2) Evidence-based Practice Flashcards
What are the origins of evidence based healthcare?
Health service delivery should be based on best available evidence
Evidence of effectiveness and cost effectiveness
Why should evidence based health care be used?
Ineffective and inapproriate interventions waste resources
Variations in treatments create inequities
What are the reasons behind practices not using evidence based healthcare?
Professional opinion
Clinical fashion
Historical practice
Organisation and social culture e.g. in a ward team
What is evidence based practice?
The integration of individual clinical expertise with the best available external clinical evidence from systematic research
Why are systematic reviews needed?
Literature reviews may be biased
Quality of studies reviewed is variable
Help address clinical uncertainty
Highlight gaps in research
Why are systematic reviews useful to clinicians?
Useful for quality control and increased certainty
Generalisable conclusions
Reduce delay between discovery and implementation
Easily converted into guidelines
Where can you look to find evidence?
Medical journals
EBP specific journals
Cochrane Library
What are some practical criticisms of evidence based practice?
Impossible to create and maintain SRs across all specialities
Challenging to disseminate and implement findings
Faith in pharmaceutical companies
RCTs not always feasible/desirable
Outcomes often biomedical
What are some philosophical criticisms of evidence based practice?
Doesn’t align with doctor’s mode of reasoning
No guarantee it will work for individual
Creates unreflective rule followers
What are some examples of problems with implementing evidence into practice?
Dissemination ineffective - doctors don’t know
Doctor’s don’t use it
Organisational and commissioning systems don’t use it
Resources not available - human and financial
Why is EBP becoming more widespread?
Clinical governance
Care Quality Commission and NICE ensure maintenance
