This document discusses the importance of evidence-based practice in nursing. It notes that practices like bloodletting and certain wound treatments are no longer used because evidence does not support their effectiveness. Randomized controlled trials are considered the gold standard for evidence, but such trials are lacking for most medical practices. The document recommends determining if existing data from other study designs can provide useful evidence to guide practices, and clarifying the desired health outcomes, rather than relying solely on past practices not supported by evidence. It provides resources for finding synthesized evidence and promoting integrity in health research publication.

1. Evidence to improve
effectiveness
Roger Watson PhD FAAN
2017 Fudan University
Evidence-based Nursing Forum
Get a copy of these PowerPoints at:
www.slideshare.net/RogerWatsonPhDRNFAAN

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8. We used to be certain about
• Blood letting
• Grommets for “glue ear”
• Episiotomy
• Lignocaine to prevent cardiac arrest post heart attack
• Egg white and Oxygen to heal pressure sores
• Vigorous rubbing of the buttocks with alcohol to prevent pressure sores

10. What counts as evidence?
• The outcome of systematic enquiry

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Intervention
Control group

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21. Where do we find evidence?
• Evidence synthesis databases

24. Centre for Reviews and Dissemination

28. For much, and perhaps most, of
modern medical practice, RCT-based
data are lacking and no RCT is being
planned or is likely to be completed to
provide evidence for action. This “dark
matter” of clinical medicine leaves
practitioners with large information
gaps for most conditions and
increases reliance on past practices
and clinical lore.

29. …better approach is to clarify the
health outcome being sought and
determine
whether existing data are available
that
can be rigorously and objectively
evaluated, independently of or in
comparison with data from RCTs, or
whether new studies (RCT or
otherwise)
are needed.

39. Enhancing the QUAlity and
Transparency Of health Research

42. Promoting integrity in research
publication
COPE http://publicationethics.org/

43. r.watson@hull.ac.uk
0000-0001-8040-7625
@rwatson1955