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This is a presentation to review evidence based practice for nurses and searching in PubMed Clinical Queries.

This is a presentation to review evidence based practice for nurses and searching in PubMed Clinical Queries.

Published in: Health & Medicine, Education

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  • 1. Especially for NursesThinking in an Evidence Based Way Helen-Ann Brown Epstein MLS, MS, AHIP Kim Barrett Medical Library epsteinhab@hss.edu http://hss.edu/academic-kimbarrett-library.asp HSS
  • 2. I DO NOT have a financial interest in commercial products or services. HSS
  • 3. Goal: To improve health through enhanced patient care and research practice.Objectives: At the close of this 1.5 hour hands-on workshop,participants will have:1. Defined evidence based practice and worked through the EBP process of assess, ask, acquire, appraise and apply.2. Framed background and foreground searching questions.3. Translated search questions into searching concepts.4. Climbed an evidence pyramid.5. Searched PubMed Clinical Queries. HSS
  • 4. Evidence based practice: Based on the current evidence available to me today,I will practice my health care.. Available My experience evidence EBP Is the combination of what the My patient’s values literature shows, EBP your experience and your patient’s values. HSS
  • 5. Evidence Based Practice Process ASSESS Everything starts with a story. Interpretation of the situation. Background questions to fill in your knowledge gaps. ASK Foreground questions pertaining to the situation. Find the best available evidence. ACQUIRE Consider evidence for validity, statistical significance and APPRAISE application for your patient. Put evidence to work for improved health. APPLY HSS
  • 6. Evidence Based Practice Process ASSESS Everything starts with a story. Interpretation of the situation.H is a new patient on the unit. He is a 52 year old gentleman withosteoarthritis in a variety of joints, including his wrists and knees.He is wearing a magnetic bracelet and sleeps on a magnet pad athome. H claims the magnets help ease pain. Incidentally, there was apiece on a TV health news show about medical magnets theother day. You decide to try and find evidence based literature onthe value of magnets for pain relief of osteoarthritis. HSS
  • 7. Evidence Based Practice Process ASK Background questions to fill in your knowledge gaps. What are medical magnets? What is osteoarthritis?How does a medical magnet work? What is osteoarthritis ? HSS
  • 8. Evidence Based Practice Process Foreground, searchable question is particular to this story. ASK Fill in the PICO formula to help frame the searchable question. . P Patient, problem, population I intervention therapy/prevention, diagnosis/screening etiology/harm prognosis C Comparison to nothing to placebo to benchmark to gold standard O Outcome eliminate symptoms, relieve pain better quality of life HSS
  • 9. Evidence Based Practice Process Foreground, searchable question is particular to this story. ASK Fill in the PICO formula to help frame the searchable question. .H is a new patient on the unit. He is a 52 year old gentleman with osteoarthritis in avariety of joints, including his wrists and knees. He is wearing a magnetic bracelet andsleeps on a magnet pad at home. H claims the magnets help ease pain. Incidentally,there was a piece on a TV health news show about medical magnets the other day. Youdecide to try and find evidence based literature on the value of magnets for pain relief ofosteoarthritis.P 52 year old gentleman with osteoarthritis in a variety of joints, including wrists and knees wearing a medical magnet on his wrist and sleeps on a magnetic padI medical magnetCO Relieve of his pain HSS
  • 10. Evidence Based Practice Process Foreground, searchable question is particular to this story. ASK Fill in the PICO formula to help frame the searchable question. .P 52 year old gentleman with osteoarthritis in a variety of joints, including wrists and knees wearing a medical magnet on his wrist and sleeps on a magnetic padI medical magnetCO Relieve of his pain (patient)In a 52 year old gentleman with osteoarthritis in a variety of joints, (intervention)including wrists and knees will wearing a medical magnet on his (outcome)wrist and sleeping on a magnetic pad relieve his pain ? HSS
  • 11. Evidence Based Practice Process Foreground, searchable question is particular to this story. ASK Fill in the PICO formula to help frame the searchable question. .In a 52 year old gentleman with osteoarthritis in a variety of joints,including wrists and knees will wearing a medical magnet on hiswrist and sleeping on a magnetic pad relieve his pain ? Translate question into significant words, significant phrases and MeSH.Magnets (word, MeSH)Magnetics (word, MeSH) Osteoarthritis (word, MeSH) HSS
  • 12. Evidence Based Practice Process ACQUIRE 6S Evidence Pyramid Climb upas far as you can to befreer of bias and have more summary,analysis andcommentary HSS
  • 13. Evidence Based Practice ProcessACQUIRE Plan #1: Use information found in a background resource. HSS
  • 14. Evidence-Based Nursing isan abstraction journal.It contains an abstract of aquality paper with anadditional commentary. HSS
  • 15. Move citation information into the PubMed Single Citation Matcher BMJ2004 32 1450 9 HSS
  • 16. Click on a Related CitationClick on a PubMed Central paper Use MeSH to find more HSS
  • 17. PubMed Clinical QueriesWhen you search here PubMed adds evidence based filters to your search strategy HSS
  • 18. Randomized Controlled Trials Systematic Reviews Medical Genetics HSS
  • 19. Evidence Based Practice Process Consider evidence for validity, statistical significance and APPRAISE application for your patientAre the results of the study valid?Are there statistics? Are they the right statistics for the question asked?Are the results statistically significant?How does the study result apply to your patient? HSS
  • 20. Evidence Based Practice Process Consider evidence for validity, statistical significance and APPRAISE application for your patientRandomised Controlled TrialsSystematic ReviewsCohort StudiesCase-Control StudiesQualitative StudiesEconomic Evaluations http://www.casp-uk.net/Diagnostic StudiesClinical Prediction Rule HSS
  • 21. HSS
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  • 24. Evidence Based Practice Process APPLY Put evidence to work for improved healthCONCLUSION:Pain from osteoarthritis of the hip and knee decreases when wearing magnetic bracelets.It is uncertain whether this response is due to specific or non-specific (placebo) effects.CONCLUSIONPatients who wore standard magnetic bracelets reported reduced pain associated withosteoarthritis of the hip and knee at 12 weeks compared with patients who woreplacebo bracelets. HSS
  • 25. Evidence Based Practice Process APPLY Put evidence to work for improved healthThe lack of evidence on magnet effectiveness dictates that nursesshould neither recommend nor discourage their use but rather shouldprovide education to clients…Although magnets are usually promoted as being safe and inexpensive,several contradictions …patients with cardiac pacemakers, defibrillators, orinsulin pumps (because these devices are magnetically controlled).2Nurses have an important role in promoting health literacy about theuse of magnets for chronic pain. HSS
  • 26. Evidence Based Practice Process ASSESS Everything starts with a story. Interpretation of the situation. Background questions to fill in your knowledge gaps. ASK Foreground questions pertaining to the situation. Find the best available evidence. ACQUIRE Consider evidence for validity, statistical significance and APPRAISE application for your patient Put evidence to work for improved health APPLY HSS
  • 27. Helen-Ann Brown Epstein MLS, MS, AHIPKim Barrett Medical Libraryepsteinhab@hss.eduhttp://hss.edu/academic-kimbarrett-library.asp HSS