The first and pivotal phase in the evidence-based practice approach is identifying an appropriate source of evidence that may effectively address a clinical inquiry. This entails using a systematic approach. To start the procedure, it is necessary to define the PICO(T) components, including the delineation of the patient or population, intervention, comparison (if relevant), outcomes, and timeframe (if appropriate) (Melnyk, 2022). An illustrative example might be: “In the context of cancer patients suffering from fatigue, this study aims to investigate the impact of meditation, in comparison to standard care, on the enhancement of quality of life within a timeframe of 6 months subsequent to treatment.”
Following the identification and clarification of the PICO (T) aspects, the subsequent stage entails carefully selecting databases deemed suitable for the research inquiry. The use of renowned databases, such as PubMed, Cochrane Library, CINAHL, and Embase, is crucial in academic research (Melnyk, 2022). The selection of a certain database should be customized according to the nature of the inquiry, whether it pertains to clinical, pharmacological, or other relevant categories.
The use of relevant keywords is of utmost importance. The efficacy of a search may be enhanced by formulating a list of keywords linked to the PICO(T) components and combining them using Boolean operators such as AND and OR. Filtering is an essential component that enables researchers to refine their search by considering factors such as publication type, study design, and other pertinent criteria (Villegas & Choque, 2020).
The assessment of the source is essential. Evaluating source credibility necessitates considering several factors, including authorship, journal repute, and publication date. In addition, it is advisable to search for systematic reviews and meta-analyses since these types of studies often provide a full synthesis of the existing data (Villegas & Choque, 2020). If systematic evaluations are not accessible, researchers have to seek out meticulously executed primary investigations.
After the identification of the relevant source, the subsequent stage in the process of evidence-based practice involves the determination of the most suitable research design. This entails taking into account the nature of the inquiry being examined. Various research designs are appropriate for various categories of inquiries, including treatment, diagnosis, prognosis, and causation (Lyons et al., 2020).
Understanding the hierarchy of evidence, which ranks research designs by reliability and validity, is vital. A gold standard for therapy and intervention questions is randomized controlled trials (RCTs). Cross-sectional, case-control, and diagnostic accuracy studies may answer diagnosis questions (Lyons et al., 2020). Depending on the issue, etiology/harm questions may need cohort studies, case-control studies, or RCTs, whereas prognosis questions require cohort studies.
The high level of evidence and synthesis of numerous studies that systematic reviews and meta-analyses offer make it possible to conduct a more thorough review of the state of research. This is particularly crucial in areas with a lot of research or contradicting results. A thorough and methodical search of the literature is necessary for systematic reviews in order to find all relevant research on a given subject (Portney, 2020). After a careful evaluation of the research, the results are combined using statistical methods like meta-analysis to determine the overall impact of the interventions or therapies under investigation.
In conclusion, evidence-based practice involves a planned way of finding relevant sources of evidence. This is done by figuring out the PICO(T) elements, choosing relevant databases, using filters and relevant keywords, evaluating sources, and thinking about study designs that are right for the type of clinical question at hand. Knowledge of the evidence hierarchy and the use of systematic reviews and meta-analyses contribute to the strength of the evidence-based practice paradigm.
References
Lyons, O., George, R., Galante, J. R., Mafi, A., Fordwoh, T., Frich, J., & Geerts, J. M. (2020). Evidence-based medical leadership development: a systematic review. BMJ leader, 5(3).
Melnyk. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Portney, L. G. (2020). Foundations of clinical research: applications to evidence-based practice. FA Davis.
Villegas, J. L. V., & Choque, R. A. M. (2020). Defining a good research question using the PICOT and FINGER format. Gaceta Médica Boliviana, 43(2), DEFINING-A.
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