實證護理步驟 - CGMH

1 Ask an answerable question EBN ( ) .. ? A B ( ) ? A B ..( ) ? ? ? ? ? (PICO) (PICO)1. or exposure3 Comparison3. Comparison4. Outcome (P), Heparin (I) (C) (O) ?

2 (C) (O) ?ParticipantsParticipants Intervention or exposureIntervention or exposure ComparisonComparison ? ( ) ( ) : OutcomesOutcomes .. ( ) ( ) (I) (P) (O) (I) (C) COPD (P) (O) ? (I) (C) (P) (O) ? (I) (P) (O) ? (I) 50 (P) (O) P:Participant/patients I: Phenomena of interestI: Phenomena of interest Co: Context : : (P) (Co) (I) ?

3 ? (1) (1) (I) (P) (O) (C) () () (I) (P) (O) (O) (C) (O) (O) (C) ? (I) (P) (O) (C) (O) (C) (2) (2) 75% 95% 95% (I) (P) 95% (C) (O) ? () () (I) (P) 95% (C ) (O) ()() ? (3) (3) (I) (P) (O)?

4 (I) (P) (O)?? (I) (P) (O)?? (I) (P) (O)??()()() (I) (P) (O)? ( ) ( ) : 10 : ? : : (P) (I) (C) (C) (O) ( ) ( ) : 1 : : (P) (I) (C ) (O) (C ) (O) ? Searching for the best available evidence ~ ~ ( )( ) CINAHL( ) OVID MEDLINE ( )PSYCHLIT( )ERIC( )PSYCHLIT( ) ERIC( ) CEPS ( ).

5 NGC: National Guideline Clearinghouse Joanna Briggs Institute (JBI)Joanna Briggs Institute (JBI).. ChLibEidbd diiCochrane Library Evidence-based medicine, Evidence-Based Nursing Critical appraisal ? ? ? ? ( ) (Odds ratio) ( ) (Odds ratio) (Afh lthhdlit 2002)(Agency for health care research and quality, 2002) (1) (1)of RCTof RCTFrom: Medical Research Library of Brooklyn - (2)-Oxford CenterLevelTherapy/Prevention, Aetilogy/Harm1 a (Randomized Clinical Trial, RCT) (systemic review, SR) b RCT c (all or none) 2 a (cohort studies) b RCT c ("Outcomes" research.)

6 Liltdi)ecological studies) 3 a b b 4 5 (3)()The Evidence HierarchyI. II. II. III. IV. V. VI. VII VII. (Melnyk & Fineout-Overholt, 2005) Systemic reviewSystemic review Meta-analysis ( ) ( ) ( )Metasynthesis ( ) Meta-synthesis ( ) Integrative review Narrative review MetaAnalysesMeta-Analyseshtt //di bhttk/ The Cochrane Library The Cochrane Database of Systematic Reviews The Cochrane Controlled Trials Register The Cochrane Controlled Trials Register The Database of Abstracts of Reviews of Effectiveness (DARE)

7 The Cochrane Review MethodologyThe Cochrane Review Methodology Database Early light reduction for preventing retinopathy of prematurity in very low birth weight infantsprematurity in very low birth weight infants Massage for promoting growth and development of d/lbi hihifpreterm and/or low birth-weight infants Early versus late discontinuation of oxygen in preterm or low birth weight infants Early developmental intervention programs post yppgphospital discharge to prevent motor and cognitive impairments in preterm infantspp Positioning for acute respiratory distress in hospitalized infants and childrenhospitalized infants and childrenCochrane Database of Systematic Reviews - Translate into clinical practice auditaudit The Evidence-Based Decision-Making Cycle: the 5 A'sRetrieved March 18, 2007, from ~ + = + / Clinical Practice Guidelines (CPG) 2004 2006 2004 2006 ?

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