With having many challenges surrounding the nurse midwives in India, she still delivers good obstetrician care and can bringing good health of mother and child. can decrease ratio of LSCS. looking for many established centers/clinics/hospitals/birthing centers which runs by midwives independently in India
Epidemiological aspects of maternal and child healthnew 3Sinmayee Kumari
"maternal and child health refers to the promotive, preventive, curative and rehabilitative health care for mothers and children"
this topic is very essential for all the health care personnel
Vital statistics related to maternal health in indiaPriyanka Gohil
This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
With having many challenges surrounding the nurse midwives in India, she still delivers good obstetrician care and can bringing good health of mother and child. can decrease ratio of LSCS. looking for many established centers/clinics/hospitals/birthing centers which runs by midwives independently in India
Epidemiological aspects of maternal and child healthnew 3Sinmayee Kumari
"maternal and child health refers to the promotive, preventive, curative and rehabilitative health care for mothers and children"
this topic is very essential for all the health care personnel
Vital statistics related to maternal health in indiaPriyanka Gohil
This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
EVIDENCE-BASED PRACTICE IN NURSING.docxHaraLakambini
-Evidence-based Practice in Nursing
-Steps of Evidence-Based Practice
-Hierarchy of Evidence | Quantitative Questions
-Elements of Evidence-Based Practice
-Nursing Research
-Types of Research
-Rights of Human Subject
-Comparison of Nursing Process with Research Process Table
-Performance Improvement in Nursing
-Examples of Performance Improvement Models
-Relationship between Evidence-Based Practice, Research, and Performance Improvement
-Similarities and Differences among Evidence-Based Practice, Research, and Performance Improvement
THE NEED FOR EVIDENCE-BASED PRACTICE
STEPS OF EVIDENCE-BASED PRACTICE
PICOT FORMAT IN EBP
RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE: QUANTITATIVE QUESTIONS
ELEMENTS OF EVIDENCE-BASED ARTICLES
INTEGRATE THE EVIDENCE
EVALUATE THE OUTCOMES OF THE PRACTICE DECISION OR CHANGE
COMMUNICATE THE OUTCOMES OF THE EVIDENCE-BASED PRACTICE DECISION
SUSTAIN KNOWLEDGE USE
NURSING RESEARCH
TRANSLATION RESEARCH
5 PHASES OF TRANSLATION RESEARCH
OUTCOMES RESEARCH
SCIENTIFIC METHOD
CHARACTERISTICS OF SCIENTIFIC RESEARCH
NURSING AND THE SCIENTIFIC APPROACH
TYPES OF RESEARCH
TYPES OF RESEARCH APPROACH
RESEARCH PROCESS
RIGHTS OF HUMAN SUBJECT
COMPARISON OF STEPS OF THE NURSING PROCESS WITH THE RESEARCH PROCESS
Performance Improvement
Performance Improvement Programs
EXAMPLES OF PERFORMANCE IMPROVEMENT MODELS
THE RELATIONSHIP BETWEEN EBP, RESEARCH, AND PERFORMANCE IMPROVEMENT
SIMILARITIES AND DIFFERENCES AMONG EVIDENCE-BASED PRACTICE, RESEARCH, AND PERFORMANCE IMPROVEMENT
KEY ELEMENTS
EBP is a systemic interconnecting of scientifically generated evidence with the tacit knowledge of the expert practitioner to achieve a change in a particular practice for the benefit of a well-defined client/ patient group.
Evidence based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients/clients.
Integration of the best research evidence with clinical expertise and patient values and using the best available research findings “to make clinical decisions that are most effective and beneficial for patients.
- It is a movement away from always doing things in the way in which we were taught and from decisions based on personal opinion. It requires that we look for and appraise research evidence to inform decisions about tests, treatments, patterns of practice, and policy.
Ask Converting information needs into clear questions
Acquire Seeking evidence to answer those questions
Appraise Evaluate the evidence for its validity and usefulness.
Apply Integrating findings with clinical expertise, patient needs, applying the finding.
Assess Evaluating performance.
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
Evidence-based practice in nursing involves providing holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods, advice from colleagues, or personal beliefs.
Nurses can expand their knowledge and improve their clinical practice experience by collecting, processing, and implementing research findings. Evidence-based practice focuses on what's at the heart of nursing — your patient. Learn what evidence-based practice in nursing is, why it's essential, and how to incorporate it into your daily patient care.
- American Nurses Association
At the end of this presentation you will be able to:
Define evidence-based practice
Describe process & outline steps of EBP
Understand PICO elements & search strategy
Identify resources to support EBP
The focus of this presentation is nursing practice, although it is still of value to physicians and other health care professionals.
Breast & it's problems and treatment made by sonal Patelsonal patel
Breast & it's problems and treatment - Anatomy of Breast and Physiology of lactation , Breast Diseases - 1. bening breast problems, Breast Cancer, bening neoplastic lump made by sonal Patel
Antenatal Care Guideline- gestational Age Assessment,Early USG, Nutritional ...sonal patel
Antenatal Care Guideline- gestational Age Assessment,Early USG, Nutritional Supplements,, Food Acquired Infections,medicine, alcohol,smoking, Sexual Intercose avoid, Exercise, Clinical Screening in PPT made by sonal patel
methods of Chromosomal Evaluation in Amniocentesis- Define, Time for test, C...sonal patel
methods of Chromosomal Evaluation in Amniocentesis- Define, Time for test, Complications,and Chorionic Villus sampling ( CVS) , Risk of Procedure, Steps of Procedure in PPT -Define, Time for test made By sonal Patel
Amenorrhea - Define, Cause, Sign and Symptoms, Type- Pathological and Physiol...sonal patel
Amenorrhea - Define, Cause, Sign and Symptoms, Type- Pathological and Physiological Amenorrhea and It's Treatment and management, Cushing Syndrome - Define, Causes, Sign And Symptoms in PPT made By Sonal Patel
Abruptio placenta- Define, cause, sign and symptoms, Risk Factors, Incidence,pathology, Classification, Prevention and Treatment, management in PPT made by sonal Patel
ABO-Rh Isoimmunisation in that The Basics of Blood, antibody can Be Detecte...sonal patel
ABO-Rh Isoimmunisation in that The Basics of Blood, antibody can Be Detected,ABO Blood Group System,Rh Blood Group System,Pathogenesis Of Rh Isoimmunisation, Prevention and Management of ABO incompatibility in PPT made By Sonal Patel
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital ...sonal patel
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital tract- Factore, Types, Diagnosis, Treatment in that one type DUB- Define, sign and Symptoms, Diagnosis, Treatment, Management, hormonal Therapy in PPT made By sonal Patel
Birth defect system according to System wise in that Respiratory System Birth...sonal patel
Birth defect system according to System wise in that Respiratory System Birth defect, Cardiovascular System Birth defect,Digestive System Birth defect, Extremity Birth defect made by sonal Patel
Embryology-all basic definition,Stage wise development of fetus,development o...sonal patel
Embryology-all basic definition,Stage wise development of fetus,development of Zygote stage ,development of Embrionic Stage ,development of Fetus Stage all are according week development,Amnione,chorion,Fetal layer, Umbilical Cord developmentmade By sonal Patel
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Evidence based Midwifery practice
Introduction:
Evidence based practice (EBP) is the integration of
best research evidence with clinical expertise and
patient values to deliver optimal care. Best
research means clinically relevant, Patient
centered research studies.
4. In many areas of clinical decision making research
has demonstrated that “tried and true” methods or
practices taught in basic nursing education are not
always best.
For example, although many nurses were taught to
give Enema to the Pregnant mother during 1st stage
of labour, But now there is persuasive evidence
that the enema during labour is contraindicated as
it increases risk of infection to the baby during
birth.
5. A basic feature of Evidence based practice as a clinical
problem solving strategy is that it de emphasis is on
indentifying the best available research evidence and
integrating it with other factors.
Evidence based decision making should integrate best
research evidence with clinical expertise, patient
preferences and circumstances and awareness of the
clinical setting and resource constraints.
6. The Benefits of Evidence-Based Practice
Nurses are responsible for the care they provide to their
patients.
Evidence-based practice in nursing means making
decisions about patient care on the basis of current best
available evidence.
It helps the nurse provide high-quality care to her patients
based on research and knowledge.
"Sue and Bill" is Copyrighted by Flickr user: jamesfischer
(Jim Fischer) under the Creative Commons Attribution
license.
7. Efficiency
Evidence-based practice increases the efficiency of
nurses.
Making decisions based on knowledge that is
backed by research makes it easier for a nurse to
choose what care to provide to her patient as
opposed to trying something that may or may not
be beneficial to her patient.
This saves her time, which she can devote to
patients who need more intensive care from her.
8. Better Patient Outcome
Nurses regularly make decisions on what care to
provide for their patients.
These decisions can impact the patients' health
negatively or positively.
The patient will likely experience a better outcome
when the care is based on researched and proven
methods.
9. It Keeps Nursing Practice Current
For nurses to apply evidence-based practice in the
care they provide, they have to stay informed on
any new discoveries that have been made.
This encourages them to read materials that cover
nursing research thus keeping their practice
current.
10. Decision Making
Using evidence-based practice to provide care to
patients increases the nurse's confidence.
This is because she knows that she is basing her
decisions about patient care on valid information that
has been thoroughly researched.
11. Magnet Status
Incorporating evidence-based practice into the
nursing care at a hospital may help the hospital
achieve Magnet status.
The Magnet Recognition Program recognizes
quality patient care, nursing excellence and
innovations in nursing practice.
Being a magnet facility, assures patients that they
are getting excellent nursing service.
13. Resources for evidence based practice
Systematic Reviews
Evidence based practice relies on meticulous
integration of research evidence on a topic.
The emphasis on best evidence in evidence based
practice implies that all or most evidence about a
clinical problem has been gathered, evaluated and
synthesized so that conclusion can be drawn about
effective practices.
14. Systematic reviews can take various forms. Until, fairly
recently, the most common type of systematic review
was a traditional narrative (qualitative) integration to
merge and synthesize research findings.
Narrative reviews of quantitative studies increasingly are
being replaced by a type of systematic review known as
Meta analysis.
Meta analysis is a technique for integrating quantitative
research findings statistically. Meta analysis treats the
findings from as study as one piece of information.
15. The findings from multiple studies on the same topic
are combined and then all the all information is
analyzed statistically in a manner similar to that in
usual study.
Thus instead of study participants being the unit of
analysis, the individual studies are the unit of analysis
in the Meta analysis.
A meta synthesis involves integrating qualitative
research findings on a specific topic that are themselves
interpretive synthesis of narrative information.
16. Clinical practice guidelines
Evidence based clinical practice guidelines, like systematic
reviews, represent an effort to distill a large body of evidence
into a manageable form.
First and foremost , clinical practice guidelines, which are
usually based on systematic reviews, give specific practice
recommendations and prescriptions for evidence based
decision making.
Second guidelines also attempt to address all the issues
relevant to a clinical decision, including the balancing of
benefits and risks.
17. The major steps in Evidence based practice include
the following
Asking clinical questions that are answerable with research
evidence.
Searching for and collecting relevant evidence.
Appraising and synthesizing the evidence
Integrating the evidence with your own clinical expertise,
patient preferences, and local context.
Assessing the effectiveness of the decision, intervention or
advice.
18. ASKING WELL WORDED CLINICAL QUESTIONS:
Fineout Overholt and Johnston recommended a 5
component scheme for formulating EBP questions
and used an acronym (PICOT) as a guide.
The five components are
- Populations (p)
- interventions or issues (i)
- Comparison of interest (c)
- Outcome (O)
- Time (T)
19. FINDING RESEARCH EVIDENCE:
For an EBP endeavor, the best place to begin is by
searching for evidence in a systematic review, clinical
practice guidelines or other preprocessed source
because this approach leads to much quicker answer .
This is partly because researchers who prepare
reviews and clinical guidelines typically are well
trained in research methods and use exemplary
standards in conducting their evaluation of the
evidence.
20. APPRAISING THE EVIDENCE
After locating appropriate evidence, it should be appraised
before taking any clinical action. The critical appraisal of
evidence for the purposes of EBP may involve several types of
assessments. Questions for appraising the evidence are:
- What is the quality of the evidence – that is how reliable is it?
- What is the evidence – what is the effect?
- How precise is the estimate of effects?
- What evidence is there of any side effects or side benefits?
- What is the financial cost of applying the evidence?
- Is the evidence relevant to particular clinical situation?
21. INTEGRATING EVIDENCE
As the definition for EBP implies, research
evidence needs to be integrated with other types of
information, including own clinical expertise and
knowledge about clinical setting. Patient
preference and values are also important.
22. IMPLEMENTING THE EVIDENCE AND
EVALUATING OUTCOMES
After the first four steps of the EBP process have
been completed use the integrated information to
make an evidence based decision or to provide
evidence based advice.
Last step is Evaluation . Part of the evaluation
process involves following up to determine
whether our action or decision was useful and
achieved the desired outcome.
23. If the implementation criteria are met and the evidence
base is judged to be adequate, the team can prepare an
action plan to move the effort forward, which would
laying out strategies for designing and piloting the new
clinical practice.
In most cases a key activity will involve developing a
local evidence based clinical practice protocol or
guideline or adapting an existing one.
If a relevant clinical practice guideline has been judged
to be of sufficiently high quality the EBP team need to
decide whether to adopt it entirely, or adopt only
certain recommendation or modify the guideline.
24. The Evidence based Midwifery Practices are as
follow
1. Antenatal Immunization
2. Estimation of Hemoglobin
3. Iron and Folic acid supplementation
4. Vaginal Examination during Pregnancy
5. Eating and drinking in labour
6. Position during labour
7. Enema during labor
25. 8. psychosocial support in labor
9. use of epidural during labour
10. episiotomy
11. use of uterine stimulants
12. water birth
13. magnesium in obstetrics
14. cesarean birth
15. cord clamping
16. breast feeding
17.kangaroo mother care