Evidence-Based Practice for Nurses

15.2 Appraising the Evidence

KEY TERMS

active rejection:

Purposefully

deciding not to

adopt an innovation

passive rejection:

Lack of consideration

given to adopting

an innovation;

hence, old practices

are continued

At the end of this section, you will be able to:

‹ Explain how findings from quantitative designs contribute to evidence

‹ Discuss characteristics that should be appraised when evaluating qualitative and

quantitative designs

‹ Rank pieces of evidence using a rating system

Does the Study Provide Good Evidence?

Determining the relevance of the evidence requires skill in analyzing research
studies. These skills include techniques used for determining the strength, signifi-
cance, and relevance of the evidence. There are five steps for evaluating and imple-
menting evidence-based practice (EBP), which are listed and briefly described in
Table 15-1 (deGroot, van der Wouden, van Hell, & Nieweg, 2013). Although each
step requires solid analytical skills and application of good research methods, the
steps are especially important for weighing the evidence. When appraising, nurses
need to ensure that the first two steps, ask and acquire, were thoroughly executed.

After specific literature about the research question has been collected, a rigorous
evaluation is conducted. The mere fact that an individual study has been published
in a peer-reviewed journal does not ensure that the findings are sound (Watson,
2012). During appraisal, the study design, how the research was conducted, and
the data analysis are all scrutinized to ensure that the study was sound. Box 15-1
presents questions that should be considered when examining individual studies.

Ask Identify the research question. Determine whether the question is well

constructed to elicit a response or solution.

Acquire Search the literature for preappraised evidence or research. Secure the best

evidence that is available.

Appraise Conduct a critical appraisal of the literature and studies. Evaluate for validity and

determine the applicability in practice.

Apply Institute recommendations and findings and apply them to nursing practice.

Assess Evaluate the application of the findings, outcomes, and relevance to nursing practice.

Modified from de Groot, M., van der Wouden, J. M., van Hell, E. A., & Nieweg, M. B. (2013).

Evidence based practice for individuals for groups: Let’s make a difference. Perspectives on

Medical Education, 2, 216–221.

TABLE 15-1 Five-Step Approach for Evidence-Based Nursing Practice

15.2 Appraising the Evidence 405