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DALAM KEPERAWATAN
(Evidence-Based Practice in Nursing)
1. Provide patient-centered care - identify, respect, and care about patients’ differences, values,
preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to,
clearly inform, communicate with, and educate patients; share decision making and management; and
continuously advocate disease prevention, wellness, and promotion of healthy lifestyles, including a
focus on population health.
2. Work in interdisciplinary teams - cooperate, collaborate, communicate, and integrate care in teams to
ensure that care is continuous and reliable.
3. Employ evidence-based practice - integrate best research with clinical expertise and patient values for
optimum care, and participate in learning and research activities to the extent feasible.
4. Apply quality improvement - identify errors and hazards in care; understand and implement basic
safety design principles, such as standardization and simplification; continually understand and measure
quality of care in terms of structure, process, and outcomes in relation to patient and community needs;
and design and test interventions to change processes and systems of care, with the objective of
improving quality.
5. Utilize informatics - communicate, manage knowledge, mitigate error, and support decision making
using information technology.
Riset membuktikan:
Pencukuran lebih
meningkatkan dari pada
menurunkan infeksi pos-
operasi
(Kjonniksen et al, 2002)
Beberapa contoh.....
Sebagai perawat anak , saya
diajarkan bahwa perawatan tali
pusar dengan alkohol berguna
untuk mencegah infeksi pada
tali pusar bayi baru lahir
Riset membuktikan:
Membersihkan tali pusar dengan air
steril memperpendek waktu
pelepasan tali pusar tanpa
menimbulkan infeksi (Medves & Brien,
1997)
Beberapa contoh.....
Kassa sudah digunakan beratus-
ratus tahun dalam perawatan
luka
Riset membuktikan:
RU
EBP
QI NR
Definition of EBP
• 1993 - the first annual Cochrane Colloquia was held at the New
York Academy of Sciences
600
530
500
400
300
200
139
100
67 83
35 47 51
25
0 0 0 1 0 0 5
'91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04
2011 – Medline search > 38,000
Within one decade, the concept of
evidence-based practice has evolved
and been embraced by nurses in nearly
every clinical specialty, across a variety
of roles and positions, and in locations
around the globe.
• Pasien
– (dewasa) pasien penyakit jantung
– Perokok
– Keluar dari rumah sakit
• Intervensi
– Program penghentian tembakau dipimpin oleh perawat
• Comparison
– (Non-nurse led tobacco cessation programs
• Self-administered,wat non-nurse administered, etc.)
– No comparison
• Outcome
– Penurunan rerata penggunaan tembakau diantara grup
pasien
Pertanyaan Klinis Keperawatan
Th
ThThe ability to incorporate
Evidence-Based Nursing
into clinical care requires a
basic understanding of the
main research designs
underlying the published
evidence
Hambatan-hambatan
• Kurang menganggap penting riset untuk
praktik
• Kurang memahami database penelitian
elektronik
• Kesulitan akses kepustakaan dan journal
• Kurang keahlian komputer
• Kurang memahami artikel penelitian
• Kurang faham cara pencarian literatur,
pengetahuan tentang penelitian, dan kritik
penelitian
Dean, Harvard Medical School to students:
Thank You
Panduan Tugas EBP
Mahasiswa dibagi kelompok, satu kelompok maksimal 6 orang,
setiap kelompok memilih topik yang berbeda. Langkah-langkah
mengerjakan sesuai panduan pertanyaan berikut:
• Dari pengalaman selama bekerja sebagai perawat di
pelayanan keperawatan, identifikasi 1 (satu) masalah klinik
keperawatan yang menurut anda perlu perubahan ke yanglebih
baik?
• Terkait masalah yang diidentifikasi tersebut, adakah
fakta/evidence/hasil riset yang anda ketahui? Bagaimana
menurut fakta/hasil riset tersebut? Evaluasi kekuatan dan
kemamputerapan hasil riset tersebut
• Bagaimana tahapan-tahapan perubahaan yang akan anda
lakukan?
• Rumuskan kriteria evaluasi keberhasilan program tersebut?