8 - Evidence Based Practice Flashcards
E3BP: 3 sources
Best available evidence from systematic research
Best available evidence from Clinical practice
Best available evidence concerning preferences of fully informed patient
E4BP: 4 sources of evidence
Clinical expertise
Training or skills of clinician
Research evidence
Empirical research
Client preferences
Preferences
Values
Context
Circumstances
Practice Context
Service delivery limits or opportunities
Location
Number of therapy hours
Technology available
What integrates 4 sources of evidence?
Clinical reasoning
Not evidence: (5)
New outlet reports
Opinions
Advertising with evidence
Blogs
wikipedia
Knowledge
Accepted body of facts or ideas acquired through senses or reason
Knowledge acquisition
Most efficiently built through research findings
Knowledge, evidence & EBP
Empirical evidence and research
Research process of journal articles (6)
Review existing literature & planning
Generate hypothesis
Research design (methodology)
Data collection
Analysis
Interpretation & conclusion
Importance of EBP
For clients
For SP
For employers / organisations
Importance of EBP
For clients
Safe, effective interventions
Management based on the most accurate information
For SP
Code of ethics
Rapid development of knowledgebase for the profession
Model for decision making and rationale
For employers
Management of finite resources
Providing cost-effective service while preserving quality of care (SPA Code of Ethics)
EBP Process: 5 As
Ask
Translate uncertainty to answerable question
Considerations:
Intervention/treatment
Diagnosis or screening
Prognosis
Patient experience
Acquire
Systematically retrieve the best available evidence
Sources
Research
Client preferences
Practice context
Appraise
Critically consider and judge evidence based on
Validity
is it trustworthy
Impact
how clinically important are the research findings?
Applicability
Are the result applicable to client?
Apply
Put it in practice
Make a plan
Integrate 4 sources of evidence
Assess
Evaluate how effective it was in your context
Regarding 4 As
How to ask a good question:
PICO
P
Population
Patient
Problem
Person
Who does the question relate to?
I
Intervention
Issue
Diagnostic test
Prognostic factor
Qualitative issue
C
Comparison
Not all qs have a comparison. Compares one intervention to another
Intervention
Diagnostic assessment
O
Outcome
What do you want to change for the client?
Increase
Decrease
maintain
Where to go for information:
Speech pathology database
Where to go for general information
Databases:
Up to date (specialised health resources for referencing up to date)
Gale ebooks
