Characteristics of Nursing Research Utilization and Evidence-Based Practice
Introduction
Research utilization and evidence-based practice (EBP) are regularly used within the nursing profession in developing positive changes for patient outcomes. Although both research methods provide results beneficial to the nursing community, each method approaches nursing research in a different manner. Research utilization focuses on implementation of the results after a study is conducted whereas EBP incorporates the research directly into the clinical decision-making process (Polit & Beck, 2006).
Characteristics of Research Utilization
In the previous lessons, the focus has been on the language and components of research. In this lesson, the focus is on how to apply research findings to improve patient outcomes. Over the past 40 years, the concept of research utilization has been described in the literature. In the nursing community, the long-held tradition has been to utilize research, through findings, to impact health changes within the profession. In order for this process to be successfully implemented into application, the research analysis would be compounded upon multiple studies within a specific nursing area. Furthermore, through the presentation of correlated findings and possibly similar results, health care professionals will have an accurate knowledge in order to influence patient and system outcomes.
Over time, issues have been raised about research utilization being affected. The key to research utilization is not only the acknowledgment and review of the findings but the implementation of those results into practice. In order for this to occur, nurses need to be active participants in evaluating current research and utilizing the results within their normal practice (Polit & Beck, 2006).
The majority of nurses in the United States are initially educated at the Associate Degree level. In these programs, the concepts of nursing research are often not discussed. Similarly, most registered nurses are not taught how to evaluate advanced nursing science, or how such advances will improve outcomes. Research utilization and evidenced-based practice principles put emphasis on these skills.
Evidence-Based Practice
Recently, a movement has been made toward evidence-based practice (EBP) research. The purpose behind this method is to implement a solution to an evidence-based problem. To accomplish this goal, registered nurses must become experts in not only reading research articles, but also in collecting relevant research findings to help them make clinical decisions. After the fundamental information is collected about a health care topic, the researcher can utilize it in creating the design and framework for the necessary research. In essence, the search for the best possible information from top-quality research, which is integrated with clinical expertise, available resources, and the needs and desires of the patient, is the basis for EBP in nursing.
The skills associated with EBP research place emphasis on diagnosis, therapy, etiology, prognosis, or prevention. EBP has been developed to provide a method for practicing nurses to understand research in a way that allows them to incorporate it into improved patient care. One skill that is helpful is the PICO method, which allows practitioners to formulate research questions. By formulating a PICO question, nurses are making the first step in preparing for their capstone project.
PICO
PICO is a mnemonic used to describe the four elements of a good clinical foreground question: (P) patient, (I) intervention, (C) comparison, and (O) outcome (see Table 5.1). The purpose of the PICO format is to assist clinicians in formulating clinical questions. This beginning process can be a challenge, but using the PICO format allows researchers to critically consider all of the components their research will address.
| PICO |
Example 1 |
Example 2 |
Example 3 |
Example 4 |
| P (Patient or problem) Describe, as accurately as possible, the patient or group of patients of interest. |
In patients with acute bronchitis, |
In children with cancer, |
Among family members of patients undergoing diagnostic procedures, |
For pain in post operative patients, |
I (Intervention/Issue of Interest or cause, prognosis)
What is the main intervention or therapy you wish to consider,
including an exposure to disease, a diagnostic test, a prognostic factor, a treatment, a patient perception, a risk factor, etc.? |
do antibiotics |
what are the current treatments |
does standard care− |
do relaxation and deep breathing accompanied by music therapy |
C (Comparison Intervention or Comparison Group)
Is there an alternative treatment to compare,
including no disease, placebo, a different prognostic factor, absence of risk factor, etc.? |
none |
none |
listening to tranquil music, or audiotaped comedy routines− |
none |
O (Outcome)
What is the clinical outcome, including a time horizon, if relevant? |
reduce sputum production, cough, or days off? |
in the management of fever and infection? |
make a difference in the reduction of reported anxiety? |
change patient reported pain score by 4-5 points? |
| Table 5.1. Example PICO Questions |
Adapted from Evidence-Based Practice: Asking the Clinical Question (Cushing/Whitney Memorial Library, n.d.). |
When developing a PICO question, researchers must take the time to carefully formulate it. They need to make it a topic about which they are passionate, and one that has a body of literature to support the intended outcome.
Conclusion
Nurses’ responsibilities lie in being observant and curious, participating in quality-management activities of their units, and supporting research activities developed by others. Using expertise and professional judgment, along with quality research evidence, is essential in developing quality care and outcomes for patients.
References
Cushing/Whitney Memorial Library. (n.d.). Evidence-based practice: Asking the clinical question. Yale University. Retrieved October 4, 2011, from http://www.med.yale.edu/library/nursing/education/…
Polit, D. F., & Beck, C. T. (2006). Essentials of nursing research: Methods, appraisal, and utilization (6th ed.). Philadelphia: Lippincott.
Discussion 1
The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.
Discussion 2
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace?
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