SlideShare uma empresa Scribd logo
1 de 54
Building Evidence-Based Practice into All Areas of Dietetics Linda Farr RD/LD TDA Delegate 2007-2012  Owner Nutrition Associates of San Antonio 210-735-2402 [email_address]
Presentation Objectives ,[object Object],[object Object],[object Object],[object Object]
 
Why is EBP important? ,[object Object]
What is Evidence-Based Practice?
[object Object],[object Object],Source:  ADA Scope of Dietetics Framework Definition of Terms  2007 ADA Definition
Key Considerations ,[object Object],[object Object],[object Object]
Clinical Expertise Client values Clinical State Evidence  Adapted from: IOM Model for Evidence-Based Clinical Decisions ACP Journal Club, March/April 2002 Clinical  Setting
Code of Ethics Supports EBP ,[object Object],[object Object]
Nutrition Care Process supports EBP March 2003
The Nutrition Care Process ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Nutrition Care Process ,[object Object],[object Object],[object Object],The NCP Core :  Relationship between the RD-DTR & the client
Why use Evidence-Based Practice?
Explosion of Literature ,[object Object],[object Object]
Unmet Information Needs ,[object Object]
Implementation Delays ,[object Object],[object Object]
Need for Data on MNT Effectiveness ,[object Object],[object Object]
Importance of collecting outcomes/data   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Standardization of Practice ,[object Object],[object Object],[object Object],[object Object]
Benefits of EBP ,[object Object],[object Object],[object Object],[object Object]
Personal Benefits of EBP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bottom Line Benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Development of EBP includes…. Five Fundamental Steps.
Evidence-Analysis Process Steps 1. Select topic & appoint  expert work group 2. Define questions and determine inclusion/ exclusion criteria 3. Conduct literature review for each question 4. Analyze Articles/ Critical Appraisal 5. Overview Table & Evidence summary ,[object Object],[object Object],7. Publish to online EAL
Guidelines Methodologies Used http://www.cebm.net/ http://www.nhlbi.nih.gov / http://www.icsi.org/ Whenever possible we don’t “reinvent the wheel.”
Expert Workgroup ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evidence Analysts ,[object Object],[object Object],[object Object],[object Object],[object Object]
Step 4--Critical Appraisal of Each Article ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Step 5--Evidence Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evidence Summary : narrative summary Evidence Table
Step 6--Conclusion and Grade ,[object Object],[object Object],[object Object],[object Object],[object Object]
12/28/10 Conclusion Statement Grading Table
Guideline   Development
Step 9--Recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendation   Examples ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendation on the EAL
Toolkit   Development
Features of Evidence-Based Toolkits   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Client Education Materials:  5-6 th  grade reading level
How do I implement  Evidence-Based Practice?
Access EBP Resources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Access Other EBP Resources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How do I practice when there’s no evidence? -- Lack of evidence is NOT the  same as lack of effectiveness
Action Steps-Client Care Settings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Is Evidence-Based Dietetics Practice for all ADA members?
A Role for All Members ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A Role for All Members ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incorporate Research into EBP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incorporate Research into EBP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Examples of Practice Areas for Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],12/28/10
EAL Tutorial   ,[object Object]
Evidence Analysis Training Workshops    ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Decide to Make a Difference!
[object Object],12/28/10

Mais conteúdo relacionado

Mais procurados

NUTRITION IN LIVER DISEASE
NUTRITION IN LIVER DISEASENUTRITION IN LIVER DISEASE
NUTRITION IN LIVER DISEASE
Hardik Patel
 
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
MD Specialclass
 

Mais procurados (20)

Screening nutrition care process
Screening nutrition care processScreening nutrition care process
Screening nutrition care process
 
NUTRITIONAL CARE PLAN
NUTRITIONAL CARE PLANNUTRITIONAL CARE PLAN
NUTRITIONAL CARE PLAN
 
NTP chapter 4
NTP chapter 4NTP chapter 4
NTP chapter 4
 
NUTRITION IN LIVER DISEASE
NUTRITION IN LIVER DISEASENUTRITION IN LIVER DISEASE
NUTRITION IN LIVER DISEASE
 
Nutrition & Diet therapy Lecture Midterm to Finals
Nutrition & Diet therapy Lecture Midterm to FinalsNutrition & Diet therapy Lecture Midterm to Finals
Nutrition & Diet therapy Lecture Midterm to Finals
 
Nutritional Screening and Nutritional Assessment NABH base hospital.pptx
Nutritional Screening and Nutritional Assessment NABH base hospital.pptxNutritional Screening and Nutritional Assessment NABH base hospital.pptx
Nutritional Screening and Nutritional Assessment NABH base hospital.pptx
 
Case Studies in Clinical Nutrition
Case Studies in Clinical NutritionCase Studies in Clinical Nutrition
Case Studies in Clinical Nutrition
 
Dietary fibre and its effect on weight loss.ppt (1)
Dietary fibre and its effect on weight loss.ppt (1)Dietary fibre and its effect on weight loss.ppt (1)
Dietary fibre and its effect on weight loss.ppt (1)
 
Importance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patientsImportance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patients
 
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...Applied nutrition   3 rd presentation - diseases of liver, gall bladder, and ...
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...
 
NTP chapter 2
NTP chapter 2NTP chapter 2
NTP chapter 2
 
Nutritional assessment
Nutritional assessmentNutritional assessment
Nutritional assessment
 
My pyramid ,my plate and Food pyramid
My pyramid ,my plate and Food pyramidMy pyramid ,my plate and Food pyramid
My pyramid ,my plate and Food pyramid
 
Healthy diet | Nutrition and Diet : weight loss India
Healthy diet | Nutrition and Diet : weight loss IndiaHealthy diet | Nutrition and Diet : weight loss India
Healthy diet | Nutrition and Diet : weight loss India
 
Medical nutrition therapy status post whipple procedure
Medical nutrition therapy status post whipple procedureMedical nutrition therapy status post whipple procedure
Medical nutrition therapy status post whipple procedure
 
Carbohydrate Counting
Carbohydrate CountingCarbohydrate Counting
Carbohydrate Counting
 
Nutrition case study
Nutrition case studyNutrition case study
Nutrition case study
 
Basic Nutrition
Basic NutritionBasic Nutrition
Basic Nutrition
 
Nutrition & Weight Management
Nutrition & Weight ManagementNutrition & Weight Management
Nutrition & Weight Management
 
Nutritional Support
Nutritional SupportNutritional Support
Nutritional Support
 

Destaque

Evaluating Transitions of Care Processes
Evaluating Transitions of Care ProcessesEvaluating Transitions of Care Processes
Evaluating Transitions of Care Processes
hedavidson
 
Stfm new orleans april 2011
Stfm new orleans april 2011 Stfm new orleans april 2011
Stfm new orleans april 2011
Paul Grundy
 
nutrition in plants
nutrition in plantsnutrition in plants
nutrition in plants
hiratufail
 
Nursing theories and frameworks.ppt
Nursing theories and frameworks.pptNursing theories and frameworks.ppt
Nursing theories and frameworks.ppt
Genalyn Cirineo
 
National nutrition programs
National nutrition programsNational nutrition programs
National nutrition programs
surendra sharma
 

Destaque (18)

Preventative Nutrition Open House & "Pets Reducing for Rescues"...
Preventative Nutrition Open House & "Pets Reducing for Rescues"...Preventative Nutrition Open House & "Pets Reducing for Rescues"...
Preventative Nutrition Open House & "Pets Reducing for Rescues"...
 
Evaluating Transitions of Care Processes
Evaluating Transitions of Care ProcessesEvaluating Transitions of Care Processes
Evaluating Transitions of Care Processes
 
Aco Care Transitions PCMM ACOS, Part II
Aco Care Transitions PCMM ACOS, Part IIAco Care Transitions PCMM ACOS, Part II
Aco Care Transitions PCMM ACOS, Part II
 
Meaningful use 2016
Meaningful use 2016Meaningful use 2016
Meaningful use 2016
 
Stfm new orleans april 2011
Stfm new orleans april 2011 Stfm new orleans april 2011
Stfm new orleans april 2011
 
ACOs, Transitions of Care, Patient Centered Medical Homes, Care Transitions: ...
ACOs, Transitions of Care, Patient Centered Medical Homes, Care Transitions: ...ACOs, Transitions of Care, Patient Centered Medical Homes, Care Transitions: ...
ACOs, Transitions of Care, Patient Centered Medical Homes, Care Transitions: ...
 
Session 1: ICT & Meaningful Learning
Session 1: ICT & Meaningful LearningSession 1: ICT & Meaningful Learning
Session 1: ICT & Meaningful Learning
 
Meaningful use overview
Meaningful use overviewMeaningful use overview
Meaningful use overview
 
Meaningful Use Stage Two: The Future of Care Coordination
Meaningful Use Stage Two: The Future of Care CoordinationMeaningful Use Stage Two: The Future of Care Coordination
Meaningful Use Stage Two: The Future of Care Coordination
 
An Overview of Patient-Centered Care
An Overview of Patient-Centered CareAn Overview of Patient-Centered Care
An Overview of Patient-Centered Care
 
Sports Nutrition Opportunities
Sports Nutrition OpportunitiesSports Nutrition Opportunities
Sports Nutrition Opportunities
 
Total enteral nutrition and total parenteral nutrition in critically ill pat...
Total enteral nutrition  and total parenteral nutrition in critically ill pat...Total enteral nutrition  and total parenteral nutrition in critically ill pat...
Total enteral nutrition and total parenteral nutrition in critically ill pat...
 
The State of Food Insecurity in the World 2014 - Strengthening the enabling e...
The State of Food Insecurity in the World 2014 - Strengthening the enabling e...The State of Food Insecurity in the World 2014 - Strengthening the enabling e...
The State of Food Insecurity in the World 2014 - Strengthening the enabling e...
 
Sports nutrition
Sports nutritionSports nutrition
Sports nutrition
 
nutrition in plants
nutrition in plantsnutrition in plants
nutrition in plants
 
Introduction to nursing theories
Introduction to nursing theoriesIntroduction to nursing theories
Introduction to nursing theories
 
Nursing theories and frameworks.ppt
Nursing theories and frameworks.pptNursing theories and frameworks.ppt
Nursing theories and frameworks.ppt
 
National nutrition programs
National nutrition programsNational nutrition programs
National nutrition programs
 

Semelhante a Evidence Based Practice in All

Healthcare quality improvement for meaningful use
Healthcare quality improvement for meaningful useHealthcare quality improvement for meaningful use
Healthcare quality improvement for meaningful use
Samantha Haas
 
Implementing Evidence Based Practice at BJU
Implementing Evidence Based Practice at BJUImplementing Evidence Based Practice at BJU
Implementing Evidence Based Practice at BJU
Jordan Kessler
 
Clinical Pathways
Clinical PathwaysClinical Pathways
Clinical Pathways
pradhasrini
 
evidencebasedpracticen-190912083548.pptx
evidencebasedpracticen-190912083548.pptxevidencebasedpracticen-190912083548.pptx
evidencebasedpracticen-190912083548.pptx
gemergencycare
 
Rese method workshop 2010
Rese method workshop 2010Rese method workshop 2010
Rese method workshop 2010
Jijo G John
 
Revalidation March 2010
Revalidation March 2010Revalidation March 2010
Revalidation March 2010
junojesu
 
Continuing Medical Education in Emerging Market
Continuing Medical Education in Emerging MarketContinuing Medical Education in Emerging Market
Continuing Medical Education in Emerging Market
saurabhjain723
 

Semelhante a Evidence Based Practice in All (20)

Clinical Audit Overview
Clinical Audit OverviewClinical Audit Overview
Clinical Audit Overview
 
Healthcare quality improvement for meaningful use
Healthcare quality improvement for meaningful useHealthcare quality improvement for meaningful use
Healthcare quality improvement for meaningful use
 
Clinical Audit by Bachchu Kailash Kaini
Clinical Audit by Bachchu Kailash KainiClinical Audit by Bachchu Kailash Kaini
Clinical Audit by Bachchu Kailash Kaini
 
Clinical audit may 2011 nes pharmacy
Clinical audit  may 2011 nes pharmacyClinical audit  may 2011 nes pharmacy
Clinical audit may 2011 nes pharmacy
 
Pharmacy: Criterion audit
Pharmacy: Criterion auditPharmacy: Criterion audit
Pharmacy: Criterion audit
 
EBP Made Easy
EBP Made EasyEBP Made Easy
EBP Made Easy
 
CLINICAL AUDIT
CLINICAL AUDITCLINICAL AUDIT
CLINICAL AUDIT
 
Evidence based practice power
Evidence based practice powerEvidence based practice power
Evidence based practice power
 
CLINICAL PATHWAY and CLINICAL PRACTICE GUIDELINES
CLINICAL PATHWAY and CLINICAL PRACTICE GUIDELINESCLINICAL PATHWAY and CLINICAL PRACTICE GUIDELINES
CLINICAL PATHWAY and CLINICAL PRACTICE GUIDELINES
 
Clinical Audit Presentation
Clinical Audit PresentationClinical Audit Presentation
Clinical Audit Presentation
 
Implementing Evidence Based Practice at BJU
Implementing Evidence Based Practice at BJUImplementing Evidence Based Practice at BJU
Implementing Evidence Based Practice at BJU
 
Clinical Pathways
Clinical PathwaysClinical Pathways
Clinical Pathways
 
Simple steps to NABH Accreditation
Simple steps to NABH AccreditationSimple steps to NABH Accreditation
Simple steps to NABH Accreditation
 
Evidence based dentistry
Evidence based dentistry Evidence based dentistry
Evidence based dentistry
 
evidencebasedpracticen-190912083548.pptx
evidencebasedpracticen-190912083548.pptxevidencebasedpracticen-190912083548.pptx
evidencebasedpracticen-190912083548.pptx
 
Rese method workshop 2010
Rese method workshop 2010Rese method workshop 2010
Rese method workshop 2010
 
Updated new techniques
Updated new techniquesUpdated new techniques
Updated new techniques
 
Revalidation March 2010
Revalidation March 2010Revalidation March 2010
Revalidation March 2010
 
Continuing Medical Education in Emerging Market
Continuing Medical Education in Emerging MarketContinuing Medical Education in Emerging Market
Continuing Medical Education in Emerging Market
 
2006 Accreditation Criteria
2006 Accreditation Criteria2006 Accreditation Criteria
2006 Accreditation Criteria
 

Evidence Based Practice in All

Notas do Editor

  1. Thank you (to whoever did the introduction. Acknowledgements as needed.) Today, I would like to update you on just some of the many, many things that are going on at the American Dietetic Association to expand the leadership role of registered dietitians, DTRs and all ADA members in the wide and growing world of food and nutrition. Under the leadership of the House and the Board and with the hard work of ADA’s Headquarters Team, we have found solutions, taken advantage of opportunities and made progress that is nothing short of amazing by any measure.
  2. EBP is an approach to health care where health practitioners use the best evidence possible to make decisions for individual patients. It involves complex and conscientious decision-making based not only on the available evidence but also on client characteristics, situations, and preferences. Emphasis is on systematically reviewed scientific evidence. But note that it must be applied when using professional expertise and knowledge of client values.
  3. The Nutrition Care Process developed and published was intended to establish a routine thinking and action process that all RDs used as they provided nutrition services/care regardless of setting and type of patient. It is intended to be applicable to acute care setting, long term care setting, ambulatory setting, community and public health and nutrition education.
  4. The Nutrition Care Process developed and published was intended to establish a routine thinking and action process that all RDs used as they provided nutrition services/care regardless of setting and type of patient. It is intended to be applicable to acute care setting, long term care setting, ambulatory setting, community and public health and nutrition education.
  5. The Nutrition Care Process developed and published was intended to establish a routine thinking and action process that all RDs used as they provided nutrition services/care regardless of setting and type of patient. It is intended to be applicable to acute care setting, long term care setting, ambulatory setting, community and public health and nutrition education.
  6. Explosion of literature--published at a rate individual clinicians can’t keep up with. EBP can be made in a focused and time efficient manner.
  7. Quality improved through promoting practices that support the best outcomes
  8. Quality improved through promoting practices that support the best outcomes
  9. Topics and questions come from a variety of sources inlcuding member requests, practice group suggestions, ADA strategy, etc
  10. The evidence summary includes of all the evidence supporting the conclusion statement and recommendation. Each evidence summary has the information presented in a narrative summary and an overview table (see overview table on next slide).
  11. After analysis is complete and a set of conclusion statements developed to summarize the research on a topic, then a series of recommendations are formed to help the practitioner understand how to use this information. The series of recommendations, introduction and treatment algorithms make up a “Evidence-Based Nutrition Practice Guideline.” You can see from the rigor of the process that the evidence-based guidelines are more than just “guidelines based on evidence”.
  12. This is an example of a recommendation- the structure is “what” the RD should do and “why” to do it. The recommendation is also given a rating, in this case Strong. The next slide shows the rating scale definitions and implications for practice.