This document discusses evidence-based practice (EBP) in healthcare. It provides several definitions of EBP, emphasizing that EBP involves integrating the best available research evidence with clinical expertise and patient values. The document notes that EBP helps ensure patients receive the best possible care, can help keep clinical knowledge up to date, and may improve outcomes and save lives. It highlights that implementing EBP involves profiling research on effective treatments to guide clinical decision making. Examples of research on effective treatments for neck pain, low back pain, and physiotherapy techniques for low back pain are also provided.

1. EVIDENCE BASED
PRACTICE
PUAN HAZLIZA RAZALI
PEG.PEMULIHAN PERUBATAN UNISZA

2. Evidence Based Practice(EBP)
The practice of health care in which the
practitioner systematically finds, appraises,
and uses the most current and valid research
findings as the basis for clinical decisions.
(Mosby’s Medical Dictionary, 8th
edition.©2009,Elsevier)

3. Evidence Based Practice(EBP)
“the conscientious, explicit and judicious use of
current best evidence in making decisions
about the care of the individual patient. It
means integrating individual clinical expertise
with the best available external clinical
evidence from systematic research.”
(Sackett D, 1996)

4. Evidence Based Practice(EBP)
“evidence-based medicine(EBM) is integration
of best research evidence with clinical
expertise and patient value”
(Sackett et al.
2000)

5. Research
Patient’s
Value
Clinical
Expertise

6. Evidence Based Practice(EBP)
“The practice of evidence-based medicine
means integrating individual clinical expertise
with the best available external clinical
evidence from systematic research”
(Sackett et al.
1996)

7. Sackett et al, 1996
 As Sackett and his colleagues point out,
clinical practices become out of date if
new evidence is not drawn upon.
 However, the clinician must be aware of
what evidence is appropriate to integrate
into their practice
 This can prove to be a difficult and time-consuming
task but it is an essential skill
in implementing evidence based practice.

8. Evidence Based Practice(EBP)
 Evidence based practice is one useful
approach to improving the impact of practice in
medicine, psychology, social work, nursing and
allied fields.
 EBP and practice evaluation work together
very well, but they have different purposes and
use very different methods.

9. Evidence Based Practice(EBP)
 Clinical guidelines should be freely accessible
with international collaboration and
endorsement
 Information to support EBP should be made
available in different languages and format.
 Duplicated in effort should be avoided
 EBP must be part of long learning and all PTs
should recognize the important of developing
necessary skill for EBP.

10. Why Evidence Based
Practice(EBP)?
 It is one step toward making sure each client
gets the best service possible
 Some argue it helps keep your knowledge up
to date, supplements clinical judgment, can
save time and most important can improve
care and even save lives.
 Some say, it’s unethical to use treatments that
aren’t known to work.

11. How is EBP Implemented in
Practice?
 Profiling research that informs professionals
and clients about what works is where
evidence based practice starts.
 These summaries tell us what we know about
treatment and program efficacy based on
experimental work-as well as what we don’t
know or aren’t really sure about.

12. How is EBP Implemented in
Practice?
 Having access to information on what works
allows professionals, in conjunction with
clients, to select treatments that are most likely
to be helpful before intervention is begun.

13. Examples
Evidence Based Practice(EBP)

14. MANUAL THERAPY IN TREATMENT OF NECK
PAIN
Rheumatic Diseases Clinics of North America-
Volume 22,Issue 3(August 1996)
 Manual therapies have been demonstrated to be
effective for mechanical neck pain in the short term when
used in combination with other treatments.
 The risk of increased symptoms resulting from manual
therapy is low(in the range of 1%-2%),with the most
common symptom aggravation being vertigo or
dizziness.
 The risk of serious complication or death from neck
manipulation is extremely low(in the range of 0.0001%)

15. Evaluation of The Effects Of Shortwave
Diathermy in Patients With Chronic Low Back
Pain
Bangladesh Med Res Counc Bull-01-APR-
2009;35(1):18-20
 A prospective experimental study on 97 patients of
chronic low back pain was conducted to find out the
effects of shortwave diathermy.
 They were divided randomly into two groups and treated
with nonsteroidal anti-inflammatory drugs, exercises,
activities of daily living instructions and with or without
shortwave diathermy
 After six weeks of treatment, improvements were
observed in both the group. But significant difference in
improvement was found in shortwave diathermy group
than in placebo group. The present study suggests that
shortwave diathermy is effective for the treatment of
patients with chronic low back pain.

16. A survey of Malaysia Physiotherapist On Current
Practice And Reasons For Preference Of
Treatment Techniques On Non-specific Low
Back Pain
 The result indicated that Manual Therapy and
Electrotherapy were most preferred, indicating a
lack of EBPT which could have been contributed
by PTs attending skill based course that lacked
evidence findings on the techniques
recommended.
 This study also identified the lack of formal
higher education training to implement EBPT.
(Divinder Kaur, 2002)

17. THANK YOU