PICOT
patient/population/problem
intervention
comparison
outcome
time
7 steps of EBP
- Spirit of Inquiry
- Asking questions: forming clinical questions using PICOT framework
- Search for evidence
- Appraising the evidence: assessing research quality and relevance
- Integrating research evidence into clinical decision making
- Evaluating outcomes
- Dissemination
RCT
most reliable
uses interventions, people go to intervention or control group - compared
systematic reviews
secondary research that identifies and appraises all available evidence on a question
meta-analyses
statistical process that combines the results from multiple studies on the same topic to produce a single result
telehealth purpose/benefits
Better access for rural settings, decrease waiting time, less foot traffic in the hospital
Benefits: inexpensive, save the patient and provider time, better healthcare choices, service quality and performance, emergencies
telehealth challenges
technology issues, patient privacy, WIFI, data security, can’t do a full or thorough assessment, variability in practices/standards
informatics (data, information, knowledge, wisdom) benefits/challenges
Benefits: improved patient safety, data-driven decisions, reducing errors
Challenges: high implementation costs, data security, nurse training
nurse’s role in informatics
some nurses work with telehealth
identify caring behaviors/red flag behaviors
Empathy, trust, clear communication, respect, advocacy, professionalism
Unprofessionalism, physical signs, burnout.
identify therapeutic responses
active listening, validation, silence, open-ended questions
nurse-client relationship
professional, time-limited, and centered on client well-being
nurse-client relationship phases
Orientation Phase – AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you)
Working phase – active listening, assessment, care planning, education
Therapeutic communication techniques
Termination phase – reflect on progress, review post-discharge goals
how to improve effective communication
Implement structured handoff protocol to maintain clarity and purpose – ensure clear, goal-directed communication
barriers to effective communication
asking personal questions, giving personal opinions, changing the subject, stating generalizations and stereotypes, providing false reassurance, showing sympathy, asking “why” questions, approving or disapproving, giving defensive responses, arguing
language and cultural differences, emotional and psychological factors, environmental distractions, personal biases and patient cognitive or sensory impairments
therapeutic communication techniques
providing information, sharing observations, feelings, empathy, humor, hope, touch, silence, clarifying, asking relevant questions, offering self, actively listening
evaluating therapeutic communication
checking for patient understanding, goal achievement, and feeling heard
population health
Focuses on health outcomes of groups of individuals – holistic approach. Includes destruction of outcomes within the group and emphasizes health determinants and policies.
Recognize the importance that good health outcomes depend on more than medical care, it requires addressing SDOH and disparities
levels of prevention
o Tertiary: affects individuals by preventing or lessening negative impact
o Secondary: affects individuals by detecting conditions or needs
o Primary: affects at-risk populations or environments by preventing problems
o Primordial: affects populations by reducing overall risk
nurse role in population health
Advocate for heath equity, educate communities on prevention, collaborate with public health systems, and use data to inform care and interventions.
types of intervention
o Upstream: (population impact): policies that change regulations, increase access, or provide economic incentives to impact health across a population
o Midstream: (organizational impact): approaches that happen within specific organizations to improve health outcomes
o Downstream: (individual impact): interventions that focus on the behaviors of individual people to modify the risk of disease, prevent illness, or manage chronic conditions
community
o A group of people with at least one characteristic in common
General purpose of community assessment frameworks/tools
Organize and plan, engage community, develop goal or vision, conduct community health assessments, prioritize health issues, develop a community health improvement plan, implement and monitor the community health improvement plan, and evaluation process and tools.
provide a structured way to systematically identify a community’s health needs, strengths, assets, and risks
nursing process for assessment framework
ADPIE - assessment, diagnosis, planning, implementation, evaluation
