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based nursing)
Kep. Komunitas
Ns. Ari Rahmat Aziz, M. Kep
Evidence-based Nursing
An integration of the best evidence available, nursing
expertise, and the values and preferences of the individuals,
families, and communities who are served.
External evidence: research and other evidence.
Internal evidence: Nurse clinical experiences and client’s
preferences.
suatu proses pengambilan keputusan klinik oleh perawat
dengan memanfaatkan hasil-hasil riset (bukti empiris) yang
terbaik, keahlian klinis, keinginan dan pilihan pasien serta
dengan mempertimbangkan sumber daya yang dimiliki
Type of Evidence
Urutan hasil riset yg dijadikan evidence mulai dari
yg terbaik:
1. Double blind randomized controlled trial (RCT).
2. Other RCTs
3. Nonrandomized clinical trials
4. Quasi-experimental studies
5. Case control report
6. Qualitative studies.
7. Expert opinion (Russell – Babin, 2009)
Con’t Expert Opinion
1. Non research- based published articles
2. Professional guidelines
3. National guidelines
4. Organizational opinions
5. Panel of experts
6. The Nurse clinical expertise
EBP in Community Nursing
Scientific literature found in systematic reviews
Scientific literature used or quoted in one or more journal
articles
Public health surveillance data
Program evaluations
Qualitative data obtained from community members and
other stakeholders.
Media and marketing data, such as the results of media
campaign to reduce smoking, word of mouth, and personal
or professional experience (Brownson, Fielding, And
Maylahn, 2009)
Faktor yg mempengaruhi Pelaksanaan
EBP
1. Knowledge of research and current evidence
2. Ability to interpret the meaning of the evidence
3. Individual professional's characteristics, such as
willingness to change.
4. Commitment of the time needed to implement EBP
5. The hierarchy of the practice environment and the
level of support of managers and and the ability to
engage in autonomous practice.
6. etc
Step in evidence- based Practice
Process
Melnyk and fineout-ovelholt (2010) described the following seven
step EBP process:
1. Cultivating a spirit in inquiry
2. Asking clinical questions
3. Searching for the best evidence
4. Critically appraising the evidence
5. Integrating the evidence with clinical expertise and client
preferences and value
6. Evaluating the outcome of the practice decisions or changes based
on evidence
7. Disseminating EBP results
Step 0
Involves a curiosity about the intervention that are
being applied. Example: apakah kunjungan rumah
(home visite) terhadap ibu baru dan bayi lebih
efektif meningkatkan kesehatan bayi?
Dapat menggunakan “PICO”
PICO
Component of PICO:
The need to define the p (population) of interest
The I (intervention) or practice strategy in question
The Population or intervention to be used for C (comparison)
The (O) outcome desired
The T (time) frame
Example:
P : Ibu baru melahirkan/ ibu hamil
I : Diskusi kelompok ibu hamil
C: Penyuluhan, Kemitraan, etc
O: Angka Kunjungan ke Faskes meningkat
T : 2 minggu
Pertanyaannya/ inquiry:
apakah intervensi dengan diskusi klp ibu hamil selama 2 minggu efektif meningkatkan kunjungan ibu
hamil ke Fasyankes?