Contributors | p. xi |
Foreword to second edition | p. xiii |
Foreword to first edition | p. xv |
Preface | p. xvii |
The Context for Evidence-Based Practice | |
Evidence-based practice in nursing | p. 3 |
Introduction | p. 4 |
Evidence-based health care: what is it and why do we need it? | p. 4 |
The evidence-based movement across health care | p. 8 |
Challenges | p. 10 |
A wide range of evidence bases relevant to nursing practice | p. 12 |
The problem of generalisability | p. 15 |
When will we get there? | p. 16 |
Skills for Evidence-based Practice | |
How to ask the right question | p. 25 |
Introduction | p. 26 |
Information for effective nursing care | p. 26 |
Turning Information needs into focused questions | p. 29 |
A framework for formulating questions | p. 32 |
Becoming proficient in asking questions | p. 40 |
Specific prompts for accessing research evidence | p. 42 |
Prioritising questions | p. 43 |
Questions for research | p. 43 |
Questions and research evidence aren't enough | p. 44 |
Summary | p. 45 |
Searching the literature | p. 51 |
Introduction | p. 52 |
Where is research information found? | p. 52 |
Getting help | p. 53 |
Basic search principles | p. 53 |
Where to search first | p. 60 |
Where to search next | p. 65 |
An example search on the MEDLINE database (PubMed version) | p. 66 |
Common queries regarding searching | p. 73 |
Tips for more advanced users | p. 75 |
Searching for a systematic review | p. 80 |
The internet | p. 83 |
Critical appraisal of quantitative studies I: Is the quality of the study good enough for you to use the findings? | p. 95 |
Introduction | p. 96 |
Is the quality of the study good enough for me to use the results? | p. 98 |
Assessing the quality of a study that asks a question about the effectiveness of a therapy or intervention | p. 104 |
Assessing the quality of a study that asks a question about the performance or accuracy of a particular diagnostic test or method of assessment | p. 110 |
Assessing the quality of a study that asks a question about the likely pattern and/or outcome of a particular health problem/disease | p. 116 |
Critical appraisal in practice | p. 120 |
Summary | p. 122 |
Critical appraisal of quantitative studies 2: Can the evidence be applied in your clinical setting? | p. 127 |
Introduction | p. 128 |
Deciding whether the results can be applied in your clinical setting | p. 129 |
What do the results of this study mean in my context/for my patients? | p. 131 |
Interpreting the results of studies about the effectiveness of a particular therapy or intervention | p. 136 |
Interpreting the results of studies that investigate the performance or accuracy of a particular diagnostic test/method of assessment | p. 141 |
Interpreting the results of studies about prognosis or outcome of a particular condition and/or harm | p. 146 |
Summary | p. 149 |
Qualitative research: critical appraisal | p. 153 |
Introduction | p. 154 |
What is qualitative research? | p. 154 |
Types of qualitative methods | p. 156 |
Appraising qualitative research | p. 162 |
How can qualitative research inform clinical practice? | p. 175 |
Conclusions | p. 178 |
Summary | p. 178 |
Systematic reviews: what are they and how can they be used? | p. 185 |
What are systematic reviews? | p. 186 |
Cochrane Systematic Reviews | p. 192 |
Critical appraisal of systematic reviews | p. 193 |
Understanding meta-analysis | p. 194 |
How can systematic reviews inform practice? | p. 201 |
Integrating research evidence into clinical decisions | p. 209 |
Introduction | p. 210 |
More than research is needed | p. 210 |
Clinical expertise | p. 212 |
Patient preferences, values and beliefs | p. 217 |
Limited resources for health care | p. 227 |
Conclusion | p. 227 |
The Process of Changing Practice | |
Evidence-based guidelines | p. 237 |
Introduction | p. 238 |
Guideline characteristics | p. 238 |
National or local guideline development | p. 239 |
Prioritising topic areas for guideline development | p. 240 |
How are guidelines developed? | p. 241 |
Consensus guidelines | p. 246 |
Example of an evidence-based guideline | p. 249 |
Appraising published guidelines | p. 249 |
Adapting nationally developed guidelines for local use | p. 255 |
Patient versions of guidelines | p. 256 |
Introducing the guideline into practice | p. 256 |
Evaluating the effectiveness of clinical guidelines in nursing and allied health professions | p. 257 |
Benefits and disbenefits of clinical guidelines | p. 259 |
Conclusion | p. 260 |
Implementing best evidence in clinical practice | p. 267 |
Introduction | p. 268 |
How is this relevant to me? | p. 268 |
Implementing best evidence - where to start? | p. 269 |
First steps | p. 274 |
What changes are needed? | p. 285 |
How to implement the changes | p. 291 |
Evaluating the progress and effects of the changes | p. 297 |
Conclusion | p. 299 |
How can we develop an evidence-based culture? | p. 305 |
Introduction | p. 306 |
National imperatives | p. 306 |
What does an evidence-based culture look like? | p. 307 |
Diagnosing the challenges to changing practice - understanding complexity | p. 310 |
How can evidence-based innovation and culture be encouraged? | p. 312 |
How can change happen? | p. 316 |
Real-life examples of changing practice and culture | p. 325 |
Conclusion: culture, practice change and evidence-based health care | p. 331 |
Glossary | p. 339 |
Index | p. 347 |
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