Term
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Definition
| patient (population, disease, or disorder), Intervention (drug or procedure), Comparason (alternative drugs or disorders), Outcome |
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Term
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Definition
| a problem solving approach combining scientific evidence with clinical expertise and pt's values and preferences |
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Term
| information literacy in practice |
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Definition
| ability to recognize you need info and seek, access, and evaluate and apply that info. |
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Term
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Definition
1. ask question (PICO)
2. locate evidence (CINAHL, Pub med, ect)
3. Appraise Evidence were results valid and facilitate care?
4. integrate evidence (determine risks, benefits and appropriateness)
5. Evaluate outcome (desired, reliable, improve pt care?) |
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Term
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Definition
| optimal pt outcomes and nursing work satisfaction |
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Term
| levels of evidence (level 1) |
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Definition
(highest)
systematic reviews of randomized clinical trials (RCTs) with EB clinical guidelines. three of more RTCs. |
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Term
| levels of evidence (level 2) |
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Definition
| one or two well designed randomized clinical trials. |
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Term
| levels of evidence (level 3) |
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Definition
| one or more clinical trials w/o randomization. |
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Term
| levels of evidence (level 4) |
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Definition
| well designed case control or cohort studies. |
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Term
| levels of evidence (level 5) |
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Definition
| systematic reviews from descriptive and qualitative studies (metasynthesis) |
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Term
| levels of evidence (level 6) |
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Definition
| single descriptive or qualitative study |
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Term
| levels of evidence (level 7) |
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Definition
| opinion or authorities or reports of expert committees. can serve as a guide. |
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Term
| heart rate - count using radial pulse, either for 30 or 60 secods. EBP |
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Definition
LOE 2 (effective)
RCT was conducted with 206 individuals...30 or 60 seconds revieled more accuracy than 15 sec. |
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Term
| standard method for BP measurement EBP |
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Definition
LOE 5 (effective)
systematic review conducted w/ a standard research strategy concluded that many factors affected BP (position of pt and extremity, the cuff, technique, auscultation, korotkoff sounds used.) inaccuracy due to inadhearance to protocol. |
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Term
| BP positioning of upper arm EBP |
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Definition
LOE 5 (effective)
systematic review found that arm positioning changed bot systolic and diastolic measurement by as much as 11 to 20 mm hg. |
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Term
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Definition
LOE 5 (effective)
systematic review found that cuff size too lg = decreased final value and too sm = increased final value. |
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Term
| trended BP measurement for clinical decisions |
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Definition
LOE 5 (effective)
systematic review emphasized importance of using serial BP measures which may overcome the anxiety assiciated w/ test or situation. |
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Term
| have pt sit with his/her ft flat on floor for BP |
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Definition
LOE 5 (possibly effective)
controlled study of 100 hypertensive males revealed that legs crossed at knees = higer BP
RCT of 103 seniors found same results (cross at knee = increased BP both sys and dia) |
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Term
| monitoring orthostatic or postural changes to BP in adults as an indicator of intravascular blood volume EBP |
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Definition
LOE 5 (not effective)
systematic review concluded that orthostatic BP changes were unreliable for detecting reduced intravascular blood volume. |
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Term
| Wash hands before and after pt care activity |
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Definition
LOE 1 (effective)
systematic review of lit demonstrated relationship b/w skin hygiene and spread of infection |
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Term
| use waterless alcohol based hand rub for routine hand hygiene |
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Definition
LOE 1 (effective)
-RCT of health care workers (50) evaluated the efficacy of two hand hygiene products (soap and rub) demonstrated decrease in microbial contamination.
-controlled study examined drug-resistant organisms before & after implemtation of rub demonstrated decrease in drug-resistant bacteria.
-controlled study demonstrated using rub decreased sepsis in low birth infants. |
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Term
| use non-antibacterial or antibacterial soap for hand hygiene for visibly soiled hands |
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Definition
LOE 1 (effective)
-rubs are not appropriate for use when hands are visibly soiled. soiled hands need to be cleaned with soap and water for 15 seconds. |
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Term
| remove hand jewelry to enhance hygiene and prevent infection |
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Definition
LOE 1 (possibly effective)
-cochrane review demonstrated insufficient evidence and no RCTs to determine association b/w jewelry and hand hygiene.
- systematic review demonstrated that wearing jewelry affected efficacy of hand hygiene. |
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Term
| using alcohol rub for hand hygiene when a pt is infected with a spore-forming bacterium |
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Definition
LOE 1 (not effective)
-RCT demonstrated rub was not effective in removing spores. |
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Term
| presence of artificial fingernails |
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Definition
LOE 4 (possibly harmful)
-case control study = in neonates, exposure to one nurse with artificial fingernails was associated with infection.
-case-control = pathogens existed after hand hygiene was performed with artificial fingernails. |
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Term
| using personal hand lotions/cream |
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Definition
LOE 4 (possibly harmful)
-case control study = use of vaseline lotion inhibited antiseptic action of chlorhexidine gluconate. |
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Term
| using alcohol based hand hygiene products when hands are not completely dry |
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Definition
LOE 6 (possibly harmful)
-flash fire with victim who lit cigarette after using rub
-flash fire after using rub when worker removed gown with static electricity. |
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Term
| using hand hygiene products that may lead to irritant or allergic contact dermatitis |
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Definition
LOE 6
-nurses reported mild to severe contact dermatitis after hand rub |
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