Evidence based practice power
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Evidence based practice power
- 1. By / Mahmoud Shaqria شقريه محمد محمود
- 2. _ Introduction. _ Definition of evidence based practice . _ Benefits of evidence based practice . _ Process of evidence based practice . _ (Lowa) model of evidence based practice . _ Factors affecting the decision making process . _ Barriers of evidence based practice . _ Examples of Appling EBP in nursing field.
- 4. During the 1980s, the term "evidence based medicine" emerged to describe the approach that used scientific. evidence to determine the best practice. later, the term shifted to become "evidence based practice" as clinicians other than physicians recognized the importance of scientific evidence in clinical decision making. various definitions of evidence based practice ( EBP ) have emerged in the literature, but the most commonly used definition is," the conscientious, explicit, an judicious use of the current best evidence in making decisions about the care of individual patients ".
- 5. -Evidence based practice (EBP) is a process through which scientific evidence is identified, appraised and applied in health care interventions. -OR
- 6. - Evidence based practice is a process by which nurses make clinical decisions using the best available research evidence, clinical expertise and patient preferences.
- 7. To Nurses: Achievement of optimum patient care by setting maintaining research based standards is clear . Such nurses will know whether research findings are Valid, reliable, and applicable. Increase staff member skills and confidence. Improve management and quality of educational programs.
- 8. To Health Care Organization: EBP allows healthcare organizations to position themselves in the market as quality institutions. EBP promote optimal outcomes or equivalent care at lower cost or in less time.
- 9. To The patient: increases satisfaction of patients. Reduce cost and improve outcomes. Improve the quality of patient care. Keep practice current and relevant. Policies and procedures are current and include the latest research
- 10. Incorporating best evidence into clinical care requires a systematic approach in order to be manageable. A clear series of steps known as the evidence cycle can provide an excellent paradigm to guide you through this process. The foundation of evidence based care remains an excellent clinical evaluation.
- 11. 1) ASSESS the problem to determine the related issues. 2) Converting information needs into clear questions ( ASK) there are 4 components to every clinical question, the patient population, intervention, comparison and outcome (PICO). Population .P Intervention .I Comparator .C Outcome .O
- 12. 3) Seeking evidence to answer those questions ( Acquire). 4) Evaluate the evidence for it's validity and usefulness (Appraise) 5) Integrating findings with clinical expertise, patient needs, applying the finding (Apply).
- 14. Step 1 :_ Selecting of a topic Selecting a topic of evidence based practice according to the priority and magnitude of the problem, the availability of data and evidence in the problem area and the commitment of staff.
- 15. Step 2 :_ Forming a team The team is responsible for development, implementation, and evaluation the plan. Team members require support from senior members from implementing evidence based practice.
- 16. Step 3 :_ Evidence retrieval From the team formation and topic selection, a brainstorming session should be held to identify available source and key terms to guide the search for evidence. Evidence should be retrieved through electronic databases such as medline, web of science and so no.
- 17. Step 4 :_ Grading the evidence To grade the evidence. the team will address quality areas of the individual research and the strength of the body of evidence overall.
- 18. Step 5 :_ Developing an EBP standard After a critique of literature, team members come together to set recommendations for practice. The type and strength of evidence used in practice needs to be clear and based in the consistency of replicated studies.
- 19. Step 6 :_ Implementing EBP For implementation to occur, aspects such as written policy, procedures and guidelines that are evidence based need to be considered. There needs to be a direct interaction between the direct care providers, the organization, and it's leadership roles ( Eg. nurse managers ) to support these changes.
- 20. Step 7 :_ Evaluation Evaluation is essential to seeing the value and contribution of the evidence into practice. A baseline of the data before implementation would benefit, as it would show how the evidence has contributed to patient care. Audit and feedback trough the process of implementation should be conducted.
- 21. 1) Up to date research evidence. 2) Clinical expertise (knowledge, education level, past and recent experience ) 3) Factors related to patient and their family such as beliefs, attitudes, value and needs. 4) Organizational factors as policies, sources, funding, equipment and time.
- 22. 1) Lack of value for research in practice 2) Difficulty in changing practice. 3) Lack of administrative support. 4) Lack of knowledge mentors. 5) Insufficient time to conduct research. 6) Lack of awareness about research or evidence based practice.
- 23. 6) Lack of awareness about research or evidence based practice. 7) research reportsarticles not readily available. 8) Difficulty accessing research reports and articles. 9) No time on the job to read research. 10) Lack of education about the research process. 11) Complexity of research reports. 12) Lack of knowledge about EBP critique of article.
- 24. Clinical Scenario: The patient is a 65 year old male with a long history of type 2 diabetes and obesity. He does not smoke. He had knee surgery 10 years ago, but has had no other major medical problems. Over the years he has tried numerous diets and exercise programs to reduce his weight, but has not been very successful. His granddaughter just started high school, and he wants to see her graduate and go on to college. He understands that his diabetes puts him at risk for heart disease and is frustrated that he cannot lose the necessary weight. His neighbor told him about a colleague at work who had his stomach stapled (stomach surgery) and as a result not only lost over 30 kilos., but also "cured" his diabetes. He wants to know if this procedure really works.
- 25. How to apply the evidence-based practice process through the following steps ? 1) Asking clinical question. 2) Acquiring the evidence. 3) Appraising the evidence. 4) Applying the result. 5) Assessing the outcome.
- 26. 1) We will use PICO to develop a clinical question. Question: In patients with type 2 diabetes and obesity, does bariatric surgery (stomach stapled ) promote the management of diabetes and weight loss as compared to standard medical care? patients with type 2 diabetes and obesity populationP (stomach stapled ) bariatric surgeryinterventionI standard medical carecomparisonC management of diabetes and weight loss outcomeO
- 27. 2) Acquiring the evidence Choosing Resources For Primary Resources: ACP Journal Club PubMed Cochrane Library For Background Information: UpToDate
- 28. 3) Appraising the Evidence Critical appraisal is the process of examining a research article to determine its validity and applicability to your clinical question. Critical appraisal is important because is ensures that you have a holistic view of the research article - including any strengths, weaknesses, or biases 4) Applying the result A) Moving Forward Applying the Evidence to your Practice B) Develop recommendations for practice. C) Integrate the evidence recommendations, with collaboration with patients, into a plan of care. D) Complete human subject protection requirements
- 29. 5) Assessing the Outcome After implementing evidence-based practice, it's important to monitor and evaluate any changes in outcomes so that positive effects can be supported and negative ones remedied. 6) Disseminating the Results _This leads to needless duplication of effort, and perpetuates clinical approaches that are not evidence based. _ Among ways to disseminate successful initiatives are evidence-based practice rounds in your institution, presentations at local, regional, and national conferences, and reports in peer-reviewed journals, professional newsletters, and publications for general audiences.