Evidence Based Practice Flashcards
Why should practice be evidence based?
Improve effectiveness by using interventions that have been shown to work
Reduce use of ineffective treatments that may have side effects
Both improve cost effectiveness
What is evidence based practice?
Clinical practice that integrates:
Research experience
Clinical expertise
Patient wishes
Clinical practice that changes as new evidence becomes available
What are CLAHRCs?
NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) undertake high-quality applied health research focused on the needs of patients and support the translation of research evidence into practice in the NHS.
CLAHRCs are collaborative partnerships between a university and the surrounding NHS organisations, focused on improving patient outcomes through the conduct and application of applied health research. They create and embed approaches to research and its dissemination that are specifically designed to take account of the way that health care is increasingly delivered across sectors and a wide geographical area.
Talk about knowledge transfer
What are cooksey’s (2006) two gaps in healthcare research?
1) translating ideas from clinical research into the development of new approaches
2) integrating these new approaches into clinical practice (CLAHRCs address this)
What are the pros of evidence based practice?
It encourages nurses to monitor and review practice.
It promotes better practice and quality student management.
It facilitates clinical reasoning and allows opportunity for informed decision making.
It assists in informing overall service delivery through pathways to clinical standards.
It assists in informing departmental and service decisions, policies or legislation.
It facilitates accountability and increased credibility, which in turn may lead to additional resources.
What are the cons of evidence based practice?
It can be time consuming to do a literature search just to find no answer to your question.
Some argue that it encourages recipe book intervention.
Some argue that it limits clinical judgement.
It may limit creativity.
It takes a lot of time and effort, particularly when new at it.
There are increased expectations from consumers or colleagues that interventions are justified.
How is evidence based practice best done?
Clinicians often say that they keep up-to-date by reading professional journals and other professional literature on a regular basis. When using the above approach it is often reading ‘just in case’ we may need that information someday.
Queensland Health CDP (2005) describes a ‘just in time’ process for gathering evidence, i.e. finding the information and evidence when you need it. Evidence-based practice fits in neatly with this process. It is focused by the clinical questions we have formulated and addresses student needs when we need the information.
How do Sackett et al (1996) refute the claims that EBP encourages a non-patient centred “cookbook” approach to treatment?
Evidence based medicine is not “cookbook” medicine. Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients’ choice, it cannot result in slavish, cookbook approaches to individual patient care. External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision. Similarly, any external guideline must be integrated with individual clinical expertise in deciding whether and how it matches the patient’s clinical state, predicament, and preferences, and thus whether it should be applied
What is an example of a CLAHRC research project transferring knowledge into practice?
Rothwell and Larkin (2012):
GM-SAT post stroke management
