This document summarizes an evidence-based practice in-service for physical therapists. It defines evidence-based practice as integrating clinical expertise, patient values, and the best available research evidence. The in-service discusses why evidence-based practice is important, such as improving efficiency and patient outcomes. It also covers how clinicians can implement evidence-based practice through using an EBP binder to choose relevant research articles and evaluate their validity. The in-service concludes with opportunities for clinicians to practice evidence-based techniques.
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
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.
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
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.
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
Janet Schnall's presentation about Evidence Based Nursing Resources at our free monthly webcast. Recording available at https://webmeeting.nih.gov/p96958659/
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.
Physiotherapist or Physical therapists are important health providers and can contribute to enhanced outcomes in many common musculoseletal disorders including osteoarthritis, ACL injuries, tendinopathies, such as rotator cuff disorders, tennis elbow and achilles tendinopathy and muscle tears
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
Janet Schnall's presentation about Evidence Based Nursing Resources at our free monthly webcast. Recording available at https://webmeeting.nih.gov/p96958659/
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.
Physiotherapist or Physical therapists are important health providers and can contribute to enhanced outcomes in many common musculoseletal disorders including osteoarthritis, ACL injuries, tendinopathies, such as rotator cuff disorders, tennis elbow and achilles tendinopathy and muscle tears
3 Things Every Sales Team Needs to Be Thinking About in 2017Drift
Thinking about your sales team's goals for 2017? Drift's VP of Sales shares 3 things you can do to improve conversion rates and drive more revenue.
Read the full story on the Drift blog here: http://blog.drift.com/sales-team-tips
How to Become a Thought Leader in Your NicheLeslie Samuel
Are bloggers thought leaders? Here are some tips on how you can become one. Provide great value, put awesome content out there on a regular basis, and help others.
Improving Comprehensive Carefor OEF and OIF Vetsby Aslie.docxbradburgess22840
Improving Comprehensive Care
for OEF and OIF Vets
by Aslie Burnett
FILE
T IME SUBMIT T ED 20- MAR- 2015 10:4 4 AM
SUBMISSION ID 51867 4 598
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CHARACT ER COUNT 39906
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Improving Comprehensive Care for OEF and OIF Vets
ORIGINALITY REPORT
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vets.arizona.edu
Int ernet Source
www.ejpt.net
Int ernet Source
Karen H. Seal. "VA mental health services
utilization in Iraq and Af ghanistan veterans in
the f irst year of receiving new mental health
diagnoses", Journal of Traumatic Stress, 2010
Publicat ion
www.f as.org
Int ernet Source
Submitted to Maryville University
St udent Paper
store.samhsa.gov
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yellow-f ever.rki.de
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cstsf orum.org
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akf sa.org
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iris.lib.neu.edu
Int ernet Source
www.acpmh.ipag.f r
Int ernet Source
onlinelibrary.wiley.com
Int ernet Source
Submitted to University of Western Australia
St udent Paper
Submitted to University of Southern Calif ornia
St udent Paper
scindeks.nb.rs
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cdn.intechopen.com
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www.healthemotions.org
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Submitted to Palo Alto University
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www.mindf ully.org
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Submitted to Pennsylvania State System of
Higher Education
St udent Paper
www.rand.org
Int ernet Source
gradworks.umi.com
Int ernet Source
patriotoutreach.org
Int ernet Source
Ticknor, Bobbie and Tillinghast, Sherry. "Virtual
Reality and the Criminal Justice System: New
Possibilities f or Research, Training, and
Rehabilitation", Journal of Virtual Worlds
Research, 2011.
Publicat ion
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Michael E. Smith. "Bilateral hippocampal
volume reduction in adults with post-traumatic
stress disorder: A meta-analysis of structural
MRI studies", Hippocampus, 2005
Publicat ion
etd.lib.f su.edu
Int ernet Source
digital.library.adelaide.edu.au
Int ernet Source
cdn.govexec.com
Int ernet Source
Yelena Bogdanova. "Cognitive Sequelae of
Blast-Induced Traumatic Brain Injury: Recovery
and Rehabilitation", Neuropsychology Review,
02/17/2012
Publicat ion
Nanda, U., H. L. B. Gaydos, K. Hathorn, and N.
Watkins. "Art and Posttraumatic Stress: A
Review of the Empirical Literature on the
Therapeutic Implications of Artwork f or War
Veterans With Posttraumatic Stress Disorder",
Environment and Behavior, 201.
R181 Naka, R., Amano, H., & Ito, T. (2014). Caring to improve patients’ energ...Takehiko Ito
R181 Naka, R., Amano, H., & Ito, T. (2014). Caring to improve patients’ energy field in community nursing: Effects of Healing Touch Intervention. Journal of International Society of Life Information Science, 32(2), 228-232.
EBPStudent’s NameInstitution AffiliationEvidence based pra.docxbudabrooks46239
EBP
Student’s Name
Institution Affiliation
Evidence based practice (EBP)
Clinical Issue
There are multiple of the mental illness which are common such Generalized Anxiety Disorder, Bipolar, Dementia, Schizophrenia and list continues.
There are various models of the treatment such Cognitive behavioral therapy, exposure therapy and medication such as use of antidepressants.
Globally, mental illnesses account for 33% of the disability that adult get due to health problems.
Therefore, narrowing down to Generalized anxiety disorder, my concern is to establish effectiveness of the psychotherapy method of treatment used and specifically cognitive behavioral therapy.
Mental disorder has been global problem that which affects over 900 million people in the world.
Global burden cuts across high income countries to low income countries.
Correct method of treatment of mental illness is important and can be helpful to persons.
Treatment of the mental disorders is put into two categories which are; psychotherapy- behavioral therapy, cognitive therapy, interpersonal therapy, Psychodynamic therapy, Group therapy and Family therapy.
Second category is medication-Antidepressants, Antipsychotics, Mood stabilisers and Sleeping pills and minor tranquillisers.
Choice of the method of treatment is determined by its effictiveness.
2
Development of PICOT
Picot is method of developing of clinical question which was introduced in 1995 (Davies, 2011).
In was developed to help in carrying out the research where relevant information ought to be collected depending on the components of the clinical question that was formulated.
In view of this, PICOT has been basis of formulation of the clinical questions that guides in coming up with evidence based practice which is used in making in making clinical decisions.
Clinicians deal with human life and it is critically important they make decision on the medication that they should give based on the level of the evidence that is available which influence delivery of quality healthcare.
In conducting the research in clinical setting, clinical questions must be formulated.
To ensure that relevant data is corrected, clinical questions is collected using the format of the question known as PICOT.
PICOT has been used since 1995 and has confirmed as an effective way to formulate clinical questions that help to collect data that is analyzed, tested and later inform desion making for better delivery of the quality care.
3
Cont.…
Considering the clinical issue discussed in the second slide, Picot clinical question will be, for generalized anxiety disorder patient, how does cognitive behavioral therapy against antidepressants affects anxiety level within first 8 weeks?
In breaking down the picot question to individual components, P ( patient population): generalized anxiety disorder patient.
I(intervention): cognitive behavioral therapy.
C(comparison): antidepressants
O (Outcome): affects anxiety level
T (time): first.
Presentation of our curricular integration, Interprofessional approaches and Student Leader Training strategies in the second year of our 3 year SBIRT Training Grant.
The State of the Science in PracticeThe phrase evidence-.docxteresehearn
The State of the Science in Practice
The phrase
evidence-based practice
may be most often thought of as a clinical reference; however, research evidence is applicable in every specialty area. What types of research evidence support your work environment? How does research evidence inform your practice?
Now, how current do you think the science is that underlies your practice? How current is the evidence that supports your specialty practice guidelines?
To prepare:
Bring to mind an issue related to your practice. You may use the issue you are exploring for your EBP Project, or another current issue in your specialty area.
If possible, examine practices and/or practice guidelines established to address your selected issue and determine how current the evidence is that supports them.
Using the Walden Library, locate recently published articles that discuss research translated into evidence that applies to your selected practice issue. If you are unable to locate current articles (within the last five years), use the Internet to find evidence-based practice articles on this topic.
Consider the following questions:
How current is the science that supported the practice or practice guidelines?
What new evidence has emerged since the practice guidelines were crafted and adopted?
By tomorrow 09/11/18 12 by 10 pm, write a minimum of 550 words in APA format with at least 3 scholarly references less than 5 years old. Include the level one header as numbered below:
Post
a cohesive scholarly response that addresses the following:
1) Discuss the state of the scientific underpinnings that relate to your selected issue. (see my PIICOT question at the bottom of this page).
2) How current is the science that supported the practice or practice guidelines?
3) What new evidence has emerged since the practice guidelines were crafted and adopted? Provide two examples that support your assessment.
Required Readings
White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016).
Translation of evidence into nursing and health care practice
(2nd ed.). New York, NY: Springer.
Chapter 1, “Evidence-Based Practice”
Chapter 2, “The Science of Translation and Major Frameworks”
Terry, A. J. (2018).
Clinical research for the doctor of nursing practice
(3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Pages 15-18, “The Process of Translating Evidence Into Clinical Practice”
Chapter 3, “Conducting a Literature Review”
Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science.
Journal of Oncology Practice
, 10(3), 200-202.
Note: You will access this article from the Walden Library databases.
Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part 1.
American Journal o ...
Physical Therapy in the Emergency Departmentchristaloyd
While at the Heart of the Rockies Regional Medical Center in Salida, CO, I got the opportunity to lead the implementation and research of physical therapy in an emergency department setting.
Similar to Evidence-Based Practice Presentation Sep2013 (20)
3. Part 1: What?
O Bottom line: Practice based on proof!
O Integration of-
O Clinical expertise
O Patient values
O Best available research evidence
References (1, 2, 3)
4. Part 1: Why?
1990’s
health care costs
skyrocket….
…third party
payers needed
justification for
PT services
1995
Guide to
Physical
Therapist
Practice
published…
….Concept of
EBP created!
2000
Vision 2020 created:
“Guided by integrity, life-long
learning, and a commitment to
comprehensive and accessible
health programs for all people,
PTs and PTAs will render
evidence-based services
throughout the continuum of care
and improve quality of life for
society…”
reference (4)
5. Part 1: Why?
O Improve efficiency!
O Improved patient
outcomes!
References (2, 3)
6. Part 2: How?
O Introducing… your new
EBP binder!
O For more on choosing a
research article using a
database: flip to the
“EBP” tab for “how-to”
articles or go to APTA’s
Evidence-based
Practice Resources
References (2, 3, 5)
7. Part 2: How?
O Elements of research article:
O Title
O Abstract
O Intro
O Method
O Results
O Discussion
O Conclusion
O References
O Appendix
O how to read a research article reference (1)
10. References
O 1. Carter R, Lubinsky J, Domholdt E. Rehabilitation Research: Principles and Applications. St. Louis, MO:
Elsevier Saunders; 2011.
O 2. Cleland J, Noteboom J, Whitman J, Allison S. A Primer on Selected Aspects of Evidence-Based Practice
Relating to Questions of Treatment, Part 1: Asking Questions, Finding Evidence, and Determining
Validity. Journal Of Orthopaedic & Sports Physical Therapy. August 2008;38(8):476-484.
O 3. Noteboom J, Allison S, Cleland J, Whitman J. A primer on selected aspects of evidence-based practice
relating to questions of treatment, Part 2: Interpreting results, application to clinical practice, and self-
evaluation. Journal Of Orthopaedic & Sports Physical Therapy. n.d.;38(8):485-501.
O 4. Pagliarulo M. Introduction to Phyiscal Therapy. St. Louis, MO: Elsevier Mosby; 2012.
O 5. APTA Evidence-based Practice Resources. American Physical Therapy Association. [www.apta.org]
O 6. BADE M, KOHRT W, STEVENS-LAPSLEY J. Outcomes Before and After Total Knee Arthroplasty
Compared to Healthy Adults. Journal Of Orthopaedic & Sports Physical Therapy. September
2010;40(9):559-567.
O 7. Murtaugh B, Ihm J. Eccentric Training for the Treatment of Tendinopathies. Current Sports Medicine
Reports (Lippincott Williams & Wilkins). May 2013;12(3):175-182.
Editor's Notes
Question: Have you heard the term EBP mentioned at one of your recent CE courses? Skimmed over it in the PT Journal? Saw it on the American Physical Therapy Association website? Do you think it could be beneficial but aren’t quite sure where to begin?
Well your not alone, a majority of APTA members feel that having evidence could help in decision making when treating patients but many still are not using it because its too time consuming or because it’s too daunting of a task.
Well today, I’m going to try and break down EBP for you and make it applicable for you, as the working clinician, not the seasoned scientist.
EBP is one of the keystones to the DPT curriculum and we are getting it thrown at us from every angle. Our very first semester in our first year has a research class and introduces us to the subject. In all of our core classes, like ortho, therex, kinesiology, we not only have our textbooks to read and learn from, but we also get several research articles from our teachers so that we are up to date with the current “literature” as they call it.
What is it? Evidence-based practice is just practice based on proof.
It’s not just based off research, it based on the integration of your clinical expertise, what the patient themselves value, and the best available research evidence.
For example, you have a pt who is recovering from a TKA and you know quad strengthening will be one of your main goals. Well, you have numerous exercises to improve quad strength, but you only have time to do just a few exercises. EBP can help you narrow down the top 3 exercises lets say, to maximizes quad over other muscles, proven by EMG
To understand why we’re using EBP, let’s review this history timeline briefly-
Back in the 1990s, as I'm sure you remember, health care costs sky rocketed and caused cost control measures to be implemented. third-party payers needed justification for PT services.
So, in 1995 the Guide to Physical Therapist Practice was published to provide a comprehensive & detailed list of physical therapy services…but there was no research to substantiate these services…. That’s when the concept of evidence-based practice was developed. “EBP is practice based on proof”
In the year 2000, the APTA house of delegates adopted the APTA Vision statement for physical therapy 2020, otherwise known as vision 2020. vision 2020 was a beacon for the profession and provided a distinct direction for current and future action.
I bet your thinking you don’t have time for looking at research, but the whole purpose of EBP is to improve efficiency in clinical decision making to select and apply interventions that will maximize positive pt outcomes.
How can you begin to use EBP? Well, I’ve composed a binder full of relevant research articles that I’ve gotten throughout my curriculum that you can use. It has articles ranging from recent surgical procedures and rehab protocols to the efficacy of modalities and other therapeutic interventions. It’s got tabs that are divided by anatomical area for you to reference at your leisure.
If this is something that your really interested in, and want to learn how to select the most appropriate articles, including how to use search engines, determine the article’s validity, quality, etc I’ve added 3 articles under the tab “EBP” to guide you if you so choose.
(pass out research article #1) Now that you have the articles, here’s how to read a research article-
First we need to understand the different sections of an article, b/c not all of it is important for you as a clinician to read- usually they’re about 10-15 pages long and you don’t need to read them all, and you don’t have to read them front to back.
So, the elements of a research article include-
The title, self explanatory but sometimes the authors try to make the article sound more interesting or try to reel you in so be weary that the article may not be exactly what it says
Next is the Abstract- this is they key element for you. An abstract is a brief summary (100-300 wds long) that sumarizes the puporse, methods, results, and discussion. Always read this first.
Then you have the introduction: this sets the stage for the problem the reserachers were trying to address and why they felt it was necessary to research. This is usually a good background of information on the condition or pt population.
Then you have the method- this is the technical part to the paper that you can skim over. this is necessary so that the research could be replicated exactly and is a way to show it’s validity.
The results section presents the results of the study without commenting on the meaning. This section has all the statistical analyses and can get very complex…
Discussion- this is where the authors interpret their results