Nursing & Health Survival Guide: Evidence Based Practice

Judith Davies

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317905981
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Taking an evidence-based approach is fundamental to ensuring good clinical practice, but it's not always easy. This info-packed guide will be an invaluable resource throughout your healthcare or nursing studies and post-registration, helping you to understand the essentials of EBP theory and application, and develop new insights into healthcare practice.

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Critical Appraisal Skills Programme (CASP) – making sense of evidence

■ TEN QUESTIONS TO HELP YOU MAKE SENSE OF REVIEWS

How to use this appraisal tool

Three broad issues need to be considered when appraising the report of a systematic review:

• Is the study valid?

• What are the results?

• Will the results help locally?

The ten questions are adapted from Oxman AD, Cook DJ, Guyatt GH, Users’ guides to the medical literature. VI. How to use an overview. JAMA 1994; 272(17), 1367–1371.

SCREENING QUESTIONS
1. Did the review ask a clearly-focused question? Consider if the question is ‘focused’ in terms of: • The population studied • The intervention given or exposure • The outcomes considered	Yes □ Can’t tell □ No □
2. Did the review include the right type of study? Consider if the included studies: • Address the review question • Have an appropriate study design	Yes □ Can’t tell □ No □

Is it worth continuing?

DETAILED QUESTIONS
3. Did the reviewers try to identify all relevant studies? Consider: • Which bibliographics databases were used • If there was follow-up from reference lists • If there was personal contact with experts • If the reviewers searched for unpublished studies • If the reviewers searched for non-English-language studies	Yes □ Can’t tell □ No □
4. Did the reviewers assess the quality of the included studies? Consider: • If a clear, predetermined strategy was used to determine which studies were included. Look for: – A scoring system – More than one assessor	Yes □ Can’t tell □ No □
5. If the results of the studies have been combined, was it reasonable to do so? Consider whether: • The results of each study are clearly displayed • The results were similar from study to study (look for tests of heterogeneity) • The reasons for any variations in results are discussed	Yes □ Can’t tell □ No □
6. How are the results presented and what is the main result? Consider: • How the results are expressed (e.g. odds ratio, relative risk, etc.) • How large this size of result is and how meaningful it is • How you would sum up the bottom-line result of the review in one sentence	Write comments here …
7. How precise are these results? Consider: • If a confidence interval were reported, would your decision about whether or not to use this intervention be the same at the upper confidence limit as at the lower confidence limit? • If a P value is reported where confidence intervals are unavailable	Write comments here …
8. Can the results be applied to the local population? Consider whether: • The population sample covered by the review could be different from your population in ways that would produce different results • Your local setting differs much from that of the review • You can provide the same intervention in your setting	Yes □ Can’t tell □ No □
9. Were all important outcomes considered? Consider outcomes from the point of view of the: • Individual • Policy-makers and professionals • Family/carers • Wider community	Yes □ Can’t tell □ No □
10. Should policy or practice change as a result of the evidence contained in this review? Consider: • Whether any benefit reported outweighs any harm and/or cost. If this information is not...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgements
• INTRODUCTION
• THE SIX ESSENTIAL STEPS IN THE EVIDENCE-BASED PRACTICE CYCLE
• CRITICAL APPRAISAL SKILLS PROGRAMME (CASP) – MAKING SENSE OF EVIDENCE
• REFERENCES