Module Components

• Learning Activities

Topics

• Decisions Making Overview
• Research
• Patient Preferences
• Clinician Expertise and Context

NRSG 790-Methods for Research and Evidence-Based Practice

Module 12: Practice Decision Making

Research

Research has an important role to play in how health care decisions are made. When reviewing evidence to make a practice decision, it is important to understand the different types of evidence that are present in the literature and how to evaluate evidence for strength and quality.

Research Evidence

Knowledge generated from empirical systematic investigation, i.e. research, is highly valued as the basis for making clinical practice decisions. Primary research studies are those that report the original work conducted by the researchers whereas secondary sources are those that compile and evaluate evidence from other sources.

• Examples of primary research are randomized controlled trials, cohort, case control, or descriptive studies.
• Examples of secondary research are systematic reviews and meta-analysis. These are designated as the strongest, highest level, research evidence available to make clinical decisions.

Practice-based Evidence

Practice based evidence, also commonly referred to as internal organizational evidence, is the generation of evidence that is intended to improve practice and patient outcomes within a local setting where it is conducted. Quality improvement or evidence-based practice initiatives are examples of activities that produce practice-based evidence. The findings from these initiatives are not intended to be generalized to other setting, but rather improve quality, outcomes, and performance within the practice setting.

Evidence Synthesis

Evidence synthesis has an important role to play in how health care decisions are made. Practice cannot be based on the findings from a single study alone. A single study could be valid, but it could also be biased, with inaccurate conclusions. Therefore, a synthesized body of research is needed to demonstrate consistent findings, from consistent procedures, with a consistent population.

Evidence synthesis refers to the process of bringing together information from a range of sources to inform decisions. Group like-level evidence together and analyze for similarities and differences in methodology and findings. Like-design studies, with more consistency in their sample, power, setting, procedures, validity, reliability, and findings are regarded as having higher quality. Refer to the Evidence Review Table under the Assignment Tab for the Synthesis Table Template and example.