Evidence-based practice (EBP) emerged in the 1980s and involves using scientific evidence to determine best practices. EBP requires critically assessing research evidence and implementing effective interventions. The goal of EBP is to provide effective care using the best available research evidence, clinical expertise, and patient preferences. Key steps in EBP include asking questions, finding evidence, evaluating evidence, and applying evidence into practice. Common models for EBP include the John Hopkins Nursing EBP model and the Iowa model. Barriers to EBP include lack of time, support, and research knowledge, while advantages include better patient outcomes, consistency of care, and structured decision-making.
evidence based practice is the most recent development of the research world. in nursing the utilization of the research is very limited as it contribute to a lots of factors. here i have discussed about the ebp in brief. this is just an short and concise form of the real matter so read extensively for more knowledge.
evidence based practice is the most recent development of the research world. in nursing the utilization of the research is very limited as it contribute to a lots of factors. here i have discussed about the ebp in brief. this is just an short and concise form of the real matter so read extensively for more knowledge.
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.
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 nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
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.
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 nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
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 dentistry (EBD) is the integration and interpretation of the available current research evidence, combined with personal experience. It allows dentists, as well as academics researchers, to keep update of the new developments and to make decisions that should improve their clinical practice.
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
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
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A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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
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2. INTRODUCTION
• During 1980s the term “evidence-based medicine” emerged to
describe the approach that used scientific evidence to
determine the best practice. Evidence based practice
movement started in England in the early 1990s
• Evidence-based medicine (EBM) or evidence based practice
(EBP), is the judicious use of the best current evidence in
making decisions about the care of the individual patient.
• Evidence-based practice represents both an ideology and a
method. The ideology springs from the ethical principle that
clients deserve to be provided with the most effective
interventions possible. The method of EBP is the way we go
about finding and then implementing those interventions.
3. DEFINITIONS
Evidence: It is something that furnishes proof or
testimony or something legally submitted to
ascertain in the truth of matter.
Evidence based practice: It is systemic inter
connecting 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.
(French 1999).
4. CONTD…
• Evidence based nursing- it is a process by
which nurses make clinical decisions using the
best available research evidence, their clinical
expertise and patient preferences (mulhall,
1998).
• Evidence based medicine or practice- The
conscientious, explicit and judicious use of
current best evidence in making decision
about the care of individual patient. (Dr. David
Sackett, Rosenberg, 1996)
5. CONTD….
providing
• EBP in nursing is
nursing
a way of
care that is guided by the
integration of the best available scientific
expertise. This
knowledge with nursing
approach requires nurses to critically
assess relevant scientific data or research
evidence and to implement high quality
interventions for their nursing practice.
(NLM PubMed)
6. NEED FOR EBP
• For making sure that each client get the
best possible services.
• Update knowledge and is essential for
lifelong learning.
• Provide clinical judgement.
• Improvement care provided and save lives.
7. GOAL OFEBP
• Provide practicing nurse the evidence based
data to deliver effective care.
• Resolve problem in clinical setting.
• Achieve excellence in care delivery.
• Reduces the variations in nursing care and
assist with efficient and effective decision
making.
9. SORCES OF EVIDENCE
• Research evidence has assumed priority over other
sources of evidence in the delivery of evidence based
health care.
• It includes
• Filtered resources- Clinical experts and subject
specialist pose a question and then synthesise evidence
to state conclusion based on available research. These
sources are helpful because the literature has been
searched and results evaluated to provide an answer to
clinical question.
• Unfiltered resources (Primary literature)- It provides
most recent information. E.g MEDLINE, CINHAL etc
provides primary and secondary literature for medicine.
10. Contd….
• Clinical experiences- Knowledge through professional
practice and life experiences makes up the second part in
the evidenced based , person-centered care.
• Knowledge from patients- Evidence delivered from pt’s
knowledge of themselves, their bodies and social lives.
• Knowledge from local context-
Audit and performance data
Patient stories and narratives
Knowledge about the culture of the organization &
individuals within it.
Social & professional networks.
Information from feedback
Local & national policy.
12. MODELS OF EBP
• John Hopkins nursing EBP Model- Used as a
framework to guide the synthesis and translation
of evidence into practice. (Newhouse, Dearholt,
Poe, Pugh, & White, 2007).
• There are three phases to the JHNEBP model
1. The identification of an answerable question.
2. A systematic review and synthesis of both
research and non-research evidence.
3. Translation includes implementation of the
practice change as a pilot study, measurement
of outcomes, and dissemination of findings.
14. IOWAmodel
• The Iowa model focuses on organization and
collaboration incorporating conduct and use of
research, along with other types of evidence.
(Titler et al, 2001). It was originated in 1994.
The star point in the model can either be
• A knowledge focused trigger (that emerges from
awareness of innovative research findings
• A problem- focused trigger (that has its root in a
clinical or organizational problem)
16. The Stetler Model
• This model examines how to use evidence to
create formal change within organizations, as
well how individual practitioners can use research
on an informal basis as part of critical thinking
and reflective practice.
The Stetler model of evidence-based practice
based on the following
1. Use may be instrumental, conceptual and/or
symbolic/strategic.
17. Contd….
2.Other types of evidence and/or non-research-
related information are likely to be combined with
research findings to facilitate decision making or
problem solving.
3.Internal or external factors can influence an
individual's or group's review and use of evidence.
4.Research and evaluation provide probabilistic
information, not absolutes.
5.Lack of knowledge and skills pertaining to research
use and evidence-informed practice can inhibit
appropriate and effective use.
18. This model consists of five phases. Each
phase is designedto
• facilitate critical thinking about the practical
application of research findings
• result in the use of evidence in the context
of daily practice
• Mitigate some of the human errors made in
decision making.
19.
20. Barriers inEBP
• Lack of value for research in practice
• Difficulty in bringing change
• Lack of administrative support
• Lack of knowledge mentors
• Lack of time for research
• Lack of knowledge about research
• Research reports not easily available
• Complexity of research reports
• Lack of knowledge about EBP
21. Advantages ofEBP
• Provide better information to practitioner
• Enable consistency of care
• Better patient outcome
• Provide client focused care
• Structured process
• Increases confidence in decision-making
• Generalize information
• Contribute to science of nursing
• Provide guidelines for further research
• Helps nurses to provide high quality patient care
22. Disadvantages of EBP
• Not enough evidence for EBP
• Time consuming
• Reduced client choice
• Reduced professional judgement/
autonomy
• Supress creativity
• Influence legal proceedings
• Publication bias
23. Research abstract
Translating research into practice: case study of a community-
based dementia caregiver intervention. (Mittelman MS, Bartels
SJ.)
Evidence from randomized clinical trials has demonstrated the
effectiveness of providing psychosocial interventions for caregivers
to lessen their burden. This case study describes outcomes of the
implementation of an evidence-based intervention in a multisite
program in Minnesota. Consistent with the original randomized
clinical trial of the intervention, assessments of this program showed
decreased depression and distress among caregivers. Some of the
challenges in the community setting included having caregivers
complete the full six counseling sessions and acquiring complete
outcome data. Given the challenges faced in the community setting,
web-based training for providers may be a cost-effective way to
realize the maximum benefits of the intervention for vulnerable
adults with dementia and their families.
24. CONCLUSION
Evidence-based nursing care is a lifelong approach to
clinical decision making and excellence in practice.
Evidence-based nursing care is informed by research
findings, clinical expertise, and patients' values, and its
use can improve patients' outcomes. Use of research
evidence in clinical practice is an expected standard
of practice for nurses and health care organizations,
but numerous barriers exist that create a gap between
new knowledge and implementation of that knowledge
to improve patient care. Using the levels of evidence,
nurses can determine the strength of research
studies, assess the findings, and evaluate the
evidence for potential implementation into best
practice.