best re – flect the study elements pertain- ing to the group’s clinical question (see Table 1; for the entire table with all 15 articles, go to http:// links.lww.com/AJN/A17). They had agreed that a “Notes” sec- tion within the “Appraisal: Worth to Practice” column would be a good place to record the nuances of an article, their impressions of it, as well as any tips—such as what worked in calling an RRT— that could be used later when they write up their ideas for ini- tiating an RRT at their hospital, if the evidence points in that direc- tion. Chen remarks that al though she thought their ini tial table con- tained a lot of information, this final version is more thorough by far. She appreciates the opportu- nity to go back and confirm her original understanding of the study essentials.
The team members discuss the evolving patterns as they complete the table. The three systematic Critical Appraisal of the Evidence: Part III The process of synthesis: seeing similarities and differences across the body of evidence.
This is the seventh article in a series from the Arizona State University College of Nursing and Health Innovation’s Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician exper- tise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved. DNP 810 Module Critical Appraisal of the Evidence Part III
The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we’ve scheduled “Chat with the Authors” calls every few months to provide a direct line to the experts to help you resolve questions. DNP 810 Module Critical Appraisal of the Evidence Part III
