EBM Literature Review

Evidence Based Medicine, Literature Review
Joy Ogunmuyiwa
Evidence Based Medicine, Literature Review
Course Director: Heather McEwen, M.L.I.S., M.S.
October 25, 2015
Introduction
For many patients, language and culture set the background and context for the procurement and
application of their health literacy skills. Health literacy is defined as the degree to which an
individual is able to access, understand, and communicate information in order to promote and
maintain their health [1]. However, a third of U.S. adults–77 million people–would have difficulty
with common health tasks, such as following directions on a prescription drug label or adhering to a
childhood immunization schedule with a standardized chart [2]. Limited health literacy has
frequently been found as a strong risk factor for inadequate health knowledge, reduced self–care
ability, increased morbidity, and mortality [3]. People with low health literacy tend to experience
higher rates of chronic illness and are less likely to use preventive health services when compared to
people with high health literacy [3].
Research that focuses on health literacy, especially of minority populations, is important because
groups such as immigrants, refugees, and non–native speakers of English are more likely to
experience limited health literacy [3]. The impact of limited health literacy disproportionately
affects lower socioeconomic and minority groups. Limited English proficiency contributes to a
greater health–related risk and lower health literacy among
... Get more on HelpWriting.net ...

Evidence-Based Practice
Evidence–Based Practice Reflective Essay
Caring for patients can be very challenging at times and patients as well as a family often has many
questions. They want to know the "why" of the problem. Evidence–based practice helps clarify the
reason behind care and treatment not only for ourselves but the patients. According to David Sackett
and colleagues, "Evidence–based medicine is the integration of best research evidence with clinical
expertise and patient values." (American Speech–Language–Hearing Association, 2016) Evidence–
Based Practice is the combination of clinical expertise, scientific evidence, and patient perspective
(American Speech–Language–Hearing Association, 2016). All three of these components are used
to provide services ... Show more content on Helpwriting.net ...
As a prison nurse, you act as a nurse as well as an officer. Correctional nurses play an important part
in the offender's lives, and we have an opportunity to help in lowering the recidivism. Evidence–
based practice in the corrections system is utilized not only by correctional officers but should be a
collaboration between all criminal systems which includes nursing (Hooley, 2010). All need to
engage with the evidence–based practice to provide an optimal outcome. Several components need
consideration when looking at recidivism the risk or need, motivation, appropriate intervention,
rewiring the brain, positive reinforcement, and ongoing support. The question that needs answering
is what needs the offender has that caused him to commit the crime. When doing this, you have to
exclude physical needs which would include food, shelter, and employment. You have to examine
what are their criminogenic needs which would include their peer and social groups, substance
abuse, lack of self–control, and antisocial belief systems. Second, you need to find out what
motivates the individual. Develop and set an appropriate intervention. If this response includes
classes or support groups, you have to make sure the offender will be able to complete the program
while in custody. Next, we have to rewire the brain through practice, muscle memory, and repetition
combined with positive

Evidence Based Practice In Nursing
Evidence–based practice is an extremely important subject because it proposes to combine
methodologically, the experience of the health professional with the most current information of the
clinical situation that it faced. With this work we want to comment about its beginnings and the
history of the evidence–based practice. Also we would appreciate its positive aspects since the
advantage is obvious: the young professional can make better decisions in spite of lacking sufficient
years in clinical practice, while veteran can take decisions up to date despite of graduating several
years ago. Evidence–based practice is a systematic approach to rational decision making that
facilitates achievement of best practices and can be used as a guide to help nurses make effective,
timely, and appropriate clinical decisions in response to the broad political, professional, and
societal forces that nurses and other health professionals are confronted with daily (Scott and
McSherry, 2009). The need to ... Show more content on Helpwriting.net ...
Now we might think has none, that other nurses are in charge of research. However, create a base of
scientific knowledge and use this evidence in practice requires the participation of all the nurses in
several research activities. Some nurses develop research and conduct studies to generate and
improve the knowledge necessary for the nursing practice. Others are users of research and use of
research evidence to improve their nursing practice. Professional nursing organizations, such as the
American Association of Colleges of Nursing (AACN) (2006) and the American Nurses Association
(ANA) (1989), have issued position statements that describe the participation of nurses in research
according to their training. Nurses with a diploma, a master's degree, a doctorate or a post–doctorate
have clearly designated in research roles (AACN, 2006;) ANA,

Evidence-Based Medicine: Physician Experience Scenario
Scenario: Patient X Ben Jones In theory, "that evidence–based medicine (EBM), determined by the
outcomes of clinical trials, would be an objective decision–making tool to help patients and their
doctors make treatment decisions, once a patient has been diagnosed" (Torrey 2012:1). However,
many problems exist with how the clinical trials that define evidence–based medicine are designed.
Not all clinical research is created equal a small clinical trial with a homogeneous set of patients
may not be applicable to the situation of Patient X. The psychological and social needs of patients
are unique, and while scientific evidence must ground practice, each case must be evaluated on an
individual basis. A sixty–five–year–old patient in the peak of health may not have the same health
goals as one which is suffering from a chronic illness. Serious questions have also been raised
regarding the bias behind many of the trials that define evidence–based medicine. "A study reported
in 2004 showed that when researchers looked into the qualifications of the authors of studies
published in the New England Journal of Medicine (NEJM) and the Journal of the American
Medical Association (JAMA), considered to be two of the most prestigious medical journals, up to
32% of them had undisclosed conflicts of interest" (Torrey 2012:1). This does not mean that all
EBM is invalid, or that there is nothing to be learned from clinical trials. But not all EBM is created
equal. Additionally, a

Evidence-Based Practice
Evidence–based clinical practice or evidence–based medicine is the conscientious, explicit and
judicious use of current best evidence in making decisions about the care of individual patients"
(Sackett et al., 1996). The beginning of Evidence–Based Practice (EBP), formerly known as
evidence–based medicine, was initiated by Archie Cochrane in the 1970's. Cochrane discovered that
when many methods of research start developing revealed as main findings that the clinicians were
making decisions about patient's care from practices commonly used for similar illnesses (Mackey
and Bassendowski, 2017). Cochrane considered that randomised controlled trials represented a
reliable form of evidence that can provide with more valid information that initiated ... Show more
content on Helpwriting.net ...
On the other hand, while those forms of evidence are essential for EBP has been emphasised taking
into consideration the holistic aspect of care provided by the nursing profession as having an
important contribution in developing guidelines and in EBP implementation (Mackey and
Bassendowski, 2017). The EBP in nursing involves the process that promotes practices related to
patient's care and nurse's knowledge (empirical, ethical, personal, aesthetic), improved and adapted
from updated evidence and theories developed from research (Gray, 1997). Throughout the years
has been debated that nursing holistic approaches (compassion, perception, knowledge gained
through learned experience) cannot be measured but can be considered as well effective practice
guidelines that lead to an improved patient outcome (Mackey and Bassendowski, 2017).
Implementation of EBP in nursing has as results numerous benefits in healthcare practices by
improving patient's outcomes and increasing patient safety through the provision of the most
updated, reliable information about healthcare services and practices, aiming to address patient's
needs (treatments, guidelines, policies) (Chrisman et al., 2014). Therefore, promoting effectiveness
and efficiency in care by using EBP has as advantages reducing healthcare costs and decreasing

Egapp Process
Analytical validity shows whether or not a test is reliable, accurate, and reproducible. Significant
evidence gaps exist in analytic validity due to tests that are developed in the lab, interests related to
patents and copyrights, and inadequate regulation. Clinical validity examines the significance of the
test to determine if the results would translate to something with clinical importance or not; for
example, risk of developing a disease, or metabolism of a drug or response to the drug. Clinical
utility shows the use of the test in clinical decision–making and its translation to an important health
outcome; it also assesses if any harms are outweighed by the benefits. On the other hand, in clinical
utility, there are very few randomized ... Show more content on Helpwriting.net ...
3: Promoting informed decision making is a valuable recommendation when sufficient evidence is
available on analytical and clinical validity and risk and benefit analysis is favorable but not
definitive. Furthermore, discourage the use of testing when there is no or little information on
validity or utility and evidence of harm. These recommendations and rigorous outcomes research
can provide sufficient guidance in clinical practice for assessing the impact of genomic testing on
patients, their families, and population based health outcomes. According to Khoury et al., since
clinical genomics and the field of personalized medicine are still evolving, the term insufficient
evidence in Tier 2 category will be used for many decades to come. It becomes important to use all
the available evidence in this category to the best possible extent so as to guide the clinical

Physical Therapy Scenario Paper
Scenario A physical therapist comes to see you about a 60–year–old female patient recovering from
a stroke. She needs information about mobility training, and best practices in using walking aids
(such as walkers or canes) versus leg braces (orthotics) to stabilize ankle and leg strength so the
patient can learn how to walk again.
PICO
P (Problem)– The client is 60 years old female. She needs information about mobility training, leg
braces and walking aids so she can learn how to walk again.
I (Interventions)– The client will be given a structured interview to analyze her daily life and see
what activities she participates in. When I deliver her results, I will be sure to utilize the strength
base approached to ensure positivity and understanding in the conversation. I will conduct a Meta–
analysis research based on evidence–based practice in to find information about mobility training
and walking systems to present to my client.
C (Comparison) – I will be comparing mobility training, walking aids and leg braces. I will closely
analyze each type of walking assistance to include the cost, mobility training needed, previous
reviews on the assistance and any other specs that 's needed for the client to make an informed
decisions.
O (Outcome)– The client will choose the best option of walking assistance for her, based on the
information I provided to her from my research.
Research Questions
What walking system and mobility training will the client benefit best from?

Evidence Based Medicine
Making decisions about the care of patients is important in every health profession. According to the
journal of Academy of Medical Sciences of Bosnia and Herzegovina, "Evidence Based Medicine
integrates clinical experience and patient values with the best available research information." It
increases the use of clinical research in clinical decision making. The practice of EBM is important
for learning information about a patient's diagnosis, prognosis, or any other health care issues.
Evidence based medicine and the scientific method are related in certain ways. There are four
different levels of evidence, known as systematic review, randomized controlled trials, cohort
studies, and case reports. The scientific method has five steps, which ... Show more content on
Helpwriting.net ...
Some physicians found that when they used EBM they lacked knowledge and skills in searching
and applying evidence. Some physicians find a problem when it comes to the statistics. "The
problem is when it comes into statistics we get scared; I'll get stuck and can't proceed any longer." I
think that EBM is a great solution in the health profession. Evidence based medicine is for when one
wants to find the whole answer to a condition. Personally, if I was the patient it would make be able
to feel more confident about figuring out what my condition is all

Nurl 935 Week 5
Karbowski Discussion Board Week Three: Nurl 935 In this discussion board, I will review the
findings and recommendations of the United States Preventive Service Task Force (USPSTF)
recommendation statement: Aspirin use for the primary prevention of cardiovascular disease and
colorectal cancer.
Evaluation
Evaluation will be performed utilizing the Rapid Critical Appraisal Checklist for Evidence–Based
Clinical Practice Guidelines (Slutsky, 2005) and use of the National Guideline Clearinghouse
(NCG), guideline summary (2016).
Generalized Applicability and Disease Cardiovascular disease (CVD) is a major cause of death and
disability in the United States among adults. More than one–half of all deaths were caused by heart
disease, cancer or ... Show more content on Helpwriting.net ...
(2016). Apsirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S.
preventive services task force rocommendation statement. Annals of Internal Medicine, 164(12),
836–846.
Slutsky, J. (2005). Using evidence–based guidelines: Tools for improving practice. In B. F.–O.
Melnyk, Evidence–based practice in nursing & healthcare. A guide to best practice (pp. 221–236).
Philadelphia, PA: Lippincott, Williams & Wilkins. initially created in 2009, this most current edition
was updated and revised in 2016 (NCG). The original article was published in the Annals of Internal
Medicine (2016) by Bibbins–Domingo. Financial disclosures and conflicts of interest were
disclosed in a broad statement covering all panelists. Funding for the research and creation of the
guidelines came from funding provided by the U.S. Congress through the Agency for Healthcare
Research and Quality.
Conclusion
The 2016 USPSTF guidelines for the prevention of CVD are highly credible and demonstrate a
thorough evaluation of credible evidence and provided understandable and easily applied practice
recommendations. The guidelines can be readily applied to a variety of health care settings and
providers to promote the long–term health of their patients. Recent updates in 2016 ensure that the
most evidence–based information has been applied in their formulation. Use of these guidelines will
help reduce the risk of CVD while minimizing complications attributed to the

Information Based Medicine ( Ebm )
A Health intervention is an effort that promotes behaviour that optimizes mental and physical health,
or discourages or re frames behaviours considered to be potentially health–threatening. So,
Evidence based medicine(EBM) is not the only but the best approach to health interventions as it
emphasizes the use of evidence from well designed and conducted research in healthcare decision–
making. EBM is regarded as the gold standard of clinical practice. The term "evidence–based
medicine", as it is currently used, has two main tributaries. Chronologically, the first is the
insistence on explicit evaluation of evidence of effectiveness when issuing clinical practice
guidelines and other population–level policies. The second is the introduction of epidemiological
methods into medical education and individual patient–level decision–making.
Evidence–based medicine (EBM) is the process of systematically reviewing, appraising and using
clinical research findings to aid the delivery of optimum clinical care to patients.
EBM is the practice of solving the clinical problems in one 's practice by judicious and systematic
use of the medical literature. This includes framing questions rightly and searching the right kind of
literature. Thereafter, the available evidence needs to be evaluated for the validity, strength and
effect size. Finally, the results are examined for applicability to the current problem which requires a
detailed knowledge of the clinical setting, patient

Weak Predictionism: Evidence Based Medicine
1. Thesis and Explanation Weak predictionism carries the best evidential weight among the four
conjectures, weak predictionism, weak explanationism, strong predictionism, and strong
explanationism. My argument will be based on evidence based medicine. Evidence based medicine
is medicine that has been tested and advanced due to success in previous studies or known facts. I
will be arguing for weak predictionism as the best conjecture. Also I will argue that predictionism is
fruitful in coming up with many other answers in the world of medicine. Weak predictionism is the
view that only confirmed predictions provide better evidence for a conjecture than explanation of
previous details. Weak explanationism is just the opposite of weak predictionism, ... Show more
Especially in the field of medicine, many philosophers feel that explanationism explains results
more than any other conjecture or view. In the article Ashcroft, Djulbegovic, and Guyatt wrote about
evidence based medicine, they talk about how philosophers believe that the tradition is based on
knowledge and not prediction. It is stated, "in the philosophical tradition that rational thinkers
respect their evidence, we show that evidence based medicine refers to making medical decisions
that are consistent with evidence" (Ashcroft, Djulbegovic, and Guyatt). This claim says that
evidence based medicine has to do with previous evidence and knowledge, and putting that
knowledge together to come up with new truths. The relationship among the two is that evidence
and knowledge go hand in hand. The article also goes a little bit deeper in explaining the depth of
the knowledge. The authors stated, "as a reliable sign, symptom, or mark to enhance reasonableness
or truthfulness of some particular claim 'evidence as a guide to the truth'... for example, as when
"positive" diagnostic test increases the likelihood that our patient truly has a certain disease. This is
also typical way how evidence is employed in scientific testing" (Ashcroft, Djulbegovic, and
Guyatt). This statement refers to the idea that evidence based medicine is completed by many
different philosophical theories of scientific evidence. The above statement mentions too that

Evidence-Based Medicine: A Case Study
The goal of every clinician is to provide the best care for the patient. Most clinicians began their
profession to make a difference in a particular area of expertise. This paper explores the meaning of
evidence–based medicine while providing some reasons current practice does not acknowledge the
proof of medicine before prescribing treatment for the patient. Lastly, the expectations of the
clinician to create forward movement in using evidence to provide the best treatment for the patient.
According to Essential Evidence–Based Medicine, the definition of evidence–based medicine as the
conscientious, explicit, and judicious use of current best evidence in making decisions about the
care of individual patients (Mayer 2010). In 1999, several clinicians coined the term evidence–based
medicine. At this point, evidence–based medicine assumed a major place in establishing the
standard of care (Rubin and Haynes 2012). Most individuals would agree that medicine should be
based on evidence and ... Show more content on Helpwriting.net ...
Some see it as oppressive interference with a practitioner's autonomy. Some scientifically educated
medical school graduates see evidence as inferior to intuition and experience. Breaking down the
wall of traditional medicine has been very difficult. In the past, the decisions were made regarding
the best care for patients based on what the school and professors taught. Often this has meant that
the reasons for treating a patient a certain way derived from information that had been passed down
through several generations. The mentality circulating is we have always done it this way or if it
seems to work just do it with little to no evidence (Rubin and Haynes 2012). This practice is
inherited from peers as well as authority figures and results in the same mistakes being made over
and over again. There are daily practices today that have clearly failed the tests of time and
confirmation due to this type of

Literature Review Of Alarm Fatigue
Capstone Part I: Literature Review
Introduction to Problem Alarm Fatigue: According to Cvach (2012), alarm fatigue is "the lack of
response due to excessive numbers of alarms resulting in sensory overload and desensitization"
(Cvach, 2012, p. 269). Alarm fatigue is a major concern in the critical care unit. In a course of a
shift nurses hear so many alarms they began to become immune to them. There are many times
when an alarm sounds the result is often a false alarm. Research has demonstrated that 72% to 99%
of clinical alarms are false (Sue Sendelbach & Funk, 2013). As a result the increased number of
false alarms has resulted in alarm fatigue. Alarm fatigue is when a nurse or health care professional
has been exposed to an excessive number of alarms resulting in desensitization to alarms and missed
alarms. As a result there has been patient injuries and deaths associated with alarm fatigue. This has
raised concern making this a very important patient safety issue. Patient safety and regulatory
agencies have focused on the issue of alarm fatigue, and it is a 2014 Joint Commission National
Patient Safety Goal (Sue Sendelbach & Funk, 2013). This issue has raised many concerns and if not
handled in a correctly fashion could result in many more incidents and sentinel effects.
There are many ways that we as health care professionals can attack the problem at hand. First we
can start by individualizing patient parameters on the alarms. Not every patient is

Summary Of How To Read A Paper: The Basics Of...
The big idea of "How to Read a Paper: The Basics of Evidence–Based Medicine" is that it describes
the different types of clinical research reporting, and explains how to critically appraise the
publications. The book provides the tools to find and evaluate the literature, and implement the
findings in an evidence–based, patient–centered way. It is written for anyone in the health care
professions who has little or no knowledge of evidence–based medicine; it provides a clear
understanding of the concepts and how to put them into practice at the basic, clinical level.
The three things I have learned about this book are: 1) Assessing methodological quality. These
questions are needed to be answered in order to interpret your findings and be able ... Show more
Was assessment 'blind'? In an attempt to achieve a comparable control group will not work out if the
people, who assess outcome, know which group the patient they are assessing was assigned to. Were
the preliminary statistical questions addressed? You will want to know the size of the sample, the
duration of the follow–up and the completeness of the follow–up. 2) When is a review systematic? A
systematic review is an overview of primary studies. They contain a statement of objectives,
sources, and methods and have been conducted in a way that is clear transparent and re–create. The
method for a systematic review is: state the objectives of the review of randomised controlled trials
and outline the eligibility criteriasearch for trials that seem to meet the eligibility criteriatabulate
characteristics of each trial identified and assesses its methodological qualityapply the eligibility
criteria and justify any exclusionsassemble the most complete datasheet feasible, with assistance
from investigators, if

SUMMATIVE B– ESSAY
Health is "a state of complete physical, mental, and social wellbeing not merely the absence of
disease or infirmity" (WHO 1948).
Functional medicine is a science based approach to the treatment of individuals towards optimal
health, rather than the treatment of disease, that is to say, the treatment is patient centered rather than
disease centered.
By the application of a systems based approach, and also factoring in lifestyle, environmental and
genetic influences, the underlying cause of disease may be identified. It is the interconnected web of
physiological functions that functional medicine considers, with the aid of relevant lab tests, as this
is unique to each individual along with their biochemical and genetic individuality. ... Show more
et al., 2012). This may be due to the considerable evidence of the influence of hereditable
epigenetics (Richards, E.J., 2009). This is also possible because of all the technological advances
giving us more information about the patient, like; genomics, epigenomics, proteomics as well as
more data about a persons' environmental influence like nutrigenomics, metabolomics, gut
microbiome status and toxins, and many more (German, J.B. et al., 2004). Hence it necessitates a
process to include all the available information from earlier paradigms as well as the new, to
evaluate how the different elements interact. The '–omics' surge in technology may help to build on
and augment previous knowledge, and improve prediction of disease likelihood, which can lead to
improvements in preventional strategies like personalized

Evidence-Based Medicine: A Case Study
Evidence–based medicine is designed to increase the quality medical care and increase the value of
medical by cutting costs through the reduction of misuse and/or overuse (Shi and Singh, 2013) EBM
guidelines are represented by "best practices and proven therapies" (Shi and Singh, 2013). The work
to improve these guidelines and protocols is ongoing as it seeks to improve the delivery of
healthcare, into the future. Shi and Singh (2013) lists 6 recommendations for improving practice
guidelines for the future (p. 352). The purpose of this jouornal entry is to offer an analysis of two of
the guidelines. The first recommendation I chose is the following: "Guidelines and protocols must
be revised and kept current to incorporate subsequent scientific ... Show more content on
Helpwriting.net ...
However, the overall economic burden falls upon the hospitals, where surgical robotics such as a da
Vinci System, can sot upwards of $1.5 million to be installed in a facility (Medical Innovation,
2013). The hospital then has to evaluate if the robotic surgery results in fewer complications vs. any
long–term risks for using he equipment, and measure any return investment of using the equipment
(Medical Innovation, 2013). One study showed that a facility would spend an average of $12,
943,60 on a more invasive surgical procedure, whereas the robotics procedure cost the facility
significantly lower at $8,212 (Medical Innovation, 2013). Overall, this guideline is important, but an
equally important argument is being sure that a push for efficacy in health care should not slow
down or curtail innovation (Medical Innovation,

Evidence-Based Decision-Making Analysis
In the article "Evidence–Based Decision Making in Public Health" by Brownson, Gurney & Land
we read that the public health has proved to be quite successful in many ways.The authors explain
that there are more challenges that need to be faced. Moreover, public health needs to apply
evidence–based decision–making in its field.The public health sector is continuously improving and
expanding. It needs to enforce evidence–based strategies to address these emerging
challenges.Evidence–based strategies are needed in the development, implementation, and
management of policies and programs.
In 1996,the Missouri Department of Health initiated a work group. The primary objective of this
workgroup was to develop a course of training and framework for health workers. The aim of this
program was to make use of more evidence–based decision making.
The authors explained the differences between evidence–based public health (EBPH) and evidence–
based medicine (EBM).
There are six stages based on this strategy: Stage one consists of the development of an operational
statement of the problem. It is an initial assessment and is like a foundation of other stages. State
two of determination of what is known through the literature based on scientific research.Stage three
deals with the quantification of the problem. Stage four involves the development of policy or ...
Show more content on Helpwriting.net ...
The statement would include the following : the public health issue and sample population group.
The public health issue can be divided into the enormity of the issue,its related risk factors, and
prevention strategies. This is a stage in which the researchers can incorporate a faith–based
perspective. Timothy 2:15: "Study to show thyself approved unto God a workman that needeth not
be ashamed rightly dividing the word of truth."Biblical teachings can act as guidance to devise new
plans,policies, and

The Significance Of Evidence-Based Practice Report
Patient safety and quality of care are vital outcomes in the healthcare system. As professionals
dealing with human lives, we consider these topics as core to our practice. In 2005, the Quality and
Safety Education (QSEN) project was created in response to the challenges recognized in preparing
nurses with the knowledge, skills, and attitude (KSAs) essential in providing safe and high–quality
care to every patient (QSEN, 2012). This QSEN collaboration was the product of the strategies
developed by the Institute of Medicine (IOM) report Crossing the Quality Chasm in 2001 and
Health Professions Education: A Bridge to Quality in 2003 (Armstrong, G. & Barton, J., 2014).
There were six competencies identified in the QSEN curriculum that includes patient–centered care,
teamwork and collaboration, evidence–based practice, quality improvement, informatics, and safety.
In this paper, the QSEN competency, evidence–based practice will be discussed in relation to
achieving quality and safety to the nursing process.
The Significance of Evidence–Based Practice
Evidence–based practice is defined as the "integration of best current evidence with clinical
expertise and patient or family preferences and values for the delivery of optimal health care"
(Quality and Safety Education for Nurses, 2012). It is "the use of research in clinical decision
making" (Brower, 2017).With the tremendous changes in the healthcare landscape, many processes
have to be evaluated for its relevance, reliability,

A Literature Review : The Walden University Library Essay
A literature review is an interpretation of arrays of circulating articles written by the scholar–
authors' of researchers related to several topics. A literature search for evidence–based research can
be overpowering. The Walden University library illuminates on the superlative quality of evidence–
based research and which databases to utilize with research searches. Filtered resources are the
superlative quality of studies related to evidence–based practice and encompasses systemic reviews,
critically appraised topics, and critically–appraised individual articles while unfiltered resources are
second along the pecking order which includes "randomized control trials, cohort trials, case–
control studies, case series, and case reports (Walden Library, 2015, para. 6). Lastly is the
background information and expert opinion, which inherently are not backed by evidence–based
studies and comprises "point–of–care resources, textbooks, conference proceedings, etc." (Walden
Library, 2015, para. 7).
Arrays of individuals diagnosed with cancer experiences anguish and deterioration related to
uncontrolled pain. According to Paley (2015), "Forty percent of people with early or intermediate
stage cancer and 90% with advanced cancer have moderate to severe pain and up to 70% of patients
with cancer inherently do not receive sufficient pain relief" (p. 1). Definitely, there has to be an
enhanced approach to alleviate cancer patients' pain, hence what is the superlative interventions to

Evidence-Based Medicine For Treatment Protocolss, And...
I. Introduction: The purpose of this paper is to evaluate evidence–based medicine for treatment
protocols, treatment guidelines, and outcomes for Obesity and provide the perspective of
conventional medicine, complementary and alternative health, and integrative medicine (IM) to
determine new standards for medical treatment.
A. Obesity – is an excessive accumulation of fat cell within the body that impairs a person's health
and is called malnutrition or undernutrition. Malnutrition includes wasting, stunting, underweight,
inadequate vitamins or minerals, overweight, obesity, and diet–related noncommunicable diseases
("WHO | Obesity," 2014).
Provide statistical data. There are 50 states that currently have an obesity rating 20% or higher. ...
Based on past research efforts and their success rate I will determine, which medical model will
most combat the obesity epidemic.
C. Conclusion – The data provides proof that obesity has only increased over the past couple of
decades. It shows that there hasn't been any fluctuations in both adult and childhood obesity. The
best practices for the disease/condition would be to understand how different foods affect different
body types. It is my belief that the human body is unique to each individual. Foods and their effects
on the body needs to be further researched and understood. There are different types of bodies and
each body many require special attention when it comes to diet and nutrition. The goal of treatment
will be to gain more knowledge of how various herbs, vitamins, and foods affect individuals
differently how to incorporate these methods successfully. A clinical care model will include a
comprehensive understanding of common foods available to the general public, how often the foods
are purchased, and the effects that they have on the general public. Healthier foods will then be
integrated that are proven to reduce weight gain and obesity. The clinical model will prove that
when lower calorie healthy plant based foods and vegetables are integrated into the diet weight loss
is inevitable.
II. Review of Evidence–Based Medicine i. The standard of care for the treatment of obesity

Is Cranberry Juice Effective for Preventing and Treating...
A 65–year–old Chinese woman, who is currently being treated for a suspected urinary tract infection
(UTI), has enquired to whether cranberry juice is effective for preventing and treating UTIs. After
querying the RN, they too are unsure how effective the therapeutic intervention is. Thus, there must
be an investigation utilising evidence–based practice (EBP) to determine the effectiveness of the
therapeutic intervention and provide accurate information to the patient. Furthermore, when
delivering the information to the patient, culturally appropriate care must be considered, to ensure
clear and coherent communication to the patient. EBP provides health professionals a method to use
critically appraised and scientifically proven evidence ... Show more content on Helpwriting.net ...
The question was rephrased as a specific, answerable question using PICO, which refined the case
study to its core components; postmenopausal women, cranberry juice and UTIs. The advanced
search limits were enabled to craft rather precise research strategies, with Boolean operators and
wildcards were utilised in the phrase search; postmenopausal wom*n AND cranberr$ juice AND
UTIs (Wolf et al., 2013). The search limits of the Cochrane Library were restricted to Cochrane
review and trials, and the publication dates from January 2010 to May 2014. From this refined
search of the selected databases, eight papers returned from over 8000 results. Evaluating the eight
papers for quality evidence was critical when selecting the two papers to utilise. The evidence
hierarchy was considered, aiming to use the highest evidence possible, such as systematic reviews
and meta–analyses; and randomized, controlled, double–blind studies, to ensure the most accurate
evidence informed the clinical decision for the patient (Bloom, Olinzock, Radjenoic & Trice, 2013).
When sorting the results, other various factors were also taken into consideration; credibility,
reputability, reasonability and support. With these factors taken into account, the two papers selected
are highly esteemed in regards to evidence, and are most relevant to the patient (Stichler, 2010). The
first paper, selected from the CINAHL database, was the

Clinical Reasoning: Combining Research and Knowledge to...
Making sound and client–centered clinical decisions in an area that demands accountability and
evidence–based practice requires not only scientific knowledge, but also a deep knowledge of the
practice of one's profession and of what it means to be human in the world of combined strength and
vulnerability that is health care. Every clinician must understand the importance of applying best
research evidence to client care, the essence of evidence–based practice, to improve the overall
quality of healthcare. Research continues to find that using evidence–based guidelines in practice,
informed through research evidence, improves patients' outcomes (Dykes et al, 2005). The literature
is replete with definitions of evidence–based ... Show more content on Helpwriting.net ...
Becoming a critical thinker is a prerequisite of becoming an evidence–based clinician. But what is
critical thinking? Critical thinking involves the application of knowledge and experience to identify
patient problems and to direct clinical judgments and actions that result in positive patient
outcomes. Critical reflection requires that the thinker examine the underlying assumptions and
radically question or doubt the validity of arguments, assertions, and even facts of the case. Critical
reflective skills are also essential for clinicians; however, these skills are not sufficient for the
clinician who must decide how to act in particular situations and avoid patient injury (Wheatley DN,
1999). Critical reasoning is a process whereby knowledge and experience are applied in considering
multiple possibilities to achieve the desired goals (Noll et al, 2001) while considering the patient's
situation (Fowler, 1997). According to Simmons it's a process where both inductive and deductive
cognitive skills are used (Simmons et al, 2003). Each client's problem is unique, a product of many
factors, including the client's physical health, lifestyle, culture, relationship with family and friends,
living environment, and experiences. Thus, a health care professional does not always have a clear
picture of the client's needs when first meeting a client. Because no two clients have identical
problems, a clinician is always

Essay on Evidence Based Practice in Nursing
Within this essay Evidence based Practice will be identified and the significant effect it has on the
nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.
Individuals need specific care tailored to them, it is vitality important to have the correct
professional and appropriate personal care. In order to receive this we need to get the patient
involved in the decision process, listen to their views and opinions and receive the relevant,
accurate, professional and medical information. Once all the information is collaborated a personal
care package can be put into practice. Evidence – Based Nursing, An introduction (2008, p.1) " At is
core evidence based 'anything' is concerned with using ... Show more content on Helpwriting.net ...
This outlines the fact it is crucial to have the best external evidence including both clinical and
professional inputs. It also highlights the patients' rights preferences and their autonomy should be
without doubt taken into account during the research process. The best method for treating patients
for nurses and any other medical professionals is to use Evidence Based Practice. This is because it
brings together years of accurately recorded clinical knowledge from previous cases with will be
relevant in the treating of your patient. The process of using Evidence Based Practice in a patients
care plan consists of five key stages. Asses the patient and formulate the problems from this you will
then need to access the relevant clinical articles. Using this information you should then be able to
assess which is the best method of treatment discarding any misleading or ambiguous articles. You
then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and
assess the patient during treatment to ensure effectiveness. Evidence – Based Nursing, An
introduction (2008, p. 285 ) " The rapidity of change and the reorganization of nursing services
within the health care sector presents challenges for the advancement of EBP. Managers and
administrators should facilitate the uptake of practice based on current, high–quality research by
formalizing the expectation that nurses care be Evidence Based".

Evidence Based Practice Summary
In medicine today it is becoming essential to remain on the journey to best possible practice, which
"involves implementing available evidence into practice" (Dogherty, et al., 2013, p. 129). Dogherty,
et al. (2013) researched the facilitation of evidence based practice by selecting 20 nurses "to attend
an interactive knowledge translation symposium to examine what has worked and what has not in
implementing evidence in practice." Results from the study showed both many positive and
negative facilitation experiences. "Successful implementation (of evidence based practice) is
associated with focus on a priority issue, relevant and easy to use evidence, development of strategic
partnerships and a multidisciplinary project team including ... Show more content on
Helpwriting.net ...
(2013) including both positive and negative experiences. Dogherty, et al. (2013) spoke of
identifying clinically driven needs, in other words, issues "related to a need articulated by the
nurses" (p. 134). As I mentioned previously, our resource nurses play a major role in EBP in the
NICU. These nurses are routinely bedside nurses that identify areas needing to change that are
"concrete and real in everyday practice" (Dogherty, et al., 2013, p. 134). Another theme the study
mentioned is "development of partnerships and a project team and engagement of key stakeholder"
(Dogherty, et al., 2013, p. 134). This topic not only also plays a part of our resource nursing
leadership but also with our monthly unit council meetings. Unit council meetings help facilitate
change by "involving frontline staff in design and delivery of the implementation" (Dogherty, et al.,
2013, p. 134). Unit council meetings are designed to engage in conversation to drive change.
Another aspect of a positive facilitator that stuck out to me is one that shows characteristics of
coaching, mentoring, effective communication and playing the role of a cheerleader. All of these
characteristics apply to the majority of the nurses here in the NICU. I feel like we excel in team
work. The use of a strategic process or plan is as well a positive facilitator I see often. Our managers
and leaders provide in services to ensure nurses are educated on the supplies, documentation and
equipment of new

The Importance Of Evidence Based Practice
Evidence based practice [EBP] is an essential component of the health care system. Combined with
both the practice of the APHRA codes of professional conduct and continual support of clinical
education there can be little excuse for nurses regardless of practice setting to not uphold a superior
level of medical care.
Evidence based practice is defined by the Monash University (2017) as the 'process of making
clinical decisions based upon evidence, combined with the clinical experience and patient
expectations'. With decades of research backing this statement such as that described by Melnyk
(2016) we can reflect upon our own behaviour and practise in the clinical setting and justify our
EBP culture. Currently working at the Bradford Clinic in a sub speciality of medicine as a registered
nurse, aesthetic medicine is aimed at improving internal and external wellbeing via the enhancement
of appearance through non–surgical techniques. This particular field has grown in popularity mainly
due to the increased acceptance of anti–ageing medicine and this can be accredited to–
The desire to enhance physical features and in–turn maintain a 'fresh' appearance.
Economic affordability. Aesthetic / cosmetic procedures are seen as a luxury for many people.
Technological and medical advances whereby new cosmeceuticals and devices boasting minimal
downtime and complications.
Media–driven demand and high pressure advertising.
Professional compulsions to undergo cosmetic

Practicing Evidence-Based Medicine
Over the past decades, there has been a shift in medicine from traditional reasoning towards
evidence–based medicine (EBM).1 Practicing evidence–based medicine has been shown to improve
quality of care.2 The providers are trained to assess the strengths and weaknesses of the evidence
and use their clinical judgment to predict whether a treatment will be beneficial for a particular
patient. One can argue that evidence–based practice is very guideline–driven and does not take into
account patient's preferences. However, evidence–based medicine is not just about using data from
clinical trials to design treatment plans for patients. It encourages a patient to be an active
participant in a decision–making, which promotes improved patient satisfaction.

Evidence-Based Medicine: Personal Statement
It was the stethoscope; I was fascinated by it. It belonged to one of my granddad's old students and
he was the only doctor in the beautiful hilly town in southern India where I spent my childhood.
Being the only doctor for miles he was always busy and watching him work tirelessly for the
community left a mark on me early on. There was this charisma about him and the stethoscope that
made me want to be just like him. Years later I realized that it was his empathy, diligence, and sense
of duty that made such a deep impression on my young mind.
As a teenager, I spent most of my summers assisting my father who was the regional head of a non–
profit organization. He undertook various projects to educate the children from the local slums,
organize ... Show more content on Helpwriting.net ...
I made good friends, a lot of memories and worked with several different attendings. Each
experience was unique and I learned to adapt quickly, be resourceful and efficient in order to gain
the most of my clinical rotations. I have always strived to procure the best education, and that is the
reason for pursuing my education in the United States. I also desire a health care system with an
importance on accountability and human life and I hope to practice evidence–based medicine to
provide my patients with the best care possible. I have a keen interest in quality improvement as
well and one of my goals is to undertake various quality improvement projects at the hospital. I feel
that by reflecting on the changes we need to make, we can improve our health care delivery and
overall health of the community. I am also drawn to the intellectual culture of Internal Medicine and
I wish to continue working in an academic setting at the end of my residency.
Hailing from a different country, I can bring a unique multicultural perspective to the program along
with the values of hard work, empathy, and efficiency. The workings of Internal Medicine embrace
my personality, interests and abilities and I am confident I will excel and fulfill my goal of making a
significant impact on patients'

Qualitative Research and Evidence-Based Medicine
Research Question: Overall investigation into the barriers patients with lymphedema perceived
within their situation that prevented them from achieving optimal skin care. Coding Issues: Within
the research, coding was used to organize, analyze, and sort thematic materials: Coding Model
Characteristics Analysis Responses to information received Anxiety, mistrust, worry, obligation,
lack of understanding Additional need for open communication and educational process Factors
germane to the individual's ability to maintain skin care Physical limitations, expenses, social
isolation, lack of motivation Realistic and definable outcomes, analysis of expenses and potential
aid Additional factors relating to decision making Lack of social support, emotional dynamics
Support dynamics (group, social services, etc.) Expectations and presumptions Realistic v.
Unrealistic presumptions of outcomes Clarification of realistic expectations Rationale:
Lymphoedema is also known as lymphatic obstruction and is a skin condition in which there is
localized fluid retention and tissue swelling. This is typically caused by a compromised lymphatic
system, also causing tissues to become infected, or at the very least, inflamed. Symptoms are severe
and include chronic fatigue, heavy swollen limbs, fluid accumulation in other body areas (head,
neck, etc.), discoloration of the skin, and eventual deformity or elephantiasis. The disease affects
about 140 million people globally, and is

Cancer Pain
Literature Review of Complementary and Alternative Methods to Treat Cancer Pain
Literature Review
A Literature review is an essential and intense appraisal of previous research, it bestows a
groundwork on which, to base a novel evidence and typically performed afore data collection, for it
magnifies upon the aims of selecting a specific research question (Polit & Beck, 2017). Introduction
Pain occurs in the human body as the result of a physiological series of electrical and chemical
modality; uncontrolled cancer–related aching interposes to the patients' anguish, henceforth, the use
of evidence–based interferences is vital to the quality of life (QoL) for cancer patients. To
understand the best practice related to the interferences of ... Show more content on Helpwriting.net
...
According to Caraceni, Pigni, and Brunelli (2011), for over two decades now, the usage of oral
morphine has reflected as the drug of first–rate for remedying the moderate to severe cancer pain
based on its extensive and broadly usage, domain established with World Health Organization
stepladders and chronological locale. Arrays and rank of orally morphine efficiency and side effects
contrasted to other opioids namely methadone, oxycodone, TTS fentanyl, diamorphine and
hydromorphone in cancer pain treatment modality by the researchers and result indicated that the
oral morphine has no known differentiation compared to other opioids, however, additional analysis
is required (Caraceni, Pigni, & Brunelli, 2011).
Inconsistencies and Contraindications in Literature with Explanation
There was some inconsistency recognized in the literature review, especially that of the World
Health Organization analgesic stepladder. The study conducted by Naga (2015), discovered that;
World Health Organization analgesic stepladder needs to be the first–rate line of treatment modality
related to cancer pain. While, Bhatnagar and Gupta (2015) indicated, that the World Health
Organization stepladder should be amended and overturned

Evidence Based Practice Research Paper
CHAPTER 5 EVIDENCE BASED PRACTICE INTRODUCTION Evidence based practice (EBP)
is the conscientious use of current best evidence in making decisions about patient care .
SIGNIFICANCE  EBP is important because it aims to provide the most effective care that is
available, with the aim of improving patient outcomes.  Patients expect to receive the most
effective care based on the best available evidence.  Evidence–based practice adds to our
understanding of decision making by explicitly inviting health professionals to consider research in
addition to other sources of information.  Evidence–based practice is not just about using research
evidence. It is also about valuing and using the education, skills and experience one has gained over
... Show more content on Helpwriting.net ...
 Evidence–based practice in nursing integrates research evidence, patient preferences and the
clinical expertise nurses gain over time from practice.  Bachelor of Science in Nursing (BSN)
degree programs include coursework on how to find , interpret, and apply evidence to improve
patient safety, care and outcomes.  Evidence–based practice in nursing closes the gap between
scientific evidence and experiential evidence.  Nurses have to decide if the evidence is applicable
for specific patients.  Clinical expertise helps nurses weigh the risks and benefits of treatments for
patients and takes into account each patient's unique circumstances, including diagnoses,
comorbidities and preferences. This integration of knowledge and experience leads to better patient
outcomes, safer, more efficient and effective care. IMPORTANCE OF CONCEPT IN CURRENT
WORLD  Variations in health care services have been well documented worldwide.  Consumers'
use of evidence–based information to choose providers, make treatment decisions, and play a more
active role represents the ultimate local application of scientific

Barriers to Evidence-Based Practices
Evidence–based practice requires ready access to external evidence that can lead to up–to–date
clinical decision making. Meanwhile, libraries have been under growing funding pressure when
physiotherapists have been adapting evidence–based practice. Journal subscription prices have
increased intensely past ten years in the field of medicine, the average price increase over this
period was 304% (Albee & Dingley 2000). A lot of library budgets are unable to afford such
increases and libraries have had to consider choices including stopping serial subscriptions and
converting from paper to electronic formats. By the same token, an individual may only be able to
afford to subscribe to a couple of journals (Maher et al. 2001). A lot of physiotherapists have
restrictions in accessing high level evidence (as there is limited access to databases of clinical trials
archives and reviews or even lack of awareness of these databases), which made them believe that
there is no much evidences about physiotherapy interventions (Bithell 2000). There is a study
which, found variations between disciplines' use of online evidence and identified ease of access
and time taken to locate the online evidence as barriers to evidence–based practice after
interviewing Australian health professionals including some physiotherapists (Gosling et al. 2003).
Both clinicians who are enquiring clinical questions and researchers who are conducting in–depth
searches for systematic reviews come across a few

Reaction Paper On Delirium
"Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness
of one's environment and confused thinking" (The Mayo Clinic, 2012). A common trend I have
noticed at my facility is the increased frequency of hospital admissions from (SNF) Skilled nursing
facilities. The resident is sent to the hospital under a psychiatric hold due to an alteration in mental
status with aggression. During the RN–RN handoff report, the nurse will state that the resident sits
in their room all day but will act out by refusing medications and striking at staff. The resident does
have some good moments, but has unpredictable or erratic behavior. Once on our unit it is
discovered that the patient has an active urinary tract infection coupled with dehydration and a lost
hearing aid; all of which are treatable at the SNF. "Treating delirium involves providing good basic
care, such as ensuring patients are getting enough fluids and nutrients"(Collier, R., 2012). Education
to healthcare workers needs to increase to prevent unnecessary hospital admissions. Placing a
person on a psychiatric hold and sending them to the hospital can be very traumatizing to elderly
clients as well as expensive. A patient exhibiting confusion followed by periods of clarity (lucidity)
is the hallmark of Delirium therefore adapting mental health assessments to daily physical
assessments is paramount in early detection. According to uptodate.com, "Nearly 30 percent of
older

What Constitutes Evidence For Physicians?
What constitutes evidence for nurses? What constitutes evidence for patients? What constitutes
evidence for physicians? How are they the same or different? T he movement toward evidenced
based healthcare has necessitated change in practice approaches and a broader understanding of
what constitutes evidence for physicians, nurses, allied health professionals and consumers. There is
a significant amount of literature published regarding this practice change in all clinical areas. Not
all literature is supportive of the use of evidence based medicine The original conceptualization of
evidence based medicine was the integration of clinical experience with conscientious, explicit, and
judicious use of current research. However, there are differences in opinion regarding the value of
evidence based medicine. An article written by Hermann W. Borg entitled "The Evidence Based
Transformation of American Medicine" indicated that the ideal originally presented with evidence
based medicine reflected a process of decision making by individual physicians in treating
individual patients. This author notes that the ranking of evidence using randomized controlled trials
as the highest level of evidence has devalued the role of intuition, clinical experience and theory
derived conclusions in practice. Part of the concern addressed is the distorted use of evidence based
practice by administrators, pharmaceutical companies and payers. Instead of an individualized
approach to care

Compression Garments
A Study of compression garments on enhancing performance in competitive athletes
1.0 Background Information 1.1 Trend and history of Compression Garment In an attempt to
enhance sporting performance, athletes seek various methods to improve their rate of recovery. A
popular trend observed is the widespread usage of compression garment (CG) during training or
competition [1– 4]. The origin of the usage of compression garments could be traced back as early
as 460 BC, when it was initially used as a form of treatment in human injuries [5]. 1.2 Studies
conducted on Compression Garment (CG) The first exercise–related research was conducted by
Berry et. al. (1987) to determine the effects of CG on blood lactate levels in the body. CG worn ...
The literatures will be excluded if they involve clinical populations and studies that are not available
as free–text. The elimination of articles will be carried out using the inclusion and exclusion criteria
set, followed by the titles, abstract and lastly the full–text (refer to Figure 1).
Database search: Duplicates eliminated: Literature remaining:
Literature eliminated based on title:
Literature remaining after screening: Literature eliminated based on abstract: Literature remaining
after screening: Literature eliminated based on full text: Literature remaining after screening: Hand
Search: +
Total literature for review:
Figure 1: Literature search methodology.
5.3 Quality assessment Studies adopting a randomized controlled trial study design will be
categorised as the highest level of evidence, followed by cohort studies and case control studies.
This ranking was done according to Oxford Centre for Evidence–Based Medicine's levels of
evidence and grades of recommendation [14]. It helps to determine level of biasness of the study
and similarly allowing a better critical evaluation of it. Other criteria taken into consideration would
be the objective, methodology, findings of the study and the support from reference work with
respect to the findings obtained [13]. 5.4 Data analysis The data will be

Future Of Medicine: Evidence Based Practice
The Institute of Medicine defines "Evidence–based practice as the integration and implementation
of the best research evidence along with clinical expertise and patient values" (IOM 2001: 147).
Speakers at the Upper Rio Grande Region IOM Future of Nursing Symposium last week strongly
emphasized that nurses are to be the driving force behind the execution of evidenced based practice
within the work places
In my current work area, the NICU, I would like to motivate increased compliance from the staff
and family members regarding infection control practices during flu and cold season. This season in
particular creates a supreme risk for viral respiratory illness to an already compromised population.
Lung and immune system immaturity coupled

What is Nursing Informatics? Essay
"The intensive care unit (ICU) often is called the epicenter of infections, due to its extremely
vulnerable population (reduced host defences deregulating the immune responses) and increased
risk of becoming infected through multiple procedures and use of invasive devices distorting the
anatomical integrity–protective barriers of patients (intubation, mechanical ventilation, vascular
access, etc.)" (Brusselaers,Vogelaers, & Blot, 2011). The purpose of this paper is to develop a
research question regarding the prevention of spreading bacteria in ICU and to identify databases
and search words to collect data by using the continuum of data, information, knowledge, and
wisdom . Also, I will describe how informatics can be used to gain ... Show more content on
Helpwriting.net ...
According to McGonigle and Garver (2012), "data are discreate entities described objectively
without interpertation" ( p. 97). The fist step in the plan is to gather data from the internet databases
and related books and journals. This data obtained will not be interpreted but will be group together
inorder to continue to the second step of the plan; obtaining relevant information about my research
question. " Information is data that are interpreted, organized, or structured" (McGonigle & Garver,
2012, p.97). This step requires precise interpretation and analization of the data was obtained. The
information will be organized and structured into each of the PICO variables. McGonigle and
Garver (2012), describe knowledge as "information that is synthezized so that relationships are
identified and formalized" (p.97). It is important to use this concept when making the decisions of
which of the information will be used and what the potential outcomes of the information chosen
will have on my reasearch question; will it favor the topic or will it unfavor it? The final concept of
the plan is the use of wisdom. "Wisdom focuses on the appropriate application of knwledge"
(McGonigle & Garver, 2012, p.99). The use of wisdom guides the decisions about what would be
the most appropriate use of

Essay On Evidence Based Medicine
Connor Reynolds 11/15/2105
HIST 275
The medical field has such a vast spectrum of aspects it is compiled of. Everything from surgery, to
antiseptics, to experimentation, to hospitalization; each and every one is important to what we know
as modern medicine today. One major concept of the field that changed medicine for the better is the
introduction of evidence based medicine. According to Wikipedia, this is "an approach to medical
practice intended to optimize decision–making by emphasizing the use of evidence from well
designed and conducted research" (Wikipedia, 2015). This was something new to physicians in the
19th century because the prior reasoning of their methodology and procedure was due to things like
curiosity ... Show more content on Helpwriting.net ...
But before we had all of the information we have today, in the 19th century, only 1/5 of Journal's
scientific articles were of the surgical nature. But by the 1920's, documents concerning surgery were
over half of the sum of total articles. Surgery was being considered more "professional" by the
people due to someone like William Halsted, who implemented the use of rubber gloves to prevent
infection or to the American College of Surgeons, who in 1917 founded the Hospital
Standardization program to help shift the role of hospitals from being a place for the poor to die, to a
place where lives can be saved. This made the impression of a hospital totally different for people
because now when they were injured or sick, they had hope to live. One of the last big things that
shifted the image of surgery was the use of the laboratory. Now, with the use of the microscope,
doctors were able to study Microbiology and study things like tissue, blood, and other various
samples (Wikipedia, 2015). This was a huge step in the right direction because now there was no
need for guessing or invasive surgery when it came to diagnosing the

Essay on Critical Appraisal
RUNNING HEAD: ASSIGNMENT 3 Appraisal 1 Critical Appraisal by Gemekia C. Parker A Paper
Submitted in partial fulfillment of the requirements for NU 608 EBP & Quality Improvement in
Health Care Systems University of South Alabama College of Nursing Fall 2010 Appraisal 2
Introduction Critical appraisal is the process of systematically examining research evidence to
assess its validity, results, and relevance. (Hill, 2001) Critical appraisal of research is preformed by
clinicians prior to using it to make healthcare decisions. The critical appraisal process systematically
finds, appraises, and acts on evidence based research after thorough review. The use of ... Show
more content on Helpwriting.net ...
(Turner, Thomas, Wagner & Mosely, 2008) Additional research and support are needed to
understand management options for obesity to improve health outcomes. This research support
current practice measures by supporting use of diet, and exercise in a multidisciplinary approach.
The level of evidence exemplifies evidence suggestive of a level IIa. According to the National
Health and Social Research and Development Centre for Evidence–Based Medicine, to qualify for
level IIa evidence data must come from at least one well– designed controlled study without
randomization. It also must have good evidence to support the recommendation that the condition or
maneuver be specifically considered in a periodic health examination. Critical Appraisal The article
titled "Fatigue and Charting Errors: The Benefit of a Reduced Call Schedule." present clear and
focused qualitative research data. The focus of the research was to evaluate errors in nursing
documentation caused by nursing fatigue. Fatigue can be caused by time on task, work load,
circadian rhythm alterations, sleep debt, shift work Appraisal 5 or illness.(Warren, 2008) Warren
reports as little as one hour of sleep loss daily, can accumulate and result in decreases in attention
span, reaction time, and problem solving ability. The suspected outcomes of this review would
determine whether a significant relationship existed between fatigue, as a result of work hours, and

What Is Evidence-Based Medicine (EBM)?
Evidence–based medicine (EBM) is a methodical manner in which to treat clinical issues
successfully by employing the following three key ingredients: elite research evidence, clinical
expertise and patient values (Akobeng, 2005a; Schardt & Mayer, 2010). As a result, quality of care
will be hopefully administered and achieved. Furthermore, EBM adheres to a five–step model: 1)
create answerable clinical questions, 2) seek for evidence, 3) assess for significance, worth and
legitimacy, 4) obtain evidence that EBM was utilized in a clinical setting, and 5) assess its
performance (Akobeng, 2005a).
The first step involves creating a well–defined and direct question which can be solved by searching
the medical literature. Sackett and other researchers ... Show more content on Helpwriting.net ...
Did the trial desist early?
Was there an intention to treat? (Schardt & Mayer, 2010). The fourth step ascertained if the evidence
supported the patient's values and situation. The evidence such as treatment, costs, and facility
locations must be discussed amongst the physicians, patients and parents if applicable to allow them
the opportunity to reach an informed decision. "This approach allows a "therapeutic alliance" to be
formed with the patient and the parents and is consistent with the fundamental principle of EBM:
the integration of good evidence with clinical expertise and patient values" (Akobeng, 2005a).
Finally, the fifth step entails constantly reviewing the previous four steps to determine if they need
improvement. This may be determined by conducting an audit (Akobeng, 2005a).
I think that evidence based medicine acknowledges that research is always evolving; thus, EBM
protocols may have to be revised later on. It must comprise of patient values, research, and clinical
expertise. Treating patients should not be based only on the best evidence. It should also include
clinicians' personal experience, judgment, and skills (Akobeng,

EBM Literature Review

Recommended

Recommended

More Related Content

More from Alejandra Rodriguez

More from Alejandra Rodriguez (6)

Recently uploaded

Recently uploaded (20)

EBM Literature Review