Introduce

Evidence Based Practice in Nursing

(EBPN)

Dr. Lilik Ma’rifatul Azizah, S. Kep., NS., M.Kes.

DEFINISI EVIDENCE BASED PRACTICE
Menurut Greenberg & Pyle (2006) dalam Keele (2011),
“Evidence-Based Practice adalah penggunaan bukti untuk
mendukung pengambilan keputusan di pelayanan
kesehatan”.

Menurut Melnyk & Fineout-Overholt (2011) Evidence-

Based Practice in Nursing adalah penggunaan bukti
ekternal, bukti internal (clinical expertise), serta manfaat
dan keinginan pasien untuk mendukung pengambilan
keputusan di pelayanan kesehatan.
 Historical Perspective
Suksesnya Evidence Based Medicine (EBM) (Tanner
(1999)) :
 Menstandarkan praktik profesi
 Mengeliminasi praktik yang tidak layak (buruk)
 Mendukung praktik yang baik (terbaik)
 Meminimalkan biaya dan meningkatkan kualitas
pelayanan kesehatan
(Keele (2011))

Evidence Based Practice (EBP)

 Evidence-based Practice
What Does it Mean for Nursing?
 Evidence-based Practice

Process by which clinical decisions are made using:

Best available research evidence

Clinical expertise

Patient preference
 Skills Required for EBP
Clearly identify practice problem or new
knowledge ( innovation)
Search/find relevant research literature
Critically evaluate research findings using
established criteria regarding scientific merit
Choose interventions/justify selection with the
most valid evidence
Apply to practice through change process
KOMPONEN EBP
(Melnyk & Fineout-Overholt, 2011)

Bukti
Bukti
Internal
ekternal

Manfaat
dan
keinginan
pasien

Evidence Based Clinical Decision Making

KOMPONEN EBP
(Melnyk & Fineout-Overholt, 2011)

Hasil penelitian, teori-

BUKTI teori yang
Bukti lahir dari
Internalpendapat
penelitian,
EKTERNAL
dari ahli, hasil dari
diskusi panel para ahli
Manfaat
dan
keinginan
pasien

Evidence Based Clinical Decision Making

Translating research into
practice
 Utilization of research
Can take up to 17 years before significant research
findings are implemented into clinical practice
(Nalas & Boren, 2000)

EBP also includes making decision about

individual patient, and quality and applicability of
existing research, patients’ preferences, costs,
clinical expertise, clinical setting, outcomes..
Clinical reality very different than research
context.
 Three Areas of Research
Competence

Interpreting & using research

Evaluating Practice
Conducting Research
KOMPONEN EBP
(Melnyk & Fineout-Overholt, 2011)

 Penilaian klinis
 Hasil dari proyek peningkatan
kualitas dalam rangka Bukti
meningkatkan kualitas Internal
Bukti
pelayanan klinik
 Hasil dari pengkajian
ekternaldan (Clinical
evaluasi pasien Expertise)
 Alasan klinis
 Evaluasi dan penggunaan Manfaat
sumber daya tenaga kesehatan dan
yang diperlukan untuk keinginan
melakukan treatment yang pasien
dipilih
 Mencapai hasil yang
diharapkan

Evidence Based Clinical Decision Making

KOMPONEN EBP
(Melnyk & Fineout-Overholt, 2011)

Memberikan manfaat terbaik untuk

kondisi pasien saat itu dan
meminimalkan pembiayaan
Bukti
Bukti
Internal
ekternal

Manfaat
dan
keinginan
pasien

Evidence Based Clinical Decision Making

Identifying Practice Problem
Why are we doing this?

Why are we doing it this way?

Can we produce better outcomes with greater

consistency?
 Evidence Based Practice
To carry out EBP, the following factors must be
considered:
Has sufficient research been published on the specific
topic ?
Does the nurse have skill in accessing and critically
analyzing research?
Does the nurse’s practice allow him/her to implement
changes based on EBP?
Role of RN
Critical link in bringing research-based changes
into clinical practice
Many organizations may not have the resources to
ensure critical, succinct evaluation and application
of research findings related to point of care
delivery.

How do these two issues merge?

Factors of EBN
Collaboration, service, integration

“ Shields” of practice, education and research can

provide best care to patients.

Library science, nursing services, nursing practice

subcommittee (NPS), nursing education
subcommittee (NES), nursing research
subcommittee (NRS).
MANFAAT EBP
(Trinder & Reynolds, 2006)
Menjadi jembatan antara penelitian dan praktik

Mengeliminasi penelitian dengan kualitas

penelitian yang buruk

Mencegah terjadinya informasi yang overload terkait

hasil-hasil penelitian

Mengeliminasi budaya “practice which is not evidence

based”
KEKUATAN DAN KELEMAHAN EBPN
(Trinder & Reynolds, 2006)

KEKUATAN
• Memberikan pelayanan yang terbaik
• Menggunakan sumber daya yang terbaik
dan terpercaya

KELEMAHAN
• Membatasi autonomi professional
 EBP Models
CURN project  Research utilization
Review, synthesis, application, evaluation

Stettler Model of Research Utilization

Critical thinking & decision making

Iowa Model of Research in Practice

Quality assurance meets research utilization
 TERIMAKASIH
SEMOGA BERMANFAAT

LMA