Evidence Based Practice Implementation and Evaluation

Implementation and Evaluation of Evidence-Based Practice

Part one

Critical components for rapid critical appraisal of clinical practice guidelines and their importance

A rapid critical appraisal refers to the study’s worthiness determination based on its applicability, reliability, and validity to clinical practice. In general, a rapid critical appraisal has to through some form of checklist to assist the reviewer in evaluating the effectiveness of the study and if it can apply to the patients. Although multiple rapid critical appraisal tools are available, most of them respond to three very critical questions to determine the study’s worth (Grove et al. 2018). For example, what is the validity of the results? What was the result? Is it critical? Does the result respond to the PICOT question and would assist patient care within the setting?

To begin with, validity is the accuracy of the results. Validity seeks to establish how accurate are the study results and if they can be trusted (Ferrell et al. 2018). To determine this, first, the selection of the participants for the study should be evaluated. For instance, what method of selection was used, where they are chosen randomly or through other means? Were mechanisms to minimize biased outcomes based on participants’ selection criteria?

Additionally, there is a need to assess the completeness and accuracy of the data. For example, whether or not the study’s authors used an instrument or a measure like a reliable and valid survey. Lastly, there is a need to assess the kind of data included and what data is excluded (Castellani et al. 2018). Moreover, is it possible that the researcher undertook practical steps to ensure complete and accurate data? Therefore, reliability would be the consistency and dependability on whether the results obtained accurately represent what is under the study.

Subsequently, another critical component asks about the results and if they are essential. In other words, the question seeks to determine what the study established and its meaningfulness. Also, to interpret the results, terminologies like effect size and significance level should be clearly understood to evaluate the treatment effect (Ferrell et al. 2018). Effect size is the relationship strength between the variables. A higher effect size translates to a strong relationship between the variables.

On the other hand, level of significance refers to the possibility of something or no occurrence. The probability or the p-value usually represents the research studies. When the p-value is smaller, there is a low probability that the results reported occurred due to a chance or fluke (Castellani et al. 2018). As a result, the author can be more confident with the significance of the reviewed data (Grove et al. 2018). Most researchers adopt a p-value of 0.5 as clinically significant.

Further, according to (Ferrell et al. 2018), it is essential to determine the results’ likely and plausible. For instance, are the study results similar? Can they be reproduced? However, if the claims appear unrealistic, it may call for similar studies to evaluate if the results obtained were the same; otherwise, the intervention may not be helpful and dangerous to the patients.

Another critical aspect of rapid critical appraisal is whether the results obtained provide an answer to the PICOT question that would enable effective patient care within the setting. It is also referred to as clinical significance (Castellani et al. 2018). To evaluate whether a study is of clinical significance, one has to consider the below questions, which mainly depend on clinical knowledge and understanding of the patient population. One whether the results apply to the patients under care? One has to evaluate if the patient population resembles those under the study.

In most cases, differences are likely; however, one has to understand what vital differences exist and if they can affect the patient population’s effectiveness. Two, what are the treatment benefits and risks? In some research, authors can control and monitor the risks. However, in the clinical setting, risks may supersede the benefits for the patient population because monitoring and control may not be as effective as those of the original study (Castellani et al. 2018). The third question considers whether the treatment is practical within the clinical setting. Finally, it seeks to determine the patients’ expectations and values for the results.

Part Two

Leadership strategies to overcome barriers to EBP implementation and their importance.

The evidence-based practice process begins with clinical questions, followed by searching and appraising of evidence critically. After determining the necessity of practice change, the subsequent step is merging clinical expertise with that evidence and patient values and preferences (Harvey et al. 2020). The final step in evidence-based practice is determining the results and disseminating the outcomes. Otherwise, clinicians often face challenges and barriers while changing clinical practice; leadership strategies facilitate practice change. One of such leadership strategies is prioritizing effective stakeholder engagement to establish a trust to provide input to the project and understand their experience. This is very important because it would encourage stakeholders to have a role in evaluating outcome measures (Alatawi et al. 2020). As a result, one can develop a better project plan and the strategies to implement it.

Another strategy is to seek and establish administration support from one’s institution because it is an acritical factor in success. Through administrative support, one can learn about prior projects that adopted similar implementation techniques and how they performed (Harvey et al. 2020). Moreover, the administration has a critical role in establishing cultures that support evidence-based practice. For example, our behavior can be changed by practicing; however, behavior change is hectic. It requires open-mindedness to new ideas, perseverance, and persistence. One may face barriers but has to find strategies to overcome them. Through teamwork, an evidence-based practice environment leading to better results can be assured for the patients (Alatawi et al. 2020). To conclude, leadership, change, and sustainability are the key strategies in overcoming challenges to evidence-based practice implementation.