evidence that the services and interventions being funded or
reimbursed are effective in securing valued goals.
Until the mid 1990s, many large hospitals had research uti-
lization departments directed by doctorally prepared nurse
scientists. These departments conducted research within the
hospital to answer clinical practice questions, and used the
research findings to dictate practice changes. Today, few hos-
pitals use findings from their own research to direct clinical
nursing practice. As a result of recent advances in informa-
tion technology, findings from published literature can be
found, analyzed, and applied to answer clinically relevant
questions. Key databases and search engines may be easily
accessed on most work computer stations as well as home
computer systems. Many research articles in journals and
guidelines developed by expert panels can be downloaded to
paper copies, read, evaluated, and shared with colleagues.
Therefore, the use of EBP mandates the analysis and
systematic review of research findings. The first step for
you as a student is to be able to read and understand a
research article. To help you, the typical format of a research
journal article with a description of each part is outlined in
Table 5-5.
Steps in Implementing EBP
To practice EBP, nurses carry out the following 5 steps
(Melnyk & Fineout-Overholt, 2005).
Step 1: Ask a question about a clinical area of interest or
an intervention
. There are several different methods that can
be used to ask clinical questions. The most common method
is the PICO format (Melnyk & Fineout-Overholt, 2002),
described in Table 5-6. See the accompanying display,
CHAPTER 5 Theory, Research, and Evidence-Based Practice
79
T
A B L E
•
5-5
PARTS OF A RESEARCH JOURNAL ARTICLE
Sections (in usual order)
Description
The abstract is at the beginning of the article. It summarizes the entire article and usually
provides the purpose of the study, a description of the subjects, data collection and data
analysis, and a summary of important findings.
The literature review discusses relevant studies that have been conducted in the area of this
study. A statement of the specific goals or purpose of the study often follows the review.
The methods section provides in detail how the study was conducted, including who and how
many subjects, what research design was used, what data were collected and how, and types
of analysis done. There should be enough information so that the study could be replicated
(repeated).
The results (findings) are often presented both in words and in charts, tables, or graphs. It is
important to understand what the results were and if they are meaningful.
The discussion section reports what the results mean in regard to the purpose of the study and
the literature review. It may also include suggestions for further research and application to
nursing education or practice, as appropriate.
The references are at the end of the article and include a list of articles and books used by the
researcher.
Abstract
Introduction
•
Review of the literature
•
Statement of the purpose
Method
•
Subjects
•
Design
•
Data collection
•
Data analysis
Results
Discussion (Conclusions)
References
T
A B L E
•
5-6
ASKING CLINICAL QUESTIONS IN PICO FORMAT
Components
Considerations
Need for explicit description; may include setting, limiting to subgroups (such as by age).
The more defined, the more focused search of the literature will be; may include exposure,
treatment, patient perception, diagnostic test, or predicting factor.
Usually the comparison is to another treatment or the usual standard of care.
Specifically identifying the outcome to enable a literature search to find evidence that examined
the same outcome, perhaps in different ways.
P Patient, population, or
problem of interest
I Intervention of interest
C Comparison of interest
O Outcome of interest
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