evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
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.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 document discusses evidence-based practice (EBP), defining it as the integration of the best available research evidence, clinical expertise, and patient values. It outlines the key components of EBP as research evidence, clinical expertise, and patient values/circumstances. The five steps of EBP are also summarized: formulating a question, finding evidence, critically appraising evidence, applying evidence in practice, and evaluating outcomes. Barriers and advantages of adopting an EBP approach are briefly mentioned.
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
Evidence based practice in physiotherapy.pptxDrNamrataMane
The document discusses evidence-based practice (EBP) in physical therapy. It defines EBP as integrating the best research evidence, clinical expertise, and patient values and describes the 5 steps of EBP as formulating a question, finding evidence, appraising evidence, implementing evidence, and evaluating outcomes. The document also explores barriers to EBP, such as lack of time and understanding of statistics, and facilitators, like access to online research summaries.
Evidence based practice aims to integrate the best research evidence with clinical expertise and patient values. It involves 5 steps: formulating a question, finding evidence, critically appraising evidence, applying evidence to a patient, and evaluating outcomes. Key resources for finding evidence include pre-appraised sources like UpToDate and filtered databases like PubMed. Models like the Stelter and Iowa models provide guidelines for implementing evidence-based projects. The goal of evidence based practice is to provide the highest quality care based on the best available research.
This document provides an overview of evidence-based practice (EBP) presented by Amritanshu Chanchal at Subharti Nursing College in Meerut. It defines EBP, discusses its components and key steps. The presentation covers asking questions using PICOT format, searching for evidence, critically appraising evidence, integrating evidence with clinical expertise and patient preferences, evaluating outcomes, and disseminating results. Models for EBP are also introduced, including the Iowa Model which outlines identifying triggers for change, determining organizational priority, and forming an interdisciplinary team to develop, evaluate and implement EBP changes.
This document defines evidence-based nursing and its key components. Evidence-based nursing integrates the best research evidence, clinical expertise, and patient values and preferences. It involves cultivating a spirit of inquiry, asking clinical questions, searching for evidence, critically appraising evidence, integrating evidence with expertise and patient preferences, evaluating outcomes, and disseminating results. Barriers to evidence-based nursing include lack of skills/time and organizational constraints, while supports include leadership, resources, and mentors.
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.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 document discusses evidence-based practice (EBP), defining it as the integration of the best available research evidence, clinical expertise, and patient values. It outlines the key components of EBP as research evidence, clinical expertise, and patient values/circumstances. The five steps of EBP are also summarized: formulating a question, finding evidence, critically appraising evidence, applying evidence in practice, and evaluating outcomes. Barriers and advantages of adopting an EBP approach are briefly mentioned.
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
Evidence based practice in physiotherapy.pptxDrNamrataMane
The document discusses evidence-based practice (EBP) in physical therapy. It defines EBP as integrating the best research evidence, clinical expertise, and patient values and describes the 5 steps of EBP as formulating a question, finding evidence, appraising evidence, implementing evidence, and evaluating outcomes. The document also explores barriers to EBP, such as lack of time and understanding of statistics, and facilitators, like access to online research summaries.
Evidence based practice aims to integrate the best research evidence with clinical expertise and patient values. It involves 5 steps: formulating a question, finding evidence, critically appraising evidence, applying evidence to a patient, and evaluating outcomes. Key resources for finding evidence include pre-appraised sources like UpToDate and filtered databases like PubMed. Models like the Stelter and Iowa models provide guidelines for implementing evidence-based projects. The goal of evidence based practice is to provide the highest quality care based on the best available research.
This document provides an overview of evidence-based practice (EBP) presented by Amritanshu Chanchal at Subharti Nursing College in Meerut. It defines EBP, discusses its components and key steps. The presentation covers asking questions using PICOT format, searching for evidence, critically appraising evidence, integrating evidence with clinical expertise and patient preferences, evaluating outcomes, and disseminating results. Models for EBP are also introduced, including the Iowa Model which outlines identifying triggers for change, determining organizational priority, and forming an interdisciplinary team to develop, evaluate and implement EBP changes.
This document defines evidence-based nursing and its key components. Evidence-based nursing integrates the best research evidence, clinical expertise, and patient values and preferences. It involves cultivating a spirit of inquiry, asking clinical questions, searching for evidence, critically appraising evidence, integrating evidence with expertise and patient preferences, evaluating outcomes, and disseminating results. Barriers to evidence-based nursing include lack of skills/time and organizational constraints, while supports include leadership, resources, and mentors.
This document discusses evidence-based practice and provides examples of how it is implemented in nursing. It begins by defining evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and preferences. It emphasizes using scientific evidence to inform decision-making and eliminate outdated practices. Several examples are then given of evidence-based practices in nursing related to infection control, oxygen use for COPD patients, measuring blood pressure in children, and intravenous catheter size. The document stresses the importance of following evidence-based protocols for patient health and safety.
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
The document discusses evidence-based nursing practice. It defines evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and needs. The key steps in evidence-based practice are asking questions, acquiring evidence, appraising the evidence, applying it to a patient, and evaluating outcomes. Barriers to evidence-based nursing include lack of time and resources, as well as difficulties interpreting and applying research. Facilitators include administrative support and accessible, clearly written research. Maximizing evidence-based nursing requires overcoming barriers, incorporating different types of evidence, and accounting for issues beyond measurement like patient preferences.
Evidence Base Practice (EBP)-Define, Benefits,Resource, steps PPTsonal patel
Evidence based practice (EBP) involves integrating the best available research evidence with clinical expertise and patient values to provide optimal care. EBP aims to move away from relying on "tried and true" practices and instead make decisions based on high-quality clinical research. The key steps of EBP include asking answerable clinical questions, searching for relevant evidence, appraising the evidence quality and applicability, integrating the evidence with expertise and context, and evaluating outcomes. EBP has benefits like improved patient outcomes, more efficient care, and keeping nursing practice current with the latest research findings.
The document discusses evidence-based practice in nursing. It defines evidence-based practice and nursing, and describes the importance of using evidence-based practice to improve patient outcomes and nursing quality. It also outlines the 5 step process for evidence-based practice: asking questions, acquiring evidence, appraising the evidence, applying to practice, and assessing performance.
Evidence-based applicability in clinical settingElhadi Miskeen
This document discusses the concept and application of evidence-based medicine (EBM). It begins by defining EBM as the integration of best research evidence, clinical expertise, and patient values. It then outlines the five steps of EBM: 1) formulating an answerable clinical question, 2) finding relevant evidence, 3) appraising the evidence critically, 4) applying the evidence to practice, and 5) evaluating performance. The document provides examples of formulating questions in PICO format and searching strategies. It also discusses study designs and hierarchies of evidence, emphasizing that randomized controlled trials provide the strongest evidence when evaluating interventions. The goal of EBM is to improve healthcare quality by incorporating valid and applicable research findings.
This document discusses evidence-based practice (EBP) and its application to a case study of a patient with diabetic peripheral neuropathy. It begins by defining EBP and outlining its key principles. It then presents the case study, formulating the clinical question using the PICO framework. It describes searching relevant literature databases using search terms derived from the PICO elements to address the clinical question. The goal is to evaluate pharmacological and alternative treatments like acupuncture for diabetic peripheral neuropathy based on the best available evidence.
Therapeutic exercise is intended to remediate or prevent impairments, improve physical function, and optimize health through planned movements, postures, and physical activities. It involves 10 components including aerobic conditioning, muscle performance exercises, stretching, joint mobilization, neuromuscular control techniques, and more. Safety is fundamental, with factors like health history, environment, and accuracy of performance influencing risk. Clinical decision making in selecting and modifying exercises requires reasoning skills and evidence-based practice. The process of patient management has five components: examination, evaluation, diagnosis, prognosis/care plan based on goals, and implementing interventions.
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.
1) Evidence based practice is a process through which scientific evidence is identified, appraised and applied in health care interventions to provide the best patient care.
2) It involves forming a team to develop, implement and evaluate an evidence based plan, searching databases to retrieve evidence, grading the strength of evidence, and developing standards for practice.
3) Barriers to evidence based practice include lack of time, administrative support, and difficulty changing practice habits, but it can improve patient and organizational outcomes when implemented successfully.
Evidence-based medicine involves integrating clinical expertise, patient values, and the best research evidence in clinical decision making. The best evidence comes from sound clinical studies. The steps of evidence-based practice are constructing a clear question, finding relevant evidence, appraising the evidence quality, applying the evidence to the individual patient, and evaluating performance. Different types and levels of evidence are used to rank the strength and applicability of clinical research findings.
This document discusses the principles of evidence-based medicine (EBM). It defines EBM as integrating the best research evidence with clinical expertise and patient values. The five step model of EBM is introduced: 1) formulating answerable clinical questions, 2) searching for evidence, 3) critical appraisal, 4) applicability of evidence, and 5) evaluation of performance. Key concepts like PICO questions, databases for searching literature, appraising validity and applying evidence are explained.
This document discusses evidence-based practice (EBP) in nursing and healthcare. It defines EBP as using research-based evidence to guide holistic patient care. The benefits of EBP include improved patient outcomes, reduced costs, and enhanced nursing practice. EBP involves five steps: asking a clear clinical question, acquiring evidence, appraising the evidence, applying the evidence to practice, and assessing outcomes. Barriers to EBP include lack of time, resources, and skills to implement research into practice. Overall, the document emphasizes that properly applying EBP through all five steps can help strengthen nursing practice and improve patient care.
The nursing process provides a framework for delivering nursing care. It involves assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting subjective and objective data about a patient's health status and history through various methods like observation, interviews, physical exams, and record reviews. This collected data is then organized, validated, and recorded to identify nursing diagnoses and develop a care plan to address any issues. The nursing process aims to improve the quality of patient care through a systematic, individualized approach.
This document provides an overview of evidence-based practice (EBP) for speech and language pathologists. It defines EBP as integrating the best research evidence, clinical expertise, and client values and preferences. The 5 steps of EBP are discussed: 1) developing an answerable clinical question, 2) finding the evidence, 3) critically appraising the evidence, 4) making an informed clinical decision, and 5) evaluating and improving the process. Key aspects of each step like developing PICO questions, searching various sources of evidence, critically evaluating research quality, and incorporating client values are explained. The importance of reflection, communication, and applying EBP principles in clinical practice is emphasized.
. 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.
1. Therapeutic exercise aims to remediate or prevent impairments, improve physical function, reduce health risks, and optimize overall health through planned bodily movements and activities.
2. Components of physical function addressed by therapeutic exercises include aerobic conditioning, muscle performance, stretching, joint mobilization, neuromuscular control, postural control, balance, relaxation, breathing, and task-specific training.
3. Safety is fundamental in therapeutic exercise and can be influenced by a patient's health history, environment, accuracy of exercise performance, and therapist safety.
This document provides an overview of evidence-based periodontics. It discusses the need for evidence-based decision making to reduce variations in clinical practice. The advantages of an evidence-based approach are that it is objective, scientifically sound, patient-focused, and incorporates clinical expertise. The process of evidence-based decision making involves framing questions, searching for and appraising evidence from various sources and levels, evaluating outcomes, and implementing decisions. Key aspects include assessing evidence critically and avoiding changes to pre-established hypotheses.
1. The document discusses critical thinking and the nursing process, which involves collecting patient data, developing nursing diagnoses, planning care, implementing interventions, and evaluating outcomes.
2. Critical thinking requires identifying patient problems, making care decisions, and prioritizing needs based on principles of nursing process and scientific reasoning.
3. The nursing process framework establishes a standard of care that respects patient dignity and autonomy while meeting basic health needs.
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
This document discusses evidence-based practice and provides examples of how it is implemented in nursing. It begins by defining evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and preferences. It emphasizes using scientific evidence to inform decision-making and eliminate outdated practices. Several examples are then given of evidence-based practices in nursing related to infection control, oxygen use for COPD patients, measuring blood pressure in children, and intravenous catheter size. The document stresses the importance of following evidence-based protocols for patient health and safety.
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
The document discusses evidence-based nursing practice. It defines evidence-based practice as integrating the best research evidence, clinical expertise, and patient values and needs. The key steps in evidence-based practice are asking questions, acquiring evidence, appraising the evidence, applying it to a patient, and evaluating outcomes. Barriers to evidence-based nursing include lack of time and resources, as well as difficulties interpreting and applying research. Facilitators include administrative support and accessible, clearly written research. Maximizing evidence-based nursing requires overcoming barriers, incorporating different types of evidence, and accounting for issues beyond measurement like patient preferences.
Evidence Base Practice (EBP)-Define, Benefits,Resource, steps PPTsonal patel
Evidence based practice (EBP) involves integrating the best available research evidence with clinical expertise and patient values to provide optimal care. EBP aims to move away from relying on "tried and true" practices and instead make decisions based on high-quality clinical research. The key steps of EBP include asking answerable clinical questions, searching for relevant evidence, appraising the evidence quality and applicability, integrating the evidence with expertise and context, and evaluating outcomes. EBP has benefits like improved patient outcomes, more efficient care, and keeping nursing practice current with the latest research findings.
The document discusses evidence-based practice in nursing. It defines evidence-based practice and nursing, and describes the importance of using evidence-based practice to improve patient outcomes and nursing quality. It also outlines the 5 step process for evidence-based practice: asking questions, acquiring evidence, appraising the evidence, applying to practice, and assessing performance.
Evidence-based applicability in clinical settingElhadi Miskeen
This document discusses the concept and application of evidence-based medicine (EBM). It begins by defining EBM as the integration of best research evidence, clinical expertise, and patient values. It then outlines the five steps of EBM: 1) formulating an answerable clinical question, 2) finding relevant evidence, 3) appraising the evidence critically, 4) applying the evidence to practice, and 5) evaluating performance. The document provides examples of formulating questions in PICO format and searching strategies. It also discusses study designs and hierarchies of evidence, emphasizing that randomized controlled trials provide the strongest evidence when evaluating interventions. The goal of EBM is to improve healthcare quality by incorporating valid and applicable research findings.
This document discusses evidence-based practice (EBP) and its application to a case study of a patient with diabetic peripheral neuropathy. It begins by defining EBP and outlining its key principles. It then presents the case study, formulating the clinical question using the PICO framework. It describes searching relevant literature databases using search terms derived from the PICO elements to address the clinical question. The goal is to evaluate pharmacological and alternative treatments like acupuncture for diabetic peripheral neuropathy based on the best available evidence.
Therapeutic exercise is intended to remediate or prevent impairments, improve physical function, and optimize health through planned movements, postures, and physical activities. It involves 10 components including aerobic conditioning, muscle performance exercises, stretching, joint mobilization, neuromuscular control techniques, and more. Safety is fundamental, with factors like health history, environment, and accuracy of performance influencing risk. Clinical decision making in selecting and modifying exercises requires reasoning skills and evidence-based practice. The process of patient management has five components: examination, evaluation, diagnosis, prognosis/care plan based on goals, and implementing interventions.
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.
1) Evidence based practice is a process through which scientific evidence is identified, appraised and applied in health care interventions to provide the best patient care.
2) It involves forming a team to develop, implement and evaluate an evidence based plan, searching databases to retrieve evidence, grading the strength of evidence, and developing standards for practice.
3) Barriers to evidence based practice include lack of time, administrative support, and difficulty changing practice habits, but it can improve patient and organizational outcomes when implemented successfully.
Evidence-based medicine involves integrating clinical expertise, patient values, and the best research evidence in clinical decision making. The best evidence comes from sound clinical studies. The steps of evidence-based practice are constructing a clear question, finding relevant evidence, appraising the evidence quality, applying the evidence to the individual patient, and evaluating performance. Different types and levels of evidence are used to rank the strength and applicability of clinical research findings.
This document discusses the principles of evidence-based medicine (EBM). It defines EBM as integrating the best research evidence with clinical expertise and patient values. The five step model of EBM is introduced: 1) formulating answerable clinical questions, 2) searching for evidence, 3) critical appraisal, 4) applicability of evidence, and 5) evaluation of performance. Key concepts like PICO questions, databases for searching literature, appraising validity and applying evidence are explained.
This document discusses evidence-based practice (EBP) in nursing and healthcare. It defines EBP as using research-based evidence to guide holistic patient care. The benefits of EBP include improved patient outcomes, reduced costs, and enhanced nursing practice. EBP involves five steps: asking a clear clinical question, acquiring evidence, appraising the evidence, applying the evidence to practice, and assessing outcomes. Barriers to EBP include lack of time, resources, and skills to implement research into practice. Overall, the document emphasizes that properly applying EBP through all five steps can help strengthen nursing practice and improve patient care.
The nursing process provides a framework for delivering nursing care. It involves assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting subjective and objective data about a patient's health status and history through various methods like observation, interviews, physical exams, and record reviews. This collected data is then organized, validated, and recorded to identify nursing diagnoses and develop a care plan to address any issues. The nursing process aims to improve the quality of patient care through a systematic, individualized approach.
This document provides an overview of evidence-based practice (EBP) for speech and language pathologists. It defines EBP as integrating the best research evidence, clinical expertise, and client values and preferences. The 5 steps of EBP are discussed: 1) developing an answerable clinical question, 2) finding the evidence, 3) critically appraising the evidence, 4) making an informed clinical decision, and 5) evaluating and improving the process. Key aspects of each step like developing PICO questions, searching various sources of evidence, critically evaluating research quality, and incorporating client values are explained. The importance of reflection, communication, and applying EBP principles in clinical practice is emphasized.
. 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.
1. Therapeutic exercise aims to remediate or prevent impairments, improve physical function, reduce health risks, and optimize overall health through planned bodily movements and activities.
2. Components of physical function addressed by therapeutic exercises include aerobic conditioning, muscle performance, stretching, joint mobilization, neuromuscular control, postural control, balance, relaxation, breathing, and task-specific training.
3. Safety is fundamental in therapeutic exercise and can be influenced by a patient's health history, environment, accuracy of exercise performance, and therapist safety.
This document provides an overview of evidence-based periodontics. It discusses the need for evidence-based decision making to reduce variations in clinical practice. The advantages of an evidence-based approach are that it is objective, scientifically sound, patient-focused, and incorporates clinical expertise. The process of evidence-based decision making involves framing questions, searching for and appraising evidence from various sources and levels, evaluating outcomes, and implementing decisions. Key aspects include assessing evidence critically and avoiding changes to pre-established hypotheses.
1. The document discusses critical thinking and the nursing process, which involves collecting patient data, developing nursing diagnoses, planning care, implementing interventions, and evaluating outcomes.
2. Critical thinking requires identifying patient problems, making care decisions, and prioritizing needs based on principles of nursing process and scientific reasoning.
3. The nursing process framework establishes a standard of care that respects patient dignity and autonomy while meeting basic health needs.
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Public Health Lecture 4 Social Sciences and Public Health
introduction to evidence based practice 1
1. Dr Muhammad khan Bugti
DPT,MSPT, MBA
Assistant Professor
BNBWU sukkur
2. Lecture objectives
Define EBP
Purpose of EBP
What is ‘best evidence’
Discuss how to ask relevant clinical question and its
importance
3. What is EBP?
The application of clinical decision making for
patient management based on research
evidence, clinical expertise, patient values and
preferences and clinical circumstances
- Dave Sackett
Patient
Concerns
Clinical
Expertise
Best research
evidence
EBM
4. Purpose of Evidence based practice
To integrate best research evidence with our clinical
expertise and our patient’s unique values and
circumstances
The concept of EBP makes sure that the patient is
provided quality care because our choices are backed
by sound scientific data
However
There is no pure scientific method that can replace the
influence of experience, intuition and creativity in
clinical judgment
5. ‘Evidence based practice’ helps in clinical decision
making by integrating the ‘art’ of clinical practice and
the ‘science’ that supports clinical practice
Therefore, it is the applied evidence to a clinical
scenario or in the context of a patient to support the
process of clinical decision making. We can also call it
EVIDENCE-BASED DECISION MAKING
Purpose Cont….
6. EBP may not be possible when:
Scientific evidence is incomplete
Scientific evidence is unavailable
There is no access to latest literature
The clinician does not realize the importance of
cognition and metacognition and practices on the
basis of intuition and antedotes
7. Why do we need ‘best evidence’
Sackett and colleagues mention that
EBP is the conscientious, explicit and
judicious use of current best evidence in
making decisions about the care of the
individual patients.
Studies that meet validity standards
should be used to determine how the
results of the research apply to the given
clinical situation
8. Component of a good clinical
question - PICO
The process of EBP starts by asking a relevant clinical
question. Therefore a good and comprehensive
question (relating to the patient issues and
management) is a basis to finding the relevant answer
P Patient/ problem
I intervention
C comparison
O outcome
9. PICO
P – the target population? Characteristics of the
patient or the problem being considered
I – intervention being considered. Prognostic factor or
a diagnostic test
C – what comparison or control condition is being
considered. (Not relevant for a question of prognosis
or examining one diagnostic test or intervention
O – outcomes of interest. What measurements will be
relevant to understanding the effectiveness of an
intervention and importance of a prognostic factor or a
diagnostic test accuracy
10. Questions may be related to:
Patient’s diagnosis, prognosis or intervention
Clinical guidelines and their validity
Etiology of patient problem
Safety and cost effectiveness of care
11. CASE EXAMPLE
MJ is a 75 yr old woman who suffered a R CVA 2
months back. She is being seen by an occupational,
physical and speech therapist in an inpatient setting.
She walks with a cane – mod assistance and exhibits
poor balance. One of your colleagues suggest that you
consider training the patient on a treadmill with
partial body weight support, but you have not tried
this approach before.
12. In an elderly patient 2 months post stroke - Patient
Is partial weight-bearing supported treadmill training -
Intervention
More effective than traditional gait training with full
weight bearing – Comparison
For improving walking speed, endurance and balance? -
Outcome
13. Lecture objectives
In today’s class we will:
Continue with the process of evidence based practice
Discuss the PICO further
Discussion and feedback on PICO assignment
14.
15. The process of EBP
The process of finding evidence to answer clinical queries is a
systematic process. It includes:
1. Formulating a clear clinical question based on patient’s
problem
2. Search the literature for relevant clinical articles/ evidence
3. Evaluate ( critically appraise) the literature for its validity
and usefulness
4. Implement the findings in clinical practice
5. Evaluate the outcome
16. Step 1 – formulating a clear clinical
question
One of the fundamental skills
required for practicing EBM is
the asking of well-built clinical
questions.
To benefit patients and clinicians,
such questions need to be both
directly relevant to patients'
problems and phrased in ways
that direct your search to
relevant and precise answers.
In practice, well-built clinical
questions usually contain four
elements
17. One of the benefits of careful and thoughtful
question-forming is that the search for evidence is
easier. The well-formed question makes it relatively
straightforward to elicit and combine the appropriate
terms needed to represent your need for information
in the query language of whichever searching service is
available to you.
Once you have formed the question using the PICO
structure, you can think about what type of question it
is you are asking, and therefore what type of research
would provide the best answer
19. PICO
Who, what and why of the clinical query
The clearer each element of the question and its
components, easier it is to find relevant articles
20. Scenario for the clinical question
You run an outpatient group on rheumatoid arthritis and teach
them joint protection and energy conservation . The energy
conservation part seems to be particularly successful. You think
of proposing this to client’s with other conditions experiencing
fatigue such as people with MS or AIDS. You decide to use the
evidence base for using energy conservation education as a way
of decreasing with these client group. You are also interested to
explore whether group or individual sessions are more effective
or whether sessions should focus solely on information or
should include discussion and a self-help focus
21. EVIDENCE BASED PHYSICAL
THERAPY PRACTICE
MM.DD.20XX ADD A FOOTER 21
Evidence-based physical therapist practice is “open and
thoughtful clinical decision making” about physical
therapist management of a patient or client that
integrates the “best available evidence with clinical
judgment” and the patient or client’s preferences and
values, and that further considers the larger social
context in which physical therapy services are provided,
to optimize patient or client outcomes and quality of
life.
23. CDM is a complex process which is used to analyze,
synthesize, and interpret relevant information.
Professional judgment is required to achieve effective
outcomes.
25. Patients/clients “ Unique Preference, Concerns,
Expectation”
Individual's expression of desirability or value of one
course of action, outcome, or selection in contrast to
others.
26. Patient
Preference Model
Traditional Model
Decision about the therapies are made by the
Physiotherapists.
Contemporary Model
Physical Therapist is able to communicate risk and benefits
of the preferences given by the client using clinical expertise
and high quality research.
a) The physical therapist must be flexible, empathy, and
honest in communication
b) In the contemporary model, physical therapist
encourages client in decision making.
27. “ Practice knowledge is knowledge arising from
professional practice and experience”
28. MM.DD.20XX
Reproduced from Evidence-Based Healthcare: A Practical Guide for Therapists, Tracy Bury & Judy Mead, Page 10,
Copyright 1999 by Elsevier. Reprintedith permission from Elsevier. 28
29. CASE SCENARIO
• 24 Year old male k/c of DM, HTN admitted
with c/o
-Fever 104
-Vomiting
-ALOC
Currently Intubated and sedated on CMV with
450 ml Tidal Volume
On Inotropic support
CXRAY Showing : Lt Lung Collapsed
Trop I 1.04
Patient is on DNR code and family wants CPR
if condition deteriorates
How will you describe the role of evidence
in your clinical decision making?
30. CASE SCENARIO
• 60 Year old female k/c of 2nd POD of
Total Knee Arthroplasty,
As per the need and demand of the
patient, High Chair is suggested for sitting,
one of the Pt’s attendant had previously
undergone same treatment but didn’t used
high chair.
What will be your physical therapy
management in this case scenario?
31. TERMINOLOGIES TO RECALL
The purposeful use of various physical therapy procedures
and techniques, in collaboration with patient/ client and
when, appropriate, other care providers, in order to effect a
change in patient/client’s condition
Intervention
Comprises knowledge of or skill of some thing or some event
gained through involvement in or exposure to that thing or
event
Experiences
Prediction of the natural course of a disease or condition or
its development based on previously identified risk factors.
Also predicted optimal level of improvement through
intervention and the amount of time required to achieve that
level
Prognosis
A process that integrates and evaluates the data obtained
during a patient/ client examination often resulting in a
classification that guides prognosis, the plan of care and
subsequent intervention
Diagnosis
The cause, set of causes, or manner of causation of a disease Harm or
33. The first step is a professional commitment as best
one can, under given environment and resource
constraint.
Second is to consider the questions that arise
during the daily management of a patient problem.
These questions direct the search for evidence
34. Background questions reflects a desire to understand
the nature of a patient/clients problem or need.
These questions focus on the natural evolution of a
condition and its medical or surgical management
rather on physical therapy component.
35. What are the side effects of steroid treatment for
asthma?
How long will it take for a total knee arthroplasty
incision to heel?
What are the sign and symptoms of an exacerbation
of multiple sclerosis?
Will it be possible to play baseball again after elbow
36. Foreground questions are the heart of evidence-based
physical therapist practice. These questions help clinicians
to make decisions about the specific physical therapy
management of the problem or issue.
37. Will the Neer’s test help me detect rotator cuff
impingement in a 35-years-old male tennis player
with shoulder pain?
Is a manual muscle test a reliable and valid measure
of quadriceps strength in a 42-years-old woman
with multiple sclerosis?
Is lower extremity muscle strength a predictor of
fall risk in a 76-year-old woman with diabetes?
Is PNF an effective treatment technique for
restoring core trunk stability in a 7 year old child
with right hemi-paresis due to stroke
39. It is a process by which PT labels and classify a
patient/client’s problem or need
Test used during PT examination provide the objective
data for the diagnostic process.
Test
Accurate and
Persuasive
information
Risk and
cost
40. Clinical Measures are used to quantify patient’s
impairment in body functions and structures as well as
Activity Limitations and Participation Restriction.
41. “Interventions are the techniques and procedures PT use to produce a
change in the patient/client ”
Focus:
Benefit or Risk of a treatment technique.
Goal:
To identify which treatment approaches will provide the desired
effect
Consider the patient/client’s preferences and values.
Minimize costs
Expedite the treatment process
42. “A process of making predictions about
the future health status of
patient/client.”
43. FOREGROUND QUESTIONS
SIMPLE
FOREGROUND QUESTIONS
COMPARITIVE
DIAGNOSTIC
TEST
Will chest X-ray help me
detect pneumonia in a 25
year old patient with
dyspnea and productive
cough?
Is chest X-ray more reliable
than chest CT in detecting
pneumonia in a 25 year old
patient with dyspnea and
productive cough?
CLINICAL
MEASURES
Is BOD POD a reliable and
valid measure to quantify
the amount of fat in tissue?
Is BOD POD more reliable
and valid than skin fold
thickness test for
quantifying amount of fat
in tissues?
PROGNOSTIC
FACTORS
Is lower extremity muscle
weakness a predictor of fall
risk in a 76-year-old woman
with diabetes?
Which is a stronger
predictor of fall risk, lower
extremity muscle weakness
or loss of proprioception,
in a 76-year-old woman
with diabetes?
44. INTERVENTION Is Mulligan technique an
effective treatment
technique for restoring
ROM in a 45 year old
adult with cervical
spondylosis?
Is Mulligan technique more
effective than Maitland
technique for restoring ROM
in a 45 year old adult with
cervical spondylosis?
OUTCOME
MEASURES
Does participation in
a cardiac
rehabilitation
program increase
the chance that a 58-
years-old man will
return to work
following a MI
Does participation in a
cardiac rehabilitation
program increase the
chance of return to work
more than home
walking program in a 58-
years-old man following
a MI
46. Practice that involves high quality research is more safe and relevant
for patients than a practice which is only of assumptions, thoughts,
poor experience and lack of knowledge.
Physiotherapy will produce the best possible clinical outcomes when
it is evidence based.
Now a days patients are increasingly demanding information about
their disease or clinical problems and the options available for
treatment.
47. Physiotherapists assert that they are professionals.
One of the unique characteristic of a professional is
Trustworthiness, in a sense that they are expected to be
good, consider the patient’s interests and have high
ethical standards.
A prerequisite is that the profession must be aware of
what the evidence says.
A practitioner that does not know whether the evidence
indicates that the interventions they offer are effective
may have a questionable claim to being ‘professional’.
physiotherapists act as a autonomous or semi
48. Identify a clinical question
Search for the most appropriate evidence
Critically appraise this evidence
Incorporate the evidence into a strategy for action
Evaluate the effects of any decisions and action taken
Thomson et al., 2005
49. Know-how in finding, appraising, and applying evidence
Information Resources on tap
Lack of Time
50. We usually break questions about the effects of
intervention into four parts (Sackett et al 2000)
Patient/ problem/ population
Intervention or management strategy
Comparative intervention
outcome
51. Patient Intervention Comparisonintervention outcome
Adult with acute low back
pain
Bed rest Advice to stay active Pain and disability
In patients with acute low back pain, does bed rest or advice
to stay active produce greater reductions in pain and
disability?’
53. What are background & Foreground
Questions?????
What is Myasthenia Gravis?
Does the use of cell phones increase the
incidence of brain cancer?
What are the symptoms of bacteremia?
What are the causes of surgical wound
infection following hip replacement?
How can we prevent falls in the elderly?
What cooling methods are used to treat
heatstroke?
54. What is Myasthenia Gravis? B
Does the use of cell phones increase the incidence
of brain cancer? F
What are the symptoms of bacteremia? B
What are the causes of surgical wound infection
following hip replacement? F
How can we prevent falls in the elderly? B
What cooling methods are used to treat
heatstroke? B
What factors influence parents' decisions
55. Examples of PICO
1. In ventilated patients ,(head-of-bed
elevation of 45 degrees compared to 20
degrees reduce incidence of ventilated
associated pneumonia
2. In hospitalized children, does the Wong-
Baker Pain FACES Rating Scale compared to
the Child Medical Fear Scale) more
effectively evaluate the child's level of pain?
56. 1. In ventilated patients (P), head-of-bed
elevation of 45 degrees (I) compared to 20
degrees (C) reduce incidence of ventilated
associated pnemonia (O)
2. In hospitalized children,(P) does the Wong-
Baker Pain FACES Rating Scale (I) compared
to the Child Medical Fear Scale (C) more
effectively evaluate the child's level of pain
(O)?
3. In non-ambulatory patients, (P) does