Ellen Fineout-Overholt | University of Texas at Tyler (original) (raw)
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Papers by Ellen Fineout-Overholt
Pediatric Nursing
From the searches presented, it can be seen that there are times when scientific studies will not... more From the searches presented, it can be seen that there are times when scientific studies will not be available to answer burning clinical questions. If systematic reviews, evidence-based guidelines, and individual studies are not available, clinicians must then turn to expert anecdotal evidence to guide their decision-making process and interventions. As further randomized controlled trials are conducted to evaluate nursing interventions, more scientific evidence will become available to guide nursing practice. However, it is important to remember that EBP not only encompasses evidence from research and its appraisal, but also includes patient preferences and expertise by the clinician. Because a meta-analysis indicated that patients had 28% better outcomes when nursing interventions were based on scientific evidence rather than interventions that were steeped in tradition (Heater, Becker, & Olson, 1988), it is essential that nurse practitioners and nurses have the appropriate knowl...
Pediatric nursing, 2005
Critical appraisal of research studies is the third step in evidence-based practice (EBP), follow... more Critical appraisal of research studies is the third step in evidence-based practice (EBP), following step one, “Asking clinical questions in PICO (i.e., population, intervention or interest area; comparison intervention or group, and outcome of interest) format,” and step two, “Searching for evidence to answer the questions.” Once research is found to answer a burning PICO clinical question (e.g., In teens, is cognitive-behavioral therapy or relaxation techniques more effective in reducing anxiety symptoms?), the clinician must be able to rapidly appraise studies in order to determine their validity and applicability to clinical practice. For years, research courses in many educational curriculums have taught critiquing studies as a very detailed, time consuming process. Unfortunately, this method of teaching the appraisal process has often contributed to lasting negative attitudes about research and misperceptions by clinicians about the length of time that it takes to read and cri...
American Journal of Nursing, 2010
ABSTRACT This is the third article in a series from the Arizona State University College of Nursi... more ABSTRACT This is the third article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Ask the Authors" call-ins every few months to provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will be published with May's Evidence-Based Practice, Step by Step.
Pediatric nursing, 2007
Although major healthcare and professional organizations as well as key leaders have long emphasi... more Although major healthcare and professional organizations as well as key leaders have long emphasized the importance of evidence-based practice (EBP) in improving patient care and outcomes, the majority of healthcare professionals do not implement EBP. There is a huge gap in time that exists between the generation of research findings and the translation of those findings into clinical practice. Many efficacious interventions are not being used in clinical practice even though research findings suggest that they improve child and adolescent health and development. Conversely, many clinical practices are being implemented without sufficient evidence to support their use. Because of the need to accelerate EBP and to generate evidence to support best practices, the first EBP Leadership Summit focused on children and adolescents was conducted in February 2007. Several nationally recognized EBP experts and healthcare leaders from a number of children's hospitals and colleges of nursin...
I n September’s evidencebased practice (EBP) article, Rebecca R., our hypotheti cal staff nurse, ... more I n September’s evidencebased practice (EBP) article, Rebecca R., our hypotheti cal staff nurse, Carlos A., her hospital’s expert EBP mentor, and Chen M., Rebecca’s nurse colleague, rapidly critically appraised the 15 articles they found to answer their clinical question—“In hospitalized adults (P), how does a rapid response team (I) compared with no rapid response team (C) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a three-month period (T)?”—and determined that they were all “keepers.” The team now begins the process of evaluation and syn thesis of the articles to see what the evidence says about initiating a rapid response team (RRT) in their hospital. Carlos reminds them that evaluation and synthesis are synergistic processes and don’t necessarily happen one after the other. Nevertheless, to help them learn, he will guide them through the EBP process one step at a time.
Enfermería actual en Costa Rica
I The objective of this study is to translate and culturally adapt to European Portuguese “EBP Be... more I The objective of this study is to translate and culturally adapt to European Portuguese “EBP Beliefs Scale for Educators” (EBPB-E), “EBP Implementation Scale for Educators” (EBPI-E) and “Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey ”for Educators (OCRSIEP-E); and to provide preliminary validation data. The study was carried out in two phases: translation and transcultural adaptation; and preliminary validation in nursing educators of nine nursing schools in Portugal. Pre-final versions of the instruments were considered easy to understand. But, the participants suggested including the possibility of "I don't know" response and increasing the recall period in the EBPI-E. 68 educators participated in phase II. The α for EBPB-E, EBPI-E and OCRSIEP-E was 0.88, 0.95 and 0.94 and the corrected element-total correlations between the items and the total score ranged from 0.20 to 0.75, 0.59 to 0.84 and -0.06 to 0.78, respect...
Nursing Critical Care
www.nursingcriticalcare.com TA M IS C IA O / S H U T T E R S T O C K Critical care nurses can bes... more www.nursingcriticalcare.com TA M IS C IA O / S H U T T E R S T O C K Critical care nurses can best explain the reasoning for their clinical actions when they understand the worth of the research supporting their practices. In critical appraisal, clinicians assess the worth of research studies to clinical practice. Given that achieving improved patient outcomes is the reason patients enter the healthcare system, nurses must be confident their care techniques will reliably achieve best outcomes. Nurses must verify that the information supporting their clinical care is valid, reliable, and applicable. Validity of research refers to the quality of research methods used, or how good of a job researchers did conducting a study. Reliability of research means similar outcomes can be achieved when the care techniques of a study are replicated by clinicians. Applicability of research means it was conducted in a similar sample to the patients for whom the findings will be applied. These three criteria determine a study’s worth in clinical practice. Appraising the worth of research requires a standardized approach. This approach applies to both quantitative research (research that deals with counting things and comparing those counts) and qualitative research (research that describes experiences and perceptions). The word critique has a negative connotation. In the past, some clinicians were taught that studies with flaws should be discarded. Today, it is important to consider all valid and reliable research informative to what we understand as best practice. Therefore, the author developed the critical appraisal methodology that enables clinicians to determine quickly which evidence is worth Abstract: Critical appraisal is the assessment of research studies’ worth to clinical practice. Critical appraisal— the heart of evidence-based practice—involves four phases: rapid critical appraisal, evaluation, synthesis, and recommendation. This article reviews each phase and provides examples, tips, and caveats to help evidence appraisers successfully determine what is known about a clinical issue. Patient outcomes are improved when clinicians apply a body of evidence to daily practice.
Worldviews on Evidence-Based Nursing
BACKGROUND Although several models of evidence-based practice (EBP) exist, there is a paucity of ... more BACKGROUND Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings. AIM The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians' EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States. DESIGN A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full implementation of the ARCC Model. SETTING AND SAMPLE The study was conducted at a 341-bed acute care hospital in the western region of the United States. The sample consisted of 58 interprofessional healthcare professionals. METHODS The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Healthcare professionals' EBP beliefs, EBP implementation, and organizational culture were measured with valid and reliable instruments. Patient outcomes were collected in aggregate from the hospital's medical records. RESULTS Findings indicated significant increases in clinicians' EBP beliefs and EBP implementation along with positive movement toward an organizational EBP culture. Study findings also indicated substantial improvements in several patient outcomes. LINKING EVIDENCE TO ACTION Implementation of the ARCC Model in healthcare systems can enhance clinicians' beliefs and implementation of evidence-based care, improve patient outcomes, and move organizational culture toward EBP.
Pediatric Nursing
From the searches presented, it can be seen that there are times when scientific studies will not... more From the searches presented, it can be seen that there are times when scientific studies will not be available to answer burning clinical questions. If systematic reviews, evidence-based guidelines, and individual studies are not available, clinicians must then turn to expert anecdotal evidence to guide their decision-making process and interventions. As further randomized controlled trials are conducted to evaluate nursing interventions, more scientific evidence will become available to guide nursing practice. However, it is important to remember that EBP not only encompasses evidence from research and its appraisal, but also includes patient preferences and expertise by the clinician. Because a meta-analysis indicated that patients had 28% better outcomes when nursing interventions were based on scientific evidence rather than interventions that were steeped in tradition (Heater, Becker, & Olson, 1988), it is essential that nurse practitioners and nurses have the appropriate knowl...
Pediatric nursing, 2005
Critical appraisal of research studies is the third step in evidence-based practice (EBP), follow... more Critical appraisal of research studies is the third step in evidence-based practice (EBP), following step one, “Asking clinical questions in PICO (i.e., population, intervention or interest area; comparison intervention or group, and outcome of interest) format,” and step two, “Searching for evidence to answer the questions.” Once research is found to answer a burning PICO clinical question (e.g., In teens, is cognitive-behavioral therapy or relaxation techniques more effective in reducing anxiety symptoms?), the clinician must be able to rapidly appraise studies in order to determine their validity and applicability to clinical practice. For years, research courses in many educational curriculums have taught critiquing studies as a very detailed, time consuming process. Unfortunately, this method of teaching the appraisal process has often contributed to lasting negative attitudes about research and misperceptions by clinicians about the length of time that it takes to read and cri...
American Journal of Nursing, 2010
ABSTRACT This is the third article in a series from the Arizona State University College of Nursi... more ABSTRACT This is the third article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Ask the Authors" call-ins every few months to provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will be published with May's Evidence-Based Practice, Step by Step.
Pediatric nursing, 2007
Although major healthcare and professional organizations as well as key leaders have long emphasi... more Although major healthcare and professional organizations as well as key leaders have long emphasized the importance of evidence-based practice (EBP) in improving patient care and outcomes, the majority of healthcare professionals do not implement EBP. There is a huge gap in time that exists between the generation of research findings and the translation of those findings into clinical practice. Many efficacious interventions are not being used in clinical practice even though research findings suggest that they improve child and adolescent health and development. Conversely, many clinical practices are being implemented without sufficient evidence to support their use. Because of the need to accelerate EBP and to generate evidence to support best practices, the first EBP Leadership Summit focused on children and adolescents was conducted in February 2007. Several nationally recognized EBP experts and healthcare leaders from a number of children's hospitals and colleges of nursin...
I n September’s evidencebased practice (EBP) article, Rebecca R., our hypotheti cal staff nurse, ... more I n September’s evidencebased practice (EBP) article, Rebecca R., our hypotheti cal staff nurse, Carlos A., her hospital’s expert EBP mentor, and Chen M., Rebecca’s nurse colleague, rapidly critically appraised the 15 articles they found to answer their clinical question—“In hospitalized adults (P), how does a rapid response team (I) compared with no rapid response team (C) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a three-month period (T)?”—and determined that they were all “keepers.” The team now begins the process of evaluation and syn thesis of the articles to see what the evidence says about initiating a rapid response team (RRT) in their hospital. Carlos reminds them that evaluation and synthesis are synergistic processes and don’t necessarily happen one after the other. Nevertheless, to help them learn, he will guide them through the EBP process one step at a time.
Enfermería actual en Costa Rica
I The objective of this study is to translate and culturally adapt to European Portuguese “EBP Be... more I The objective of this study is to translate and culturally adapt to European Portuguese “EBP Beliefs Scale for Educators” (EBPB-E), “EBP Implementation Scale for Educators” (EBPI-E) and “Organizational Culture & Readiness for School-wide Integration of Evidence-based Practice Survey ”for Educators (OCRSIEP-E); and to provide preliminary validation data. The study was carried out in two phases: translation and transcultural adaptation; and preliminary validation in nursing educators of nine nursing schools in Portugal. Pre-final versions of the instruments were considered easy to understand. But, the participants suggested including the possibility of "I don't know" response and increasing the recall period in the EBPI-E. 68 educators participated in phase II. The α for EBPB-E, EBPI-E and OCRSIEP-E was 0.88, 0.95 and 0.94 and the corrected element-total correlations between the items and the total score ranged from 0.20 to 0.75, 0.59 to 0.84 and -0.06 to 0.78, respect...
Nursing Critical Care
www.nursingcriticalcare.com TA M IS C IA O / S H U T T E R S T O C K Critical care nurses can bes... more www.nursingcriticalcare.com TA M IS C IA O / S H U T T E R S T O C K Critical care nurses can best explain the reasoning for their clinical actions when they understand the worth of the research supporting their practices. In critical appraisal, clinicians assess the worth of research studies to clinical practice. Given that achieving improved patient outcomes is the reason patients enter the healthcare system, nurses must be confident their care techniques will reliably achieve best outcomes. Nurses must verify that the information supporting their clinical care is valid, reliable, and applicable. Validity of research refers to the quality of research methods used, or how good of a job researchers did conducting a study. Reliability of research means similar outcomes can be achieved when the care techniques of a study are replicated by clinicians. Applicability of research means it was conducted in a similar sample to the patients for whom the findings will be applied. These three criteria determine a study’s worth in clinical practice. Appraising the worth of research requires a standardized approach. This approach applies to both quantitative research (research that deals with counting things and comparing those counts) and qualitative research (research that describes experiences and perceptions). The word critique has a negative connotation. In the past, some clinicians were taught that studies with flaws should be discarded. Today, it is important to consider all valid and reliable research informative to what we understand as best practice. Therefore, the author developed the critical appraisal methodology that enables clinicians to determine quickly which evidence is worth Abstract: Critical appraisal is the assessment of research studies’ worth to clinical practice. Critical appraisal— the heart of evidence-based practice—involves four phases: rapid critical appraisal, evaluation, synthesis, and recommendation. This article reviews each phase and provides examples, tips, and caveats to help evidence appraisers successfully determine what is known about a clinical issue. Patient outcomes are improved when clinicians apply a body of evidence to daily practice.
Worldviews on Evidence-Based Nursing
BACKGROUND Although several models of evidence-based practice (EBP) exist, there is a paucity of ... more BACKGROUND Although several models of evidence-based practice (EBP) exist, there is a paucity of studies that have been conducted to evaluate their implementation in healthcare settings. AIM The purpose of this study was to examine the impact of the Advancing Research and Clinical practice through close Collaboration (ARCC) Model on organizational culture, clinicians' EBP beliefs and EBP implementation, and patient outcomes at one healthcare system in the western United States. DESIGN A pre-test, post-test longitudinal pre-experimental study was conducted with follow-up immediately following full implementation of the ARCC Model. SETTING AND SAMPLE The study was conducted at a 341-bed acute care hospital in the western region of the United States. The sample consisted of 58 interprofessional healthcare professionals. METHODS The ARCC Model was implemented in a sequential format over 12 months with the key strategy of preparing a critical mass of EBP mentors for the healthcare system. Healthcare professionals' EBP beliefs, EBP implementation, and organizational culture were measured with valid and reliable instruments. Patient outcomes were collected in aggregate from the hospital's medical records. RESULTS Findings indicated significant increases in clinicians' EBP beliefs and EBP implementation along with positive movement toward an organizational EBP culture. Study findings also indicated substantial improvements in several patient outcomes. LINKING EVIDENCE TO ACTION Implementation of the ARCC Model in healthcare systems can enhance clinicians' beliefs and implementation of evidence-based care, improve patient outcomes, and move organizational culture toward EBP.