LESSON REVIEW (5 minutes)

NUR 027 (Nursing Research 1-Lecture) BS

STUDENT ACTIVITY NURSING/SECOND YEAR
SHEET Session # 4

Materials:
LESSON TITLE: IMPORTANCE OF EBP AND THE KEY Book, pen and notebook
STEPS IN EBP
Textbook:
LEARNING OUTCOMES:
Barrientos-Tan, C. (2011). A Research Guide in Nursing
Upon completion of this lesson, the nursing student will be Education: Building an Evidence-Based Practice. Pasay
able to: City: Philippines, Visprint Inc.
1. Discuss the importance of Evidence-based Practice
(EBP) in Nursing.
References:
2. Identify the key steps in EBP.
Polit, Denise F. & Beck, Cheryl T. (2012). Nursing
research: Generating and assessing evidence for nursing
research (9th ed.), Philadelphia, PA: Wolters Kluwer Health/
Lippincott Williams & Wilkins.
https://systematicreviewsjournal.biomedcentral.co
m/articles/10.1186/s13643-020-01369-8

The instructor will open a box of rolled papers with students’ assigned numbers. The students whose numbers
were picked by the instructor will answer one of the following questions:
1. What is evidence-based practice? applying or translating research findings in our daily patient
care practices and clinical decision-making
2. What about evidence-based practice in nursing? The conscientious use of current best evidence of
making clinical decision about patient care.
3. What are the sources of evidence for nursing practice? Tradition and authority, clinical experience,
trial and error and intuition, logical reasoning, disciplined research

MAIN LESSON (30 minutes)

Importance of Evidence –Based Practice in Nursing

This challenges nurses to look at the “why” behind existing methods and processes in search for improvement.
Nurses need to use evidence and speak that language. The importance of EBP in Nursing are as follows: 1.
Ensures patient/clients receive the care that fits their needs
2. Facilitates sound decision making and makes it more explicit
3. Minimizes risk to the patient/client so that benefits outweigh harm
4. Provides the nurse with skills and knowledge to evaluate healthcare literature and
practice 5. Exposes gaps in knowledge and conflicts in evidence

Key Steps in EBP

1. Formulation of a clinical question. This will yield the most relevant and best evidence
by: a. Recognizing need for new information
b. Formulating an answerable clinical question

2. Finding the best evidence to answer the clinical question. This is done by using the PICO Question
format: Patient Population or Problem
Intervention or area of Interest
Comparison intervention or Control group
Outcome
3. Critical appraisal and synthesis of the best evidence or research-based information

This document and the information thereon is the property of PHINMA

 Education (Department of Nursing) 1 of 5
4. Integration of the evidence with the nurse own expertise, assessment of patients
condition, available resources and patient’s preferences and values to implement a
clinical decision
5. Assessment of effectiveness or evaluation of the practice change, as a result of
implementing the evidence

1. Asking the
question

5. Assessment Figure 1. Key Steps in EBP

of effectiveness
EBP: Things to Remember
2. Finding the
evidence

4. Integration of
evidence

3. Critical
appraisal and
synthesis of
evidence

Step 1: The inability to ask a focused and precise question can be a

major impediment to EBP. Step 2: Always strive to use the best
evidence available.
Step 3: The fact that an article or research study has been published does not
necessarily mean that it is valid or reliable, or applicable to your clinical practice.
Step 4: Resistance to change can be a big problem. Involving stakeholders can ensure the change is made
and sustained.
Step 5: EBP is all about having a questioning approach to your work. It is a continuous process to provide
the best quality care to your patients, and to develop you as a nurse , personally and professionally.
This document and the information thereon is the property of PHINMA
Education (Department of Nursing) 2 of 5
CHECK FOR UNDERSTANDING (15 minutes)
Group Quiz. You will be grouped into 5. You are to work in a group by reading the proposed study below and apply the
PICO steps in EBP (10 points).

Associations of loneliness and social isolation with cardiovascular and metabolic health: a systematic
review and meta-analysis protocol

∙ Adriano Winterton,
∙ Linn Rødevand,
∙ Lars T. Westlye,
∙ Nils Eiel Steen,
∙ Ole A. Andreassen &
∙ Daniel S. Quintana

Abstract

Background

A growing number of studies suggest that social isolation and loneliness are associated with premature mortality
and are more prevalent among people with mental illness than in the general population, outlining many potential
paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between
loneliness, social isolation, and established cardiovascular/metabolic risk factors and disorders, especially in
severe mental illness, and to account for potential heterogeneity in the literature.

Methods/design

Studies that report measures of loneliness and/or social isolation along with cardiovascular/metabolic risk factors
will be identified. PubMed, EMBASE (through Ovid SP), Scopus, and PsycINFO (through Ovid SP) will be
searched, along with citation lists of retrieved articles and the Cochrane Database of Systematic Reviews. Grey
literature will be searched using Google Scholar. Data will be extracted from eligible studies for a random effects
meta-analysis. For each study, a summary effect size, heterogeneity, risk of bias, publication bias, and the effect
of categorical and continuous moderator variables will be determined.

Discussion

This proposed systematic review and meta-analysis will identify and synthesise evidence to determine if there is an
association between loneliness, social isolation, and cardiovascular/metabolic risk factors, with a special focus on
severe mental illnesses. The results will help determine links and promising avenues of further research.

(Source: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01369-8)

Answers:
Step 1: Formulation of a clinical question:
a. Recognizing need for new information
b. Formulating an answerable clinical question Asking well-constructed clinical questions is one of
the key skills necessary for doing EBP. Such questions must be both directly related to patients'
concerns and phrased in a way that directs your search to relevant and clear responses in order to
help both patients and professionals. With its well-built clinical question, the PICOT model makes
the research process easy. It also aids in the development of a search strategy by defining the main
topics that must be included in the article in order to answer the query.
P = Patient, Problem, Population I = Intervention C = Comparison O = Outcome T – Time Target
Step 2: Finding the best evidence:
The PICO Question format is used to accomplish this: Patient Population, Problem Intervention,
Comparison Intervention, or Control Group Outcome. The researchers will conduct a comprehensive
literature search to the association between loneliness and social isolation and recognized
cardiovascular and metabolic risk factors for metabolic disease.
The traditional approach to search for evidence has been using major databases, such as PubMed,
or EMBAS comprehensive sources including millions of relevant articles. Considering the massive
amount of information, a discard periodically reviewing our favorite journals as a means of sourcing
the best available evidence, search loneliness/or social isolation/or social deprivation/or social
alienation/or psychosocial deprivation.
Critical appraisal is the process of carefully and methodically evaluating the results of scientific
study (evidence) to determents trustworthiness, value, and applicability in a specific context. Critical
appraisal investigates the methodology of a research and aspects such as internal validity,
generalizability, and relevance. To significantly alter the best evidence, researchers.

Step 3: Critical appraisal and synthesis of the best evidence.

Ensure that the research evidence is from a well-known source. a trustworthy source that has been
evaluated, consider the evidence supporting its usefulness, evaluate the advantages and strengths
of research against the flaws and drawbacks, and so on. The evidence must be current, and the
research method and findings must be analyzed.

Step 4. Integration of the evidence.

Integration of the evidence with the nurse own expertise, assessment of patient’s condition,
available resources and patient’s preferences and values to implement a clinical decision

Step 5. Assessment of effectiveness. (NOT AVAILABLE). The abstract presented is a study proposal.

RATIONALIZATION ACTIVITY
The instructor will now rationalize the answers to the students and will encourage them to ask questions and to
discuss among their classmates for (ten) 10 minutes.
Answers:

Step 1: Formulation of a clinical question:

Step 2: Finding the best evidence:

Step 3: Critical appraisal and synthesis of the best evidence.

Step 4. Integration of the evidence.

Step 5. Assessment of effectiveness. (NOT AVAILABLE). The abstract presented is a study proposal.

This document and the information thereon is the property of PHINMA

Education (Department of Nursing) 4 of 5
LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help
you track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: Think, Pair Share

Pair up with the person to your right. The instructor will pose the question, “What do you think is the most relevant
research problem in healthcare today that can be addressed by EBP?”. Each pair will share insights and write
their answer on a sheet of paper. You have to articulate your answer as the instructor calls on you to recite.
This document and the information thereon is the property of PHINMA
Education (Department of Nursing) 5 of 5