Table of Contents
About the Authors viii
Contributing Authors xiii
Introduction xxii
I Introduction to the Evidence-Based Practice Competencies 1
1 The Foundation for Improving Healthcare Quality, Patient Outcomes, & Costs with Evidence-Based Practice 3
Setting the Stage 4
Evidence-based Practice and the Quadruple Aim in Healthcare 5
Definition of Evidence-based Practice 8
The Seven Steps of Evidence-based Practice 10
Rationale for the New EBP Competencies 16
Summary 16
References 16
2 Development of and Evidence to Support the Evidence-Based Practice Competencies 19
Setting the Stage 20
Importance of Evidence-based Practice Competencies 21
Implications for Use of the EBP Competencies 28
Summary 29
References 29
II Achieving Competency with the Evidence-Based Practice Competencies 31
3 The Evidence-Based Practice Competencies Related to Clinical Inquiry 33
Setting the Stage 34
Clinical Inquiry Defined and Described 35
Building a Culture That Supports Clinical Inquiry 36
Summary 53
References 54
4 The Evidence-Based Practice Competencies Related to Searching for Best Evidence 55
Setting the Stage 56
Developing a Systematic Approach to Searching 58
Summary 74
References 74
5 The Evidence-Based Practice Competencies Related to Critical Appraisal: Rapid Critical Appraisal, Evaluation, Synthesis, and Recommendations 77
Setting the Stage 78
Understanding the Critical Appraisal Process 81
Taking a Group Approach to Critical Appraisal 89
Summary 106
References 106
6 The Evidence-Based Practice Competencies Related to Implementation 109
Setting the Stage 110
Implementing an Evidence-based Practice Change: Planning for Change 112
Tools to Guide the EBP Change Process 114
Summary 128
References 128
7 The Evidence-Based Practice Competencies Related to Outcomes Evaluation 129
Setting the Stage 130
Evaluating Outcomes 131
Summary 141
References 141
8 The Evidence-Based Practice Competencies Related to Leading and Sustaining Evidence-Based Practice 143
Setting the Stage 144
Essential Components of an Evidence-based Practice Culture and Environment 145
The ARCC Model: A System-Wide Framework for Implementing and Sustaining EBP 151
Summary 159
References 160
9 The Evidence-Based Practice Competencies Related to Disseminating Evidence 163
Setting the Stage 164
The Importance of Disseminating Evidence 164
Summary 181
References 181
III A Practical Guide to Integrating the Evidence-Based Practice Competencies in Different Roles 183
10 Integrating the Evidence-Based Practice Competencies in Healthcare Settings 185
Strategies for Integrating the EBP Competencies in Healthcare Settings 186
Calculating the ROI of EBP 195
Developing Educational Programs around EBP Competencies 198
Creating Opportunities for Interprofessional Learning and Collaboration 201
Developing Other Skills 201
Examples of Integration of the EBP Competencies 202
Summary 202
References 203
11 Integrating the Evidence-Based Practice Competencies into the Role of Advanced Practice Nurses 205
Clinical Nurse Specialists' Role in EBP 207
The CNS as an EBP Mentor 209
The CNS and the EBP Competencies 210
Building the Infrastructure for EBP at an Academic Medical Center through the Role of the CNS 211
Summary 222
References 222
12 Using the Evidence-Based Practice Competencies with Policy and Procedure Committees 225
EBP Competency and the Patient/Family Care Policy Committee 226
A Cost-Effective EBP Competency Assessment and Education 228
Determining an Interprofessional Education Framework 229
Challenges to Using the Evidence-based Practice Competencies with Policy and Procedure Committees 234
Development of a Unit-Based EBP Policy: A Personal Narrative 237
Summary 243
References 244
13 Teaching the Evidence-Based Practice Competencies in Clinical and Academic Settings 245
Matching EBP Competencies to Existing Standards 249
Teaching and Evaluation Strategies for Incorporating EBP Competencies 262
Summary 273
References 273
IV Appendixes 277
A Picot Worksheet and Search Strategy Development 279
B Example of a Completed General Appraisal Overview (GAO) 283
C Example of a Completed Rapid Critical Appraisal Checklist with Rationale 287
D Evaluation Table Template 293
Glossary 297
Index 309
