Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...
Evidence-based medicine combines the patient's preferences with clinical experience and the best research evidence. Randomized clinical trials are considered the most valid research design for evaluating health-care interventions. However, empirical research shows that intervention effects may...... practice. By investments in education, applied research, and The Cochrane Collaboration, evidence-based medicine may form a stronger basis for clinical practice....
American Psychologist, 2006
The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…
Adams, Susan; McCarthy, Ann Marie
School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by…
Schaefer, Jessica D; Welton, John M
To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.
Brendtro, Larry K.; Mitchell, Martin L.
Many methods claim to be Evidence-Based Practices. Yet success comes not from a particular practice, but principles that underlie all effective helping. This article uses the principle of consilience to tap knowledge from science, values, and practical experience.
Cook, Bryan G.; Cook, Lysandra
Evidence-based practice is among the most influential and compelling reforms in contemporary education. Despite their potential to improve the outcomes of students with disabilities, adoption and implementation of evidence-based reforms have been disappointing, with the gap between research and practice remaining wide. Practice-based evidence…
Stuart, Richard B.; Lilienfeld, Scott O.
Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. Regrettably, the task force report was largely silent on three critical issues. As a consequence, it omitted much of the evidence necessary for a complete picture of evidence-based…
Gudray, Kiran; Walmsley, Anthony Damien
This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.
Garattini, Silvio; Jakobsen, Janus C; Wetterslev, Jørn
Using the best quality of clinical research evidence is essential for choosing the right treatment for patients. How to identify the best research evidence is, however, difficult. In this narrative review we summarise these threats and describe how to minimise them. Pertinent literature was consi......Using the best quality of clinical research evidence is essential for choosing the right treatment for patients. How to identify the best research evidence is, however, difficult. In this narrative review we summarise these threats and describe how to minimise them. Pertinent literature...
Hotelling, Barbara A.
Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided.
Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.
Gale, Barbara Van Patter; Schaffer, Marjorie A
This study explored factors that affect the adoption or rejection of evidence-based practice (EBP) changes and differences in nurse manager and staff nurse perceptions about those factors. Roger's Diffusion of Innovations Theory explains relevant organizational strategies for guiding practice change. The primary author developed the Evidence-Based Practice Changes Survey consisting of 12 items, completed by 92 nurses at a level 1 trauma center. Top barriers to EBP were insufficient time, lack of staff, and not having the right equipment and supplies. Top reasons to adopt EBP were having personal interest in the practice change, avoiding risk of negative consequences to the patient, and personally valuing the evidence. Several statistically significant differences emerged for demographic variables. Planning for EBP change must address barriers and facilitators to practice change and emphasize the benefit for patients and value of the practice change to nurses.
The idea of evidence- based practice is influential in public welfare services, including education. The idea is controversial, however, not least because it involves a poten tial redefinition of the relation ship between knowledge, authority and professionalism. This is discussed based on a study...... of evidence- based methods in Danish pre-school education and care. The management sees the use of these methods as strengthening pre- school teacher professionalism, but the actual practices in the day-careinstitutions are ambiguous. In some cases, using the methods becomes an end in itself and tends...... to displace important educational objectives. In other cases, the methods are reflectively adjusted to a given context. Used in this way only, evid ence-based practice and methodology is a valuable resource for professional practice in education. From such a perspective, at least some types of research based...
B. Spek; M. Wieringa-de Waard; C. Lucas; N. van Dijk
BACKGROUND: Worldwide speech-language therapy (SLT) students are educated in evidence-based practice (EBP). For students to use EBP in their future day-to-day clinical practice, they must value EBP as positive and must feel confident in using it. For curricula developers it is therefore important to
Wigram, Tony; Gold, Christian
This chapter begins by outlining the challenges of preparing a chapter on evidence-based practice (EBP) to underpin the use of music as a therapeutic tool in treatment, in the overall frame of music, health, and wellbeing. It then reviews the terminology of EBP and evidence-based medicine...... practice as health, education, and social services tighten their belts and the demand on their resources grows, there is increasing interest in the value of music for health and wellbeing, despite even less ‘hard’ evidence that it is effective against illness and disability....
Lystbæk, Christian Tang
, cost-efficiency and measurable quality. Thus, today, evidence-based practice has become an expectation and fashion, often used to emphasize the grounding of practice in research based knowledge that provides measurable evidence for best practice. But at the same time, there is a growing distrust......“Knowledge” is of the utmost significance for professional practice and learning. Today, though, the established knowledge base is changing in all areas of the labour market (Alvesson, 2004). Work and society are dominated by commitment to demands for high levels of demonstrable accountability...
Mesibov, Gary B.; Shea, Victoria
Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…
Full Text Available Evidence based library and information practice (EBLIP is a strategy to bridge research and practice. Generally EBLIP is seen as a movement to encourage and give practitioners the means to incorporate research into their practice, where it previously may have been lacking. The widely accepted definition of EBLIP (Booth, 2000 stresses three aspects that contribute to a practice that is evidence based: 1 "the best available evidence;" 2 "moderated by user needs and preferences;" 3 "applied to improve the quality of professional judgements." The area that the EBLIP movement has focused on is how to create and understand the best available research evidence. CE courses, critical appraisal checklists, and many articles have been written to address a need for librarian education in this area, and it seems that strides have been made.But very little in the EBLIP literature talks about how we make professional judgements, or moderate evidence based on our user needs and preferences. Likewise, how do we make good evidence based decisions when our evidence base is weak. These things seem to be elements we just take for granted or can’t translate into words. It is in keeping with tacit knowledge that librarians just seem to have or acquire skills with education and on the job experience. Tacit knowledge is "knowledge that is not easily articulated, and frequently involves knowledge of how to do things. We can infer its existence only by observing behaviour and determining that this sort of knowledge is a precondition for effective performance" (Patel, Arocha, & Kaufman, 1999, p.78. It is something that is difficult to translate into an article or guideline for how we work. I think of this area as the "art" of evidence based practice. And the art is crucial to being an evidence based practitioner.Science = systematized knowledge, explicit research, methodological examination, investigation, dataArt = professional knowledge of your craft, intuition
Zeeman, Laetitia; Aranda, Kay; Grant, Alec
This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley
Falzon, Louise; Davidson, Karina W.; Bruns, Daniel
There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down questions into searchable statements, and adapting statements to suit both the question being asked and the resource being searched. A number of free, evidence-based resources are listed. Knowing how and where to access this information will enable practitioners to more easily use an evidence-based approach to their practice. PMID:21503266
Hajebrahimi, Sakineh; Sadeghi-Ghyassi, Fatemeh; Olfati, Nahid; Dastgiri, Saeed; Maghbouli, Leili
To determine the attitudes and beliefs of Iranian urologists toward Evidence Based Medicine (EBM) and investigation of the barriers of evidence based practice (EBP). A self- administrated, Likert scale questionnaire designed in Persian and filled up by censuses selected urologist from Iranian Urology Association (IUA). Data were entered to Predictive Analytics Soft Ware version 18.0 and descriptive statistics were obtained for all parts of the questionnaire. A total of 111 out of 500 Iranian urologists who attended in IUA annual meeting, responded to the questionnaires. Mean attitude score of respondents was 30.4 (SD: 5.7, range 16-40). Attitude score showed statistically significant association to previous participation in EBM workshops (P = .01). Of participants 96% believed EBP will improve patient care and 76.2% of them appreciated the impact of use of research utilization and application of evidence based guidelines on clinical decision making and the outcome of surgery. The main barriers to EBP stated as lack of time (64.8%), facilities (53.4%), and training in EBM (29.4%). The urologists have positive attitudes towards EBP. However, regarding lack of time, pre-appraised databases or EBP guidelines can be helpful. Evidence based workshops and familiarity with evidence databases is recommended for Iranian urologists. In addition, health care system and policy makers could play a major role to provide a culture of EBP.
Adams, Susan; McCarthy, Ann Marie
The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…
JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…
Full Text Available There is a vast literature on evidence-based practice (EBP in education. What function does evidence have in practical deliberations toward decisions about what to do? Most writers on EBP seem to think of evidence largely as quantitative data, serving as a foundation from which practice could and should be directly derived. In this paper I argue that we are better served by according a different and more indirect function to evidence in practical reasoning. To establish this claim I employ Toulmin’s model of argumentation. On this model the evidence-as-foundation view amounts to evidence as data/grounds. The model also offers a different function for evidence, as backing of the warrant, and I argue in this paper that this is a more adequate understanding of the function of evidence in practical reasoning
Full Text Available I love food. I love cooking, baking, testing, and eating. I read about food preparation, food facts, and food service. Over the years I’ve developed my fair share of knowledge about cooking and I’m a decent cook, but I’m no chef. I guess I’m what you’d call a “foodie”. However, I have the good fortune to have a friend who is a chef and owns one of the best, and certainly the most innovative, restaurants in town. During this summer I hosted a cooking class in my home for my family with my chef friend as instructor. The Tex-Mex barbecue theme was a big hit (you can contact me for recipes, if you like, but much more fascinating was the explanation of the science behind the cooking. It turns out that there is a term for this: molecular gastronomy. Another term, and hence the genesis of my “Eureka!” moment of the summer, is evidence based cooking. Good cooking is not just following a recipe (not all of which are evidence based but at its best is the culmination of heaps of tested information regarding why and how chemical and environmental factors work together to result in a gastronomical delight. For example, will brining or marinating a pork chop make it moister? And, if brining, what temperature should the water be, how long should it soak, and how much salt is needed? Why does pounding meat increase its tenderness? What will keep guacamole from browning better – the pit or lime juice? What does baking soda do in a chocolate cake? Eggs or no eggs in fresh pasta? Like most librarians, I tend not to take information at face value. I want to know where information comes from and whether or not it is valid, based on specific factors. I’ve come to notice that evidence based, or evidence informed, practice is everywhere and has a tremendous impact on our lives. Why do you rotate the tires on your car? Evidence shows that the front tires wear more quickly (think about all those 3-pointturns, the braking, etc and therefore
The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.
Ross J. Todd
Full Text Available Objective – This paper provides an overview of progress and developments surrounding evidence based practice in school librarianship, and seeks to provide a picture of current thinking about evidence based practice as it relates to the field. It addresses current issues and challenges facing the adoption of evidence based practice in school librarianship.Methods – The paper is based on a narrative review of a small but growing body of literature on evidence based practice in school librarianship, set within a broader perspective of evidence based education. In addition, it presents the outcomes of a collaborative process of input from 200 school libraries leaders collected at a School Library summit in 2007 specifically to address the emerging arena of evidence based practice in this field.Results – A holistic model of evidence based practice for school libraries is presented, centering on three integrated dimensions of evidence: evidence for practice, evidence in practice, and evidence of practice.Conclusion – The paper identifies key challenges ahead if evidence based school librarianship is to develop further. These include: building research credibility within the broader educational environment; the need for ongoing review and evaluation of the diverse body of research in education, librarianship and allied fields to make quality evidence available in ways that can enable practicing school librarians to build a culture of evidence based practice; development of tools, strategies, and exemplars to use to facilitate evidence based decision-making; and, ensuring that the many and diverse advances in education and librarianship become part of the practice of school librarianship.
This first of three articles on evidence-based dental practice discusses the historical background of evidence-based medicine/evidence-based dentistry, how to formulate clear clinical questions and how to track down (search) the available evidence in the literature databases. Nigerian Quarterly Journal of Hospital Medicine ...
Falzon, Louise; Davidson, Karina W.; Bruns, Daniel
There is an increased awareness of evidence-based methodology among psychologists, but little exists in the literature about how to access the research. Moreover, the prohibitive cost of this information combined with limited time are barriers to the identification of evidence to answer clinical questions. This article presents an example of a question worked though in an evidence-based way. Methods are highlighted, including distinguishing background and foreground questions, breaking down q...
Full Text Available Hale Zerrin Toklu Department of Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive “medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.” Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs. Keywords: pharmacist, rational use of medicine, pharmacotherapy, pharmaceutical, outcome
R.A. Bal (Roland)
textabstractThe call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more
Laville, Martine; Segrestin, Berenice; Alligier, Maud
BACKGROUND: Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities...... as patient-centred outcomes may occur decennia into the future. The methodologies and regulations for drug trials are, however, applicable to nutrition trials. CONCLUSIONS: Research on clinical nutrition should start by collecting clinical data systematically in databases and registries. Measurable patient...
Chen, Yu-Chih; Tang, Lee-Chun; Chou, Shin-Shang
Evidence-based practice has been demonstrated to improve quality of care, increase patients' satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice.
Pring, Richard; Thomas, Gary
The book begins with an explication of evidence-based practice. Some of the ideas of its proponents are discussed, including the Campbell Collaboration, and the application to education of Cochrane-style reviews and meta-analyses. The thinking behind evidence-based practice has been the subject of much criticism, particularly in education, and…
Blamey, Katrin; Beauchat, Katherine
Four evidence-based instructional approaches create an essential resource for any early literacy teacher or coach. Improve your teaching practices in all areas of early literacy. Use four proven instructional approaches--standards based, evidenced based, assessment based, and student based--to improve their teaching practice in all areas of early…
Evidence-based practice (EBP) is now the dominant model in health care; its aim is to increase the use of research evidence to inform clinical decision making. Clinical practice guidelines are the predominant method by which research is distilled into practice recommendations. Clinical psychology has its own model which promotes the integration of research evidence with clinical expertise, the scientist practitioner model (SPM). Recent developments within the United Kingdom health service, su...
Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.
The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…
Abdellatif, Hoda; Dechow, Paul C; Jones, Daniel L
In an effort to improve patient care, there has been a growing trend across the nation and the world to embed the principles of evidence-based dentistry into mainstream care delivery by private practicing dentists. Evidence-based dentistry is an essential tool that is used to improve the quality of care and to reduce the gap between what we know, what is possible, and what we do. An evidence-based health care practice is one that includes the decision maker's ability to find, assess, and incorporate high-quality, valid information in diagnosis and treatment. The evidence is considered in conjunction with the clinician's experience and judgment, and the patient's preferences, values, and circumstances. This article introduces the basic skills of evidence-based dentistry. Their practice requires a discipline of lifelong learning in which recent and relevant scientific evidence are translated into practical clinical applications.
Johannsen, Carl Gustav
The article examines problems concerning the introduction and future implementation of evidence-based practice (EBP) in libraries. It includes important conceptual distinctions and definitions, and it reviews the more controversial aspects of EBP, primarely based on experiences from Denmark...
Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin
Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715
Lee, Catherine M; Hunsley, John
Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills.
Lee, Catherine M; Hunsley, John
Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821
Full Text Available The patients with chronic pain are increasingly reporting to the physicians for its management. Chronic pain are associated with head, neck and shoulder pain, spinal pain, pain in the joints and extremities, complex regional pain syndrome and phantom pain. The chronic pain is being managed worldwide. The different specialty of medicine is producing a lot of evidence through the published literature but the same is not being published in the field of chronic pain management. Though some evidence is being reported as to different aspects of pain management from different parts of the world but same is lacking from Indian subcontinent. This is in contrast to much done clinical work in this field as well. We present here the available evidence in relation to chronic pain management.
The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education.
Newhouse, Robin P; Dearholt, Sandi; Poe, Stephanie; Pugh, Linda C; White, Kathleen M
Evidence-based practice, a crucial competency for healthcare providers and a basic force in Magnet hospitals, results in better patient outcomes. The authors describe the strategic approach to support the maturation of The Johns Hopkins Nursing evidence-based practice model through providing leadership, setting expectations, establishing structure, building skills, and allocating human and material resources as well as incorporating the model and tools into undergraduate and graduate education at the affiliated university.
Wampold, Bruce E.; Goodheart, Carol D.; Levant, Ronald F.
Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in…
Park, Alayna L.; Chorpita, Bruce F.; Regan, Jennifer; Weisz, John R
This study examined patterns of evidence-based treatment (EBT) implementation within community settings by evaluating integrity along separate dimensions of practice content (PC; a session included the prescribed procedure) and practice sequencing (a session occurred in the prescribed sequence) within a recent randomized effectiveness trial. We measured whether sessions showed integrity to PC and to flexible or linear practice sequences. Findings revealed that providers tended to incorporate ...
Full Text Available Global acknowledgement of ecological restoration, as an important tool to complement conservation efforts, requires an effort to increase the effectiveness of restoration interventions. Evidence-based practice is purported to promote effectiveness. A central tenet of this approach is decision making that is based on evidence, not intuition. Evidence can be generated experimentally and in practice but needs to be linked to baseline information collection, clear goals and monitoring of impact. In this paper, we report on a survey conducted to assess practitioners’ perceptions of the evidence generated in restoration practice in South Africa, as well as challenges encountered in building this evidence base. Contrary to a recent assessment of this evidence base which found weaknesses, respondents viewed it as adequate and cited few obstacles to its development. Obstacles cited were mostly associated with planning and resource availability. We suggest that the disparity between practitioners’ perceptions and observed weaknesses in the evidence base could be a challenge in advancing evidence-based restoration. We explore opportunities to overcome this disparity as well as the obstacles listed by practitioners. These opportunities involve a shift from practitioners as users of scientific knowledge and evidence, to practitioners involved in the co-production of evidence needed to increase the effectiveness of restoration interventions.
Määttä, Sylvia; Wallmyr, Gudrun
The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.
Examines to what extent the skills and techniques of evidence-based practice are transferable to the areas of professional practice of librarians and information professionals? Is it desirable for information professionals to integrate research findings into their day-to-day decision making?
Cook, Bryan G.; Tankersley, Melody; Landrum, Timothy J.
Determining evidence-based practices is a complicated enterprise that requires analyzing the methodological quality and magnitude of the available research supporting specific practices. This article reviews criteria and procedures for identifying what works in the fields of clinical psychology, school psychology, and general education; and it…
Bates, Joanne; McClure, Janelle; Spinks, Andy
Evidence-based practice is the collection, interpretation, and use of data, such as collection statistics or assessment results, that measure the effectiveness of a library media program. In this article, the authors will present various forms of evidence and show that any library media specialist can use data to make informed decisions that…
Evidence-based medicine (EBM) is a rapidly expanding subject. The aim of this editorial is to give an overview and address some of the practical issues relevant to the developing world. EBM may be defined as the conscientious, explicit and judicious use of current best evidence in making decisions about the care of ...
Full Text Available . In this paper, we report on a survey conducted to assess practitioners’ perceptions of the evidence generated in restoration practice in South Africa, as well as challenges encountered in building this evidence base. Contrary to a recent assessment...
Mackey, April; Bassendowski, Sandra
Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.
Nguyen, Thi Ngoc Minh; Wilson, Anne
Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association. © 2016 John Wiley & Sons Australia, Ltd.
Vratny, Amy; Shriver, Deb
Nursing administration at a small medical center is developing and implementing an evidence-based practice (EBP) model of care to support a culture of quality care, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth. The purpose of this article is to describe a conceptual model for EBP that addresses how to overcome barriers to implementation. Clinician expertise and values, experience, patient preference and expectation, and caring become grounded in a practice environment that must strive to become rooted in clinical research to evolve into a practice that is evidence-based. Education helps to nourish EBP, but leadership, enthusiasm, mentorship, clinical inquiry, and reflective practice make EBP thrive. The EBP ambassadors branch out to each department to grow journal clubs, EBP Web pages, EBP projects, research utilization projects, and staff-led practice reviews. The fruits are quality patient care and outcomes, clinical excellence, cost-effectiveness, critical thinking, empowerment of staff, and professional growth.
Kessel, Line; Erngaard, Ditte; Flesner, Per
In 2013, the Danish Health and Medicines Authorities published a National Clinical Guideline on the treatment of age-related cataracts. The guideline provided evidence-based recommendations on the indication for cataract surgery, cataract surgery in patients with age-related macular degeneration...... medicine. Thus, evidence-based guidelines do change practice patterns unless they are counteracted by the reimbursement system....... likely to prescribe non-steroidal anti-inflammatory eye drops and to not prescribe topical antibiotic eye drops after the guideline was published. Other parameters, most notably the use of toric IOLs and use of postoperative examinations were more guided by reimbursement standards than by evidence-based...
Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh
The major difference between Iranian traditional medicine and allopathic medicine is in the application of evidence and documents. In this study, criteria for evidence-based practice in Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.
Rousseau, Denise M; Gunia, Brian C
Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.
Ollendick, Thomas H.
Evidence-based practice has a long history; however attempts to bridge the gap between science and practice have been only partially effective and much work remains to be done. Part of the problem has been the unilateral approach associated with dissemination of research findings to clinical practitioners. In this special series, Goldfried and colleagues suggest a two-way bridge, in which practitioners are afforded the opportunity to disseminate their rich clinical experiences to researchers ...
Kennedy, Margaret Ann
Evidence-based practice in nursing is considered foundational to safe, competent care. To date, rigid traditional perceptions of what constitutes 'evidence' have constrained the recognition and use of practice-based evidence and the exploitation of novel forms of evidence from data rich environments. Advancements such as the conceptualization of clinical intelligence, the prevalence of increasingly sophisticated digital health information systems, and the advancement of the Big Data phenomenon have converged to generate a new contemporary context. In today's dynamic data-rich environments, clinicians have new sources of valid evidence, and need a new paradigm supporting clinical practice that is adaptive to information generated by diverse electronic sources. This opinion paper presents adaptive practice as the next generation of evidence-based practice in contemporary evidence-rich environments and provides recommendations for the next phase of evolution.
Oct 13, 2014 ... Thus, as important as the practice of nursing that is based on evidence could be, there are however contending issues that should be addressed for success to be achieved. As a fairly new concept, Stetler, Brunnel,. Giuliano, Morsi, Prince and Newell-Stokes (2008) asserted that its meaning is not always ...
Concept and practice of evidence-based psychiatry and its application in Nigerian psychiatry: a critical review. PO Onifade, LO Oluwole. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 15(1) 2006: 16-19. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry
Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.
Schaffner, Angela D.; Buchanan, Linda Paulk
This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…
Morrow, Michael T.; Lee, Hsin-Hua; Bartoli, Eleonora; Gillem, Angela R.
Evidence-based practice (EBP) is a core priority in counselor education. This paper details one United States' counselor education program's self-assessment of its EBP curriculum. Faculty members collaborated to identify challenges and generate solutions to strengthen the EBP emphasis within the program. This paper is intended as a resource for…
While research is needed and necessary, promoting the value of evidence-based practice (EBP), quality improvement (QI) and project evaluation (PE) initiatives could rapidly and economically further the development of nursing and midwifery disciplines globally, perhaps especially in resource constrained settings.
Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.
Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…
Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin
For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.
Regional Resource Center Program, 2014
One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…
Saunders, Hannele; Vehviläinen-Julkunen, Katri
Although systematic implementation of evidence-based practice (EBP) is essential to effectively improve patient outcomes, quality, and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' readiness for EBP, including nurses' EBP beliefs and lack of EBP mentors. Favorable EBP beliefs are foundational to Registered Nurses' (RNs) use and integration of best evidence into clinical decision making, whereas EBP mentors are in a key role for strengthening RNs' beliefs in the value of EBP and confidence in their ability to implement EBP. Although nurses' EBP beliefs and role of BP mentors have been widely studied in countries leading the EBP movement, less is known about them in the non-English-speaking world. To determine RNs EBP beliefs and the role of EBP mentors at Finnish university hospitals and to explore the associations between RNs' EBP beliefs and sociodemographic factors. A cross-sectional descriptive survey was conducted in November-December 2014 at every university hospital in Finland with a convenience sample (n = 943) of practicing RNs. The data were collected via an electronic survey, and analyzed using descriptive and inferential statistics. RNs reported low levels of EBP beliefs in the degree to which they believed that clinical nursing practice and their own practice were based on evidence. EBP mentors worked in many professional nursing roles. Several significant differences were found between RN's EBP beliefs and sociodemographic variables. Although RNs were familiar with and believed in the value of EBP in improving care quality and patient outcomes, their ratings were low about the degree to which they believed that clinical nursing practice and their own practice were based on evidence, indicating a modest level of individual EBP readiness among Finnish RNs required for integrating best evidence into clinical care delivery. © 2016 Sigma Theta Tau International.
Klem, Mary L; Weiss, Patricia M
The implementation of evidence-based practice (EBP) requires acquisition and use of a complex set of skills, including the ability to locate and critically evaluate clinically relevant research literature. In this article, we discuss information resources and tools that may be of value to educators faced with the task of teaching students to search for and evaluate research-based evidence. In addition, we discuss how health sciences librarians, with the use of new models of information instruction and delivery, can work with nursing faculty in developing curricula for training students in EBP.
Fernanda Carolina Camargo
Full Text Available Abstract Objective: To analyze the apprehensions of nurse managers in the implementation of the Evidence Based Practice in a Teaching Hospital of Triângulo Mineiro. Method: Qualitative research guided by the Theory of the Diffusion of Innovations. Five workshops were conducted per focal group (n = 18 participants, conducted by hermeneutic-dialectic interactions between August and September/2016. Textual records resulting from each workshop were analyzed by semantic categories. Results: Aspects conditioning to the implementation of the Evidence Based Practice permeate from elements related to the fragmentation of the care network to the necessary expansion of the governability of the nurse managers to put changes into practice in their sectors. Most importantly, timely access to the results of research conducted at the teaching hospital was mentioned as crucial to guide better practices. Final considerations: The approach allowed the recognition of contextual conditions for the implementation of the Evidence-Based Practice, which may coincide with similar scenarios, as well as increase the national scientific production on the subject, which is still scarce.
Sweeney, Jane K; Heriza, Carolyn B; Blanchard, Yvette; Dusing, Stacey C
(1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations. Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified. Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.
Schaffer, Marjorie A; Sandau, Kristin E; Diedrick, Lee
To provide an overview, summary of key features and evaluation of usefulness of six evidence-based practice models frequently discussed in the literature. The variety of evidence-based practice models and frameworks, complex terminology and organizational culture challenges nurses in selecting the model that best fits their practice setting. The authors: (1) initially identified models described in a predominant nursing text; (2) searched the literature through CINAHL from 1998 to current year, using combinations of 'evidence', 'evidence-based practice', 'models', 'nursing' and 'research'; (3) refined the list of selected models based on the initial literature review; and (4) conducted a second search of the literature on the selected models for all available years to locate both historical and recent articles on their use in nursing practice. Authors described model key features and provided an evaluation of model usefulness based on specific criteria, which focused on facilitating the evidence-based practice process and guiding practice change. The evaluation of model usefulness can be used to determine the best fit of the models to the practice setting. The Johns Hopkins Model and the Academic Center for Evidence-Based Practice Star Model emphasize the processes of finding and evaluating evidence that is likely to appeal to nursing educators. Organizations may prefer the Promoting Action on Research Implementation in Health Services Framework, Advancing Research and Clinical Practice Through Close Collaboration, or Iowa models for their emphasis on team decision-making. An evidence-based practice model that is clear to the clinician and fits the organization will guide a systematic approach to evidence review and practice change. © 2012 Blackwell Publishing Ltd.
Bishop, SueZanne Monique
Little research exists linking interview-appropriate attire to improved employment outcomes for women. Thus, it appears that the professional clothing bank has not been investigated as evidence-based practice. To provide preliminary evidence for clothing banks, in this article the author synthesizes findings from existing research on the provision of a professional clothing bank as a means for offering interview-appropriate attire to poor women in job readiness programming. For context, job readiness programs are explored and a case study of one program operating a professional clothing bank is presented. Finally, preliminary considerations for planning and implementing clothing banks based on this literature review are given.
Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro
To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.
Wolf, Fredric M.
Presents statistics of deaths caused by medical errors and argues the effects of misconceptions in diagnosis and treatment. Suggests evidence-based medicine to enhance the quality of practice and minimize error rates. Presents 10 evidence-based lessons and discusses the possible benefits of evidence-based medicine to evidence-based education and…
Byiers, Breanne J; Reichle, Joe; Symons, Frank J
Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. The authors discuss the requirements of each design, followed by advantages and disadvantages. The logic and methods for evaluating effects in SSED are reviewed as well as contemporary issues regarding data analysis with SSED data sets. Examples of challenges in executing SSEDs are included. Specific exemplars of how SSEDs have been used in speech-language pathology research are provided throughout. SSED studies provide a flexible alternative to traditional group designs in the development and identification of evidence-based practice in the field of communication sciences and disorders.
I respond to Kamhi's (2011) conclusion in his article "Balancing Certainty and Uncertainty in Clinical Practice" that rational or critical thinking is an essential complement to evidence-based practice (EBP). I expand on Kamhi's conclusion and briefly describe what clinicians might need to know to think critically within an EBP profession. Specifically, I suggest how critical thinking is relevant to EBP, broadly summarize the relevant skills, indicate the importance of thinking dispositions, and outline the various ways our thinking can go wrong. I finish the commentary by suggesting that critical thinking skills should be considered a required outcome of our professional training programs.
Satterfield, Jason M; Spring, Bonnie; Brownson, Ross C; Mullen, Edward J; Newhouse, Robin P; Walker, Barbara B; Whitlock, Evelyn P
Context This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed. PMID:19523122
Full Text Available Background: The purpose of this discussion is to explore the theory, evidence base, and practice of Qigong for individuals with cancer. Questions addressed are: What is qigong? How does it work? What evidence exists supporting its practice in integrative oncology? What barriers to wide-spread programming access exist? Methods: Sources for this discussion include a review of scholarly texts, the Internet, PubMed, field observations, and expert opinion. Results: Qigong is a gentle, mind/body exercise integral within Chinese medicine. Theoretical foundations include Chinese medicine energy theory, psychoneuroimmunology, the relaxation response, the meditation effect, and epigenetics. Research supports positive effects on quality of life (QOL, fatigue, immune function and cortisol levels, and cognition for individuals with cancer. There is indirect, scientific evidence suggesting that qigong practice may positively influence cancer prevention and survival. No one Qigong exercise regimen has been established as superior. Effective protocols do have common elements: slow mindful exercise, easy to learn, breath regulation, meditation, emphasis on relaxation, and energy cultivation including mental intent and self-massage. Conclusions: Regular practice of Qigong exercise therapy has the potential to improve cancer-related QOL and is indirectly linked to cancer prevention and survival. Wide-spread access to quality Qigong in cancer care programming may be challenged by the availability of existing programming and work force capacity.
Aarons, Gregory A; Cafri, Guy; Lugo, Lindsay; Sawitzky, Angelina
Mental health and social service provider attitudes toward evidence-based practice have been measured through the development and validation of the Evidence-Based Practice Attitude Scale (EBPAS; Aarons, Ment Health Serv Res 6(2):61-74, 2004). Scores on the EBPAS scales are related to provider demographic characteristics, organizational characteristics, and leadership. However, the EBPAS assesses only four domains of attitudes toward EBP. The current study expands and further identifies additional domains of attitudes towards evidence-based practice. A qualitative and quantitative mixed-methods approach was used to: (1) generate items from multiples sources (researcher, mental health program manager, clinician/therapist), (2) identify potential content domains, and (3) examine the preliminary domains and factor structure through exploratory factor analysis. Participants for item generation included the investigative team, a group of mental health program managers (n = 6), and a group of clinicians/therapists (n = 8). For quantitative analyses a sample of 422 mental health service providers from 65 outpatient programs in San Diego County completed a survey that included the new items. Eight new EBPAS factors comprised of 35 items were identified. Factor loadings were moderate to large and internal consistency reliabilities were fair to excellent. We found that the convergence of these factors with the four previously identified evidence-based practice attitude factors (15 items) was small to moderate suggesting that the newly identified factors represent distinct dimensions of mental health and social service provider attitudes toward adopting EBP. Combining the original 15 items with the 35 new items comprises the EBPAS 50-item version (EBPAS-50) that adds to our understanding of provider attitudes toward adopting EBPs. Directions for future research are discussed.
Ollendick, Thomas H
Evidence-based practice has a long history; however, attempts to bridge the gap between science and practice have been only partially effective and much work remains to be done. Part of the problem has been the unilateral approach associated with dissemination of research findings to clinical practitioners. In this special series, Goldfried and colleagues (2014--this issue) suggest a two-way bridge, in which practitioners are afforded the opportunity to disseminate their rich clinical experiences to researchers as well. In this manner, a more collaborative working relationship is espoused. Surveys of practitioners on the use of CBT procedures in the treatment of panic disorder, social anxiety disorder, and generalized anxiety disorder are described. The findings are reviewed and limitations associated with the surveys are noted. Finally, future directions are suggested for rapprochement, hopefully resulting in a greater synthesis of research and practice. © 2013.
Bilder, Robert M.
Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift towards evidence-based science and practice can be enabled by innovations, including: (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress towards these goals. PMID:21092355
Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli
Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a
Research is a fundamental tool for GPs' clinical practice. Independent research should be the answer to important questions on population needs not yet answered. To have a democratic approach, the results of the studies should be available not only to GPs but also to patients participating to the research. Research has also a formative value for investigators: a process of learning by doing. Risk and Prevention Study is a model of the 'Italian experience' in doing research in primary health care. To describe the collaboration between Centro Studi e Richerche in Medicina Generale and Mario Negri Institute in producing observational and experimental research in the setting of family medicine such the Risk and Prevention Study. Risk and Prevention Study has two main aims and two different methods: the first, to establish the effectiveness of an intensive recommended treatment and lifestyle advice in cardiovascular (CV) prevention is an observational design. The second, the efficacy of n-3 polyunsaturated fatty acid in patients with CV risk is a randomized controlled trial design. The Risk and Prevention trial has enrolled up until now 860 Italian GPs and over 12 500 high CV risk patients that will be followed during 5 years. They will visit their GP at least once a year. The first year of follow-up of the study has been completed. Relatively few patients (2.5%) have withdrawn. The treatment was well tolerated. Enrolment of large number of GPs in research appears feasible when an independent design with clear benefit for the patient's needs is offered.
Leboeuf-Yde, Charlotte; Lanlo, Olivier; Walker, Bruce F
All clinicians of today know that scientific evidence is the base on which clinical practice should rest. However, this is not always easy, in particular in those disciplines, where the evidence is scarce. Although the last decades have brought an impressive production of research that is of inte...
Crumley, Ellen; Koufogiannakis, Denise
Evidence-based librarianship (EBL) is a relatively new concept for librarians. This paper lays out a practical framework for the implementation of EBL. A new way of thinking about research in librarianship is introduced using the well-built question process and the assignment of librarian research questions to one of six domains specific to librarianship. As a profession, librarianship tends to reflect more qualitative, social sciences/humanities in its research methods and study types which tend to be less rigorous and more prone to bias. Randomised controlled trials (RCT) do not have to be placed at the top of an evidence 'hierarchy' for librarianship. Instead, a more encompassing model reflecting librarianship as a whole and the kind of research likely to be done by librarians is proposed. 'Evidence' from a number of disciplines including health sciences, business and education can be utilized by librarians and applied to their practice. However, access to and availability of librarianship literature needs to be further studied. While using other disciplines (e.g. EBHC) as a model for EBL has been explored in the literature, the authors develop models unique to librarianship. While research has always been a minor focus in the profession, moving research into practice is becoming more important and librarians need to consider the issues surrounding research in order to move EBL forward.
Lawson, Jennifer; Berrick, Jill Duerr
In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.
Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z
It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Shreeve, Michael W.
Evidence-based practice has emerged as a driving factor in current curriculum development in chiropractic education. This commentary discusses educational strategies incorporating evidence-based practices in the doctor of chiropractic curriculum and explores whether all five steps of the evidence-based process and patient outcomes from evidence-based practice are being assessed.
The authoritarian standpoint in medicine has been under challenge by various groups and researchers since the 1980s. The challenges have been ethical, political and medical, with patient movements at the forefront. Over the past decade, however, a deep challenge has been posed by evidence-based...... medicine (EBM), which has challenged the entire strategy of medical treatment from the point of view of a self-critical, anti-authoritarian and hereby also (it has been claimed) a more democratic medical practice. Previously, the challenges arose out of the patient rights perspective. EBM, by contrast...
Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb
The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.
As evidence-based practice sweeps the applied health professions, it is a good time to evaluate the generation of knowledge in Kinesiology and its transmission to professionals and the public. Knowledge transmission has been debated in the past from the perspectives of the theory-to-practice gap and the discipline versus profession emphasis.…
Slocum, Timothy A; Detrich, Ronnie; Wilczynski, Susan M; Spencer, Trina D; Lewis, Teri; Wolfe, Katie
Evidence-based practice (EBP) is a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients. This framework provides behavior analysts with a structure for pervasive use of the best available evidence in the complex settings in which they work. This structure recognizes the need for clear and explicit understanding of the strength of evidence supporting intervention options, the important contextual factors including client values that contribute to decision making, and the key role of clinical expertise in the conceptualization, intervention, and evaluation of cases. Opening the discussion of EBP in this journal, Smith (The Behavior Analyst, 36, 7-33, 2013) raised several key issues related to EBP and applied behavior analysis (ABA). The purpose of this paper is to respond to Smith's arguments and extend the discussion of the relevant issues. Although we support many of Smith's (The Behavior Analyst, 36, 7-33, 2013) points, we contend that Smith's definition of EBP is significantly narrower than definitions that are used in professions with long histories of EBP and that this narrowness conflicts with the principles that drive applied behavior analytic practice. We offer a definition and framework for EBP that aligns with the foundations of ABA and is consistent with well-established definitions of EBP in medicine, psychology, and other professions. In addition to supporting the systematic use of research evidence in behavior analytic decision making, this definition can promote clear communication about treatment decisions across disciplines and with important outside institutions such as insurance companies and granting agencies.
Visovsky, Constance; Maguire, Denise J; Zambroski, Cheryl; Palacios, Linette
Evidence-based practice (EBP) continues to gain global attention. In the Latin American country of Panama, nursing practice has largely been guided by oral tradition and clinical experience rather than the use of best evidence. The authors used a conference-based approach in a joint effort between the University of South Florida and the University of Panama to introduce EBP to nursing leaders in Panama to bring change to the nursing curricula and, ultimately, change in nursing practice. J Contin Educ Nurs. 2017;48(11):512-516. Copyright 2017, SLACK Incorporated.
McAlister, Finlay A; Graham, Ian; Karr, Gerald W; Laupacis, Andreas
OBJECTIVE To assess the attitudes of practicing general internists toward evidence-based medicine (EBM—defined as the process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions) and their perceived barriers to its use. DESIGN Cross-sectional, self-administered mail questionnaire conducted between June and October 1997. SETTING Canada. PARTICIPANTS Questionnaires were sent to all 521 physician members of the Canadian Society of Internal Medicine with Canadian mailing addresses; 296 (60%) of 495 eligible physicians responded. Exclusion of two incomplete surveys resulted in a final sample size of 294. MAIN RESULTS Mean age of respondents was 46 years, 80% were male, and 52% worked in large urban medical centers. Participants reported using EBM in their clinical practice always (33, 11%), often (173, 59%), sometimes (80, 27%), or rarely/never (8, 3%). There were no significant differences in demographics, training, or practice types or locales on univariate or multivariate analyses between those who reported using EBM often or always and those who did not. Both groups reported high usage of traditional (non-EBM) information sources: clinical experience (93%), review articles (73%), the opinion of colleagues (61%), and textbooks (45%). Only a minority used EBM-related information sources such as primary research studies (45%), clinical practice guidelines (27%), or Cochrane Collaboration Reviews (5%) on a regular basis. Barriers to the use of EBM cited by respondents included lack of relevant evidence (26%), newness of the concept (25%), impracticality for use in day-to-day practice (14%), and negative impact on traditional medical skills and “the art of medicine” (11%). Less than half of respondents were confident in basic skills of EBM such as conducting a literature search (46%) or evaluating the methodology of published studies (34%). However, respondents demonstrated a high level of interest
Singleton, Joanne K
Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.
Aio’s huisartsgeneeskunde hebben adequate kennis ten aanzien van evidence-based medicine (geneeskunde op basis van bewijs). In de huisartspraktijk is evidence-based gedrag vaak niet direct zichtbaar, maar artsen kunnen wel aangeven op welk aspect van evidence-based medicine de voorgeschreven
Buckwalter, Kathleen C; Cullen, Laura; Hanrahan, Kirsten; Kleiber, Charmaine; McCarthy, Ann Marie; Rakel, Barbara; Steelman, Victoria; Tripp-Reimer, Toni; Tucker, Sharon
The Iowa Model is a widely used framework for the implementation of evidence-based practice (EBP). Changes in health care (e.g., emergence of implementation science, emphasis on patient engagement) prompted the re-evaluation, revision, and validation of the model. A systematic multi-step process was used capturing information from the literature and user feedback via an electronic survey and live work groups. The Iowa Model Collaborative critically assessed and synthesized information and recommendations before revising the model. Survey participants (n = 431) had requested access to the Model between years 2001 and 2013. Eighty-eight percent (n = 379) of participants reported using the Iowa Model and identified the most problematic steps as: topic priority, critique, pilot, and institute change. Users provided 587 comments with rich contextual rationale and insightful suggestions. The revised model was then evaluated by participants (n = 299) of the 22nd National EBP Conference in 2015. They validated the model as a practical tool for the EBP process across diverse settings. Specific changes in the model are discussed. This user driven revision differs from other frameworks in that it links practice changes within the system. Major model changes are expansion of piloting, implementation, patient engagement, and sustaining change. The Iowa Model-Revised remains an application-oriented guide for the EBP process. Intended users are point of care clinicians who ask questions and seek a systematic, EBP approach to promote excellence in health care. © 2017 University of Iowa Hospitals and Clinics, Worldviews on Evidence-Based Nursing © 2017 Sigma Theta Tau International.
Thiel, Linda; Ghosh, Yashowanto
As health care systems worldwide move toward instituting evidence-based practice (EBP), its implementation can be challenging. Conducting a baseline assessment to determine nurses' readiness for EBP presents opportunities to plan strategies before implementation. Although a growing body of research literature is focused on implementing EBP, little attention has been paid to assessing nurses' readiness for EBP. The purpose of this study was to assess registered nurses' readiness for EBP in a moderate-sized acute care hospital in the Midwestern United States before implementation of a hospital-wide nursing EBP initiative. A descriptive cross-sectional survey design was used; 121 registered nurses completed the survey. The participants (n= 121) completed the 64-item Nurses' Readiness for Evidence-Based Practice Survey that allowed measurement of information needs, knowledge and skills, culture, and attitudes. Data were analyzed using descriptive statistics and a post hoc analysis. The majority (72.5%) of respondents indicated that when they needed information, they consulted colleagues and peers rather than using journals and books; 24% of nurses surveyed used the health database, Cumulative Index to Nursing & Allied Health Literature (CINAHL). The respondents perceived their EBP knowledge level as moderate. Cultural EBP scores were moderate, with unit scores being higher than organizational scores. The nurses' attitudes toward EBP were positive. The post hoc analysis showed many significant correlations. Nurses have access to technological resources and perceive that they have the ability to engage in basic information gathering but not in higher level evidence gathering. The elements important to EBP such as a workplace culture and positive attitudes are present and can be built upon. A "site-specific" baseline assessment provides direction in planning EBP initiatives. The Nurses' Readiness for EBP Survey is a streamlined tool with established reliability and
Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte
Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present ca...
Powers, Joelle D.; Bowen, Natasha K.; Bowen, Gary L.
In spite of multidisciplinary recommendations to use evidence-based interventions in schools and a growing knowledge base of such practices, most schools are not using empirically supported interventions. On the basis of a careful analysis of barriers to the implementation of the best researched programs, an online, free, and publicly available…
Render, Marta L; Brungs, Suzanne; Kotagal, Uma; Nicholson, Mary; Burns, Patricia; Ellis, Deborah; Clifton, Marla; Fardo, Rosie; Scott, Mark; Hirschhorn, Larry
In 2003, through the Greater Cincinnati Health Council nine health care systems agreed to participate and fund 50% of a two-year project to reduce hospital-acquired infections among patients in intensive care units (ICU) and following surgery (SIP). Hospitals were randomized to either the CR-BSI or SIP project in the first year, adding the alternative project in year 2. Project leaders, often the infection control professionals, implemented evidence-based practices to reduce catheter-related blood stream infections (CR-BSIs; maximal sterile barriers, chlorhexidine) at their hospitals using a collaborative approach. Team leaders entered process information in a secure deidentifled Web-based database. Of the four initial sites randomized to CR-BSI reduction, all reduced central line infections by 50% (CR-BSI, 1.7 to 0.4/1000 line days, p leadership and development of a local community of practice, facilitated cooperation of physicians, problem solving, and success. Use of forcing functions (removal of betadine in kits, creation of an accessory pack and a checklist for line insertion) improved reliability. The appropriate floor for central line infections in ICUs is < 1 infection /1,000 line days.
Chen, Kee-Hsin; Kao, Ching-Chiu; Chen, Chiehfeng
In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.
Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser
Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. Results: According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Conclusion: Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP. PMID:23922597
Reichenpfader, Ursula; Carlfjord, Siw; Nilsen, Per
This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. A systematic review with narrative synthesis was conducted. Relevant electronic bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency, and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention.
Baker, Elise; McLeod, Sharynne
Purpose: This article provides both a tutorial and a clinical example of how speech-language pathologists (SLPs) can conduct evidence-based practice (EBP) when working with children with speech sound disorders (SSDs). It is a companion paper to the narrative review of 134 intervention studies for children who have an SSD (Baker & McLeod, 2011).…
Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara
The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital
Unger, Karen V.
Supported Education is a promising practice that helps people with mental illnesses who are interested in education and training return to school. Current research shows that Supported Education has demonstrated results. While more research is needed, Supported Education services show promise of becoming an evidence-based practice. Education…
Cooper, Stewart E.; Benton, Sherry A.; Benton, Stephen L.; Phillips, Julia C.
This empirically based study sought to discover factors underlying diverse sources of information used to inform therapy practice, perceived salience of sources of evidence for clinical practice, importance of common factors to therapy efficiency, and beliefs about evidence-based practice, particularly in the form of evidence-supported treatments…
Yadav, B L
Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.
Friesen-Storms, J.H.; Bours, G.J.; Weijden, T.T. van der; Beurskens, A.J.
In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be
GJ Bours; T van der Weijden; JH Friesen-Storms; AJ Beurskens
In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be
The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. Conclusion: The development of this guideline was based on the ...
Doran, Diane M; Haynes, R Brian; Kushniruk, André; Straus, Sharon; Grimshaw, Jeremy; Hall, Linda McGillis; Dubrowski, Adam; Di Pietro, Tammie; Newman, Kristine; Almost, Joan; Nguyen, Ha; Carryer, Jennifer; Jedras, Dawn
To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes. The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies. The authors took place over a 12-month period. Diffusion of Innovation theory and the Promoting Action on Research Implementation in Health Services (PARIHS) model guided the selection of variables for study. A longitudinal design involving questionnaires was used to evaluate the impact of the mobile technologies on barriers to research utilization, perceived quality of care, and on nurses' job satisfaction. The setting was 29 acute care, long-term care, home care, and correctional organizations in Ontario, Canada. The sample consisted of 488 frontline-nurses. Nurses most frequently consulted drug and medical reference information, Google, and Nursing PLUS. Overall, nurses were most satisfied with the Registered Nurses Association of Ontario (RNAO) BPGs and rated the RNAO BPGs as the easiest resource to use. Among the PDA and Tablet users, there was a significant improvement in research awareness/values, and in communication of research. There was also, for the PDA users only, a significant improvement over time in perceived quality of care and job satisfaction, but primarily in long-term care settings. It is feasible to provide nurses with access to evidence-based practice resources via mobile information technologies to reduce the barriers to research utilization.
VanDeusen Lukas, Carol; Engle, Ryann L; Holmes, Sally K; Parker, Victoria A; Petzel, Robert A; Nealon Seibert, Marjorie; Shwartz, Michael; Sullivan, Jennifer L
Despite recognition that implementation of evidence-based clinical practices (EBPs) usually depends on the structure and processes of the larger health care organizational context, the dynamics of implementation are not well understood. This project's aim was to deepen that understanding by implementing and evaluating an organizational model hypothesized to strengthen the ability of health care organizations to facilitate EBPs. CONCEPTUAL MODEL: The model posits that implementation of EBPs will be enhanced through the presence of three interacting components: active leadership commitment to quality, robust clinical process redesign incorporating EBPs into routine operations, and use of management structures and processes to support and align redesign. In a mixed-methods longitudinal comparative case study design, seven medical centers in one network in the Department of Veterans Affairs participated in an intervention to implement the organizational model over 3 years. The network was selected randomly from three interested in using the model. The target EBP was hand-hygiene compliance. Measures included ratings of implementation fidelity, observed hand-hygiene compliance, and factors affecting model implementation drawn from interviews. Analyses support the hypothesis that greater fidelity to the organizational model was associated with higher compliance with hand-hygiene guidelines. High-fidelity sites showed larger effect sizes for improvement in hand-hygiene compliance than lower-fidelity sites. Adherence to the organizational model was in turn affected by factors in three categories: urgency to improve, organizational environment, and improvement climate. Implementation of EBPs, particularly those that cut across multiple processes of care, is a complex process with many possibilities for failure. The results provide the basis for a refined understanding of relationships among components of the organizational model and factors in the organizational context
Miwa, Hiroto; Kusano, Motoyasu; Arisawa, Tomiyasu; Oshima, Tadayuki; Kato, Mototsugu; Joh, Takashi; Suzuki, Hidekazu; Tominaga, Kazunari; Nakada, Koji; Nagahara, Akihito; Futagami, Seiji; Manabe, Noriaki; Inui, Akio; Haruma, Ken; Higuchi, Kazuhide; Yakabi, Koji; Hongo, Michio; Uemura, Naomi; Kinoshita, Yoshikazu; Sugano, Kentaro; Shimosegawa, Tooru
General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the world's first country to list "functional dyspepsia" as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment.
Evidence-Based Nursing (EBN) permits the highest quality of care in meeting the multifaceted needs of clients using the best available evidence from research findings, expert ideas from specialists in the various health care sectors and feedback from clients. However, in many instances, various challenges need to be ...
Hetrick, Sarah E; Parker, Alexandra G; Callahan, Patrick; Purcell, Rosemary
Within the field of evidence-based practice, a process termed 'evidence mapping' is emerging as a less exhaustive yet systematic and replicable methodology that allows an understanding of the extent and distribution of evidence in a broad clinical area, highlighting both what is known and where gaps in evidence exist. This article describes the general principles of mapping methodology by using illustrations derived from our experience conducting an evidence map of interventions for youth mental-health disorders. Evidence maps are based on an explicit research question relating to the field of enquiry, which may vary in depth, but should be informed by end-users. The research question then drives the search for, and collection of, appropriate studies utilizing explicit and reproducible methods at each stage. This includes clear definition of components of the research question, development of a thorough and reproducible search strategy, development of explicit inclusion and exclusion criteria, and transparent decisions about the level of information to be obtained from each study. Evidence mapping is emerging as a rigorous methodology for gathering and disseminating up-to-date information to end-users. Thoughtful planning and assessment of available resources (e.g. staff, time, budget) are required by those applying this methodology to their particular field of clinical enquiry given the potential scope of the work. The needs of the end-user need to be balanced with available resources. Information derived needs to be effectively communicated, with the uptake of that evidence into clinical practice the ultimate aim. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Evidence-based practice (EBP) first appeared on the healthcare horizon just over a decade ago. In 2003 its presence has intensified and extended beyond its initial relation to medicine embracing as it does now, nursing and the allied health disciplines. In this paper, I contend that its appearance and subsequent growth and development are the effects of potent "regimes of truth", four of which bear the names: positivism, empiricism, pragmatism and economic rationalism. My aim is to show how EBP generates the controversy it does because its nature and methods are inextricably interwoven with the way it has become politicised and professionalised. This exegesis is an attempt to outline how the combined effects of the four forms of rationality mentioned above allow for both the methods and objectives of EBP to be constructed as they are, while at the same moment producing the particular effects of knowledge and power in terms of who sells and who buys the idea of EBP in the culture of contemporary healthcare.
Oude Rengerink, K
This thesis presents a number of research projects centred on ‘evidence-based medicine’. It consists of two parts. Part 1 focuses on improving recruitment of the necessary number of patients in clinical trials, as this is the major problem while evaluating the effectiveness of interventions in health care. To improve our understanding of patient recruitment we tried to identify obstacles and facilitators for successful recruitment. Part 2 focuses on improving integration of evidence-based dec...
de Ruijter, D.; Smit, E.S.; de Vries, H.; Hoving, C.
Background: Practice nurses in general practice sub-optimally adhere to evidence-based smoking cessation treatment guidelines, but factors explaining their adherence have not yet been investigated. Understanding such factors is important to develop interventions improving practice nurses' smoking
Kaper, N.M.; Swennen, M.H.J.; van Wijk, A.J.; Kalkman, C.J.; van Rheenen, N.; van der Graaf, Y.; van der Heijden, G.J.M.G.
Objectives To design and validate a practical questionnaire for clinicians, to identify barriers and facilitators for evidence-based practice (EBP), that is, the use of research evidence in patient care. The inventory is ultimately intended for departments to assess local conditions for EBP, to aim
Kaper, Nina M; Swennen, Maartje H J; van Wijk, Arjen J; Kalkman, Cor J|info:eu-repo/dai/nl/078251818; van Rheenen, Nanda; van der Graaf, Yolanda|info:eu-repo/dai/nl/072825847; van der Heijden, Geert J M G
OBJECTIVES: To design and validate a practical questionnaire for clinicians, to identify barriers and facilitators for evidence-based practice (EBP), that is, the use of research evidence in patient care. The inventory is ultimately intended for departments to assess local conditions for EBP, to aim
Ketterlin-Geller, Leanne R.; Yovanoff, Paul; Jung, EunJu; Liu, Kimy; Geller, Josh
In this article, we highlight the need for a precisely defined construct in score-based validation and discuss the contribution of cognitive theories to accurately and comprehensively defining the construct. We propose a framework for integrating cognitively based theoretical and empirical evidence to specify and evaluate the construct. We apply…
Diedrick, Lee A; Schaffer, Marjorie A; Sandau, Kristin E
The purpose of this study was to determine if a consistent communication strategy for implementation of evidence-based practice (EBP), developed with input from staff nurses, improved staff nurse satisfaction with communication of practice changes. Integration of EBP knowledge into clinical practice supports optimal nursing care. Awareness of a practice change and the ability to reference the information may be problematic. A quasi-experimental single group before-after design was used to survey all RNs of a level III neonatal ICU for satisfaction before and after implementation of the EBP communication strategy. Registered nurse satisfaction improved regarding the amount of communication (P strategy can improve nurse satisfaction with communication of EBP changes. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ruzafa-Martínez, María; Molina-Salas, Yolanda; Ramos-Morcillo, Antonio Jesús
Evidence-based practice (EBP) learning has become a key issue for nurses. An EPB subject was included in the 4(th) year in the new syllabus of the Nursing Degree at University of Murcia (UM). To know the competence level in EBP of undergraduate nursing students at UM and compare the results between all four years. Observational descriptive study with a cross-sectional approach. undergraduate nursing students from all four years at Nursing Degree at the Faculty of Social and Healthcare Science at UM in the year 2013-14. EBP evaluation of competence of the nursing students consisted of attitude, skills and knowledge on EBP. A validated questionnaire, the EBP-COQ, was used. The scale range is 1 point «lowest level» to 5 points «higher level».The SPSS 21.0 program has been used to carry out descriptive and bivariate analyses. 144 students were included, 76.4% was female, and the median age was 23 years, 84.7% attended more than 75% class hours. The mean differences in the questionnaire between first and fourth years were 0.58 points in attitude, 0.60 in skills, 1.6 in knowledge and 0.83 in global competence in EBP. Significant differences in mean scores between the fourth and the remaining years in the global competence in EBP were observed, as well as in the three dimensions (p <0.05). The undergraduate-nursing students studied here have acquired an appropriate competence level in EBP, with a gradual increase by year. The biggest increase was in the fourth year students. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Hoagwood, Kimberly; Johnson, Jacqueline
Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…
Martin, Sharon D.
Evidence-based practice is highly valued in health care literature at this time. But research suggests that U.S. RNs face many obstacles when implementing evidence-based practice including a lack of value for research in practice (Pravikoff et al, 2005). Additional obstacles may exist for traditional U.S. BSN nursing students who may not value the…
Sowter, Julie; Cortis, Joseph; Clarke, David J
Although the use of portfolios is widespread within healthcare education, agreement on their purpose, content, assessment and value is still debated. The objective of this study was to achieve consensus on quality criteria for clinical practice portfolios that would act as guidance for students and lecturers. A Delphi survey was undertaken to seek consensus on the opinions of 23 'expert participants' through a series of rounds of structured questionnaires. The Delphi tool was produced as an on-line survey questionnaire and panel experts were invited to score statements using a discrete 7 point visual analogue scale. The statements were written as quality criteria relating to portfolio development which had been identified from the literature and by the research team. The survey employed three rounds of feedback and consensus was measured as 80% agreement for each quality criteria scoring 5 and above. Consensus was reached on 31 quality criteria which were categorised into 4 areas: structured collection of labelled evidence; nature of evidence; critical reflection; and assessment and judgement. Mean scores for the final wording of the quality criteria ranged from 5.3 to 6.8 with the standard deviation for all of the mean scores being below 1.5. There was consensus that these quality criteria were relevant to health and social care professionals involved in developing clinical practice portfolios. The Delphi process facilitated exchange of ideas amongst panel 'experts' about the content and evaluation of clinical practice portfolios, with most debate relating to judgement of competence and rewarding originality and creativity. These issues illustrate the tensions between educational values and professional constraints. The Delphi process proved to be an effective method for achieving consensus on quality criteria for clinical practice portfolios and enabled the development of validated guidelines. Copyright Â© 2011 Elsevier Ltd. All rights reserved.
Objectives: The aim of this cross-sectional study was to determine the awareness and attitude of hospital resident doctors towards evidence-based medicine (EBM) and their related educational needs. Methods: A cross-sectional descriptive study was performed on a randomly selected sample of 141 hospital resident ...
Oude Rengerink, K.
This thesis presents a number of research projects centred on ‘evidence-based medicine’. It consists of two parts. Part 1 focuses on improving recruitment of the necessary number of patients in clinical trials, as this is the major problem while evaluating the effectiveness of interventions in
Sarker, Abeed; Mollá, Diego; Paris, Cecile
Evidence-based medicine practice requires medical practitioners to rely on the best available evidence, in addition to their expertise, when making clinical decisions. The medical domain boasts a large amount of published medical research data, indexed in various medical databases such as MEDLINE. As the size of this data grows, practitioners increasingly face the problem of information overload, and past research has established the time-associated obstacles faced by evidence-based medicine practitioners. In this paper, we focus on the problem of automatic text summarisation to help practitioners quickly find query-focused information from relevant documents. We utilise an annotated corpus that is specialised for the task of evidence-based summarisation of text. In contrast to past summarisation approaches, which mostly rely on surface level features to identify salient pieces of texts that form the summaries, our approach focuses on the use of corpus-based statistics, and domain-specific lexical knowledge for the identification of summary contents. We also apply a target-sentence-specific summarisation technique that reduces the problem of underfitting that persists in generic summarisation models. In automatic evaluations run over a large number of annotated summaries, our extractive summarisation technique statistically outperforms various baseline and benchmark summarisation models with a percentile rank of 96.8%. A manual evaluation shows that our extractive summarisation approach is capable of selecting content with high recall and precision, and may thus be used to generate bottom-line answers to practitioners' queries. Our research shows that the incorporation of specialised data and domain-specific knowledge can significantly improve text summarisation performance in the medical domain. Due to the vast amounts of medical text available, and the high growth of this form of data, we suspect that such summarisation techniques will address the time
Gary, Jodie C; Hudson, Cindy E
This article describes an innovative approach to introducing RN-to-BSN students to nursing research and evidence-based practice (EBP). Reverse engineering updates an existing EBP project to better emphasize the role of research and evidence to practicing RNs enrolled in an RN-to-BSN program. Reverse engineering of a nursing practice guideline offers a method for teaching an appreciation of research and supporting nursing practice with best evidence.
Visser, Claire; Hadley, Gina; Wee, Bee
There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard’ randomised controlled trials (RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves cons...
van Twillert, S.; Geertzen, J.; Hemminga, T.; Postema, K.; Lettinga, A.
Background: A divide is experienced between producers and users of evidence in prosthetic rehabilitation. Objective: To discuss the complexity inherent in establishing evidence-based practice in a prosthetic rehabilitation team illustrated by the case of prosthetic prescription for elderly
Eric Barends; Josh Villanueva; Denise M Rousseau; Rob B Briner; Denise M Jepsen; Edward Houghton; Steven ten Have
Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions...
Krainovich-Miller, Barbara; Haber, Judith; Yost, Jennifer; Jacobs, Susan Kaplan
The TREAD Evidence-Based Practice Model is a framework for faculty to use in graduate research courses so students can become excellent consumers of the best available evidence to use in their clinical decision making in the practice setting. This model is based on competency in information literacy as the basis for developing evidence-based search strategies to find, appraise, and synthesize Level I evidence, including systematic reviews, meta-analyses, and evidence-based practice guidelines. This model emphasizes the use of standardized critical appraisal tools, such as the Critical Appraisal Skills Programme (CASP) or Appraisal of Guidelines for Research and Evaluation (AGREE), to facilitate user-friendly rapid appraisal of Level I evidence. Faculty are challenged to embrace this paradigm shift, to unlearn how they learned, and to teach their graduate research course focusing on the importance of Level I evidence to enable their graduates to make informed advanced practice decisions and improve patient outcomes.
To assess the evidence showing that a specific method of toilet training (TT) is more effective than others, as any method of TT recommended by a physician faces obstacles because parents rarely request advice on TT from physicians, and TT practices vary tremendously across cultures and socioeconomic levels. Reports on the natural course of urinary incontinence in children and different methods of TT, published in English between 1946 and 2012, were reviewed. Specifically investigated were historical recommendations on TT, the prevalence of urinary incontinence during childhood, the outcome of TT methods, and the effect of culture and socioeconomic status on the choice of TT method and timing. TT now occurs at later ages than it did previously. This progression reflects changing ideas about normal childhood physiology and psychology. The prevalence of urinary incontinence in European countries progressively decreased in children aged between 6-7 years and 16-17 years old. TT methods change with increasing socioeconomic levels to 'child-centred' techniques applied at older ages, but the prevalence of urinary incontinence after 'parent-centred' techniques of TT at younger ages has not been studied. There is currently no evidence that a specific timing or method of TT is more effective or prevents voiding dysfunction. Follow-up studies of urinary continence in children toilet trained at 6-12 months of age might provide evidence for whether a given method or timing of TT is beneficial to prevent voiding dysfunction. The recommendations of physicians might be more readily adopted if they fit culturally accepted ideas of good parenting techniques.
Chang, Zhong-Fu; Zhu, Ce; Tao, Dan-Ying; Feng, Xi-Ping; Lu, Hai-Xia
To investigate the knowledge, attitude and practice related to evidence-based dentistry among dental students, and to provide a reference for targeted evidence-based dentistry teaching and practice evidence-based dentistry in dental students. Dental students who attended the internship in Shanghai Ninth People's Hospital and Pudong People's Hospital were invited to attend this survey. Information on knowledge, attitude and practices related evidence-based dentistry was collected through questionnaires. SPSS 21.0 software package was used for data analysis. A total of 62 dental students attended this survey. Evidence-based dentistry related knowledge and attitude scores were 5.5±1.9 and 5.1±1.0, respectively. Over three quarters of students took courses on evidence-based medicine, while around half of students (56.5%) self-reported that they knew little about evidence-based medicine. 70.5% students practiced evidence-based dentistry less than once in the process of clinical decision making per week. The majority of students (80.3%) used MEDLINE or other databases to search for practice-related literature less than once per week. 63.9% students used practice guideline. The top three barriers to practice evidence-based dentistry were lack of information resources, insufficient time and lack of search skills. Evidence-based dentistry related knowledge and practice among dental students is deficient, whereas they hold positive attitude on practice. The top three barriers to practice evidence-based dentistry are lack of information resources, insufficient time and lack of search skills.
Watson, Amy C; Compton, Michael T; Draine, Jeffrey N
As academic researchers, we are often asked to opine on whether the Crisis Intervention Team model (CIT) is an evidence-based practice (EBP) or evidence-based policing. Our answer is that it depends on how you define evidence-based practice and what outcome you are interested in. In this commentary, we briefly describe the CIT model, examine definitions of evidence-based practice and evidence-based policing, and then summarize the existing research on what is known about the effectiveness of CIT to date. We conclude that CIT can be designated an EBP for officer-level cognitive and attitudinal outcomes, but more research is needed to determine if CIT can be designated an EBP for other outcomes. Using an evidence-based practice process approach, CIT may also be a justified strategy for many communities. Future directions to inform the field are discussed. Copyright © 2017 John Wiley & Sons, Ltd.
Jenson, William R.; Clark, Elaine; Kircher, John C.; Kristjansson, Sean D.
Evidence-based practice approaches to interventions has come of age and promises to provide a new standard of excellence for school psychologists. This article describes several definitions of evidence-based practice and the problems associated with traditional statistical analyses that rely on rejection of the null hypothesis for the…
Lubas, Margaret; Mitchell, Jennifer; De Leo, Gianluca
Evidence-based practice related to autism research is a controversial topic. Governmental entities and national agencies are defining evidence-based practice as a specific set of interventions that educators should implement; however, large-scale efforts to generalize autism research, which are often single-subject case designs, may be a setback…
Wendt, Dennis C., Jr.; Slife, Brent D.
In its policy rationale for evidence-based practice in psychology (EBPP), the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) claims to have constituted itself with "scientists and practitioners from a wide range of perspectives and traditions, reflecting the diverse perspectives within the field" (p. 273). We…
Stahmer, Aubyn C.; Rieth, Sarah; Lee, Ember; Reisinger, Erica M.; Mandell, David S.; Connell, James E.
The purpose of this study was to examine the extent to which public school teachers implemented evidence-based interventions for students with autism in the way these practices were designed. Evidence-based practices for students with autism are rarely incorporated into community settings, and little is known about the quality of implementation.…
Evidence based educational policy and practice means, first of all, that new programs use relevant scientific knowledge for design purposes, or for critical review of initial program ideas (ex ante evaluation). Secondly, before programs are implemented on a large scale it is considered desirable to
Visser, Claire; Hadley, Gina; Wee, Bee
There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine (EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by 'gold standard' randomised controlled trials (RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient's physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle (noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a 'mixed methods approach' are likely to pose the correct clinical questions and derive evidence-based yet clinically relevant outcomes.
Aarons, Gregory A
Leadership in organizations is important in shaping workers' perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers' attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers' attitudes toward adopting evidence-based practice. Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers' characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors' leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers' characteristics. Both transformational and transactional leadership were positively associated with providers' having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers' perception of difference between the providers' current practice and evidence-based practice. Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices.
Aarons, Gregory A.
Objective Leadership in organizations is important in shaping workers’ perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers’ attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers’ attitudes toward adopting evidence-based practice. Methods Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers’ characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors’ leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers’ characteristics. Results Both transformational and transactional leadership were positively associated with providers’ having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers’ perception of difference between the providers’ current practice and evidence-based practice. Conclusions Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices. PMID:16870968
Shuman, Clayton J; Xie, Xian-Jin; Herr, Keela A; Titler, Marita G
Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.
Full Text Available This article explores professional discourses in the Norwegian residential child care system. It discusses how the discourses serve as constraints on and possibilities for evidence-based practice when different definitions of evidence-based practice are considered. Among the Nordic countries, Norway has been a forerunner in the implementation of evidence-based practice in child welfare. However, I argue that tensions exist, both within professional practice and between professional understandings and policy aims. I use discourse theory to analyze interviews with 19 professionals working in coercive residential child care. The results reveal two competing professional discourses: the discourse of technoscience and the discourse of indeterminacy. Possibilities of evidence-based practice in residential child care are found within both discourses if a wide and inclusive definition of evidence-based practice is applied. This study emphasizes the importance of engaging in constant reflection when discussing possibilities for evidence-based practice within residential child care. Keywords: professional discourses, residential child care, evidence-based practice, scientific knowledge, professional judgment, indeterminacy, discretion
Netting, F; O'Connor, Mary
The need for using evidence-based macro practices is examined. EBP is viewed as practitioners recognizing client values and then using the most promising research to guide programmatic, organizational, community, and policy activities to facilitate change. There are multiple ways to search for evidence. The nature of evidence in macro practice will look different depending on the practice situation. Being able to assess the situation and recognize the context in which one is practicing will set the stage for how EBP should be defined. A set of questions are suggested to guide decision-making regarding the use and the management of evidence.
Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A
This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.
Foster, Margaret J; Shurtz, Suzanne; Pepper, Catherine
The research determined to what extent best practices are being followed by freely available online modules aimed at teaching critical thinking and evidence-based practices (EBPs) in health sciences fields. In phase I, an evaluation rubric was created after reviewing the literature. Individual rubric questions were assigned point values and grouped into sections, and the sections weighted. Phase II involved searching Internet platforms to locate online EBP modules, which were screened to determine if they met predetermined criteria for inclusion. Phase III comprised a first evaluation, in which two authors assessed each module, followed by a second evaluation of the top-scoring modules by five representatives from different health sciences units. The rubric's 28 questions were categorized into 4 sections: content, design, interactivity, and usability. After retrieving 170 online modules and closely screening 91, 42 were in the first evaluation and 8 modules were in the second evaluation. Modules in the first evaluation earned, on average, 59% of available points; modules in the second earned an average of 68%. Both evaluations had a moderate level of inter-rater reliability. The rubric was effective and reliable in evaluating the modules. Most modules followed best practices for content and usability but not for design and interactivity. By systematically collecting and evaluating instructional modules, the authors found many potentially useful elements for module creation. Also, by reviewing the limitations of the evaluated modules, the authors were able to anticipate and plan ways to overcome potential issues in module design.
Foster, Margaret J.; Shurtz, Suzanne; Pepper, Catherine
Objectives: The research determined to what extent best practices are being followed by freely available online modules aimed at teaching critical thinking and evidence-based practices (EBPs) in health sciences fields. Methods: In phase I, an evaluation rubric was created after reviewing the literature. Individual rubric questions were assigned point values and grouped into sections, and the sections weighted. Phase II involved searching Internet platforms to locate online EBP modules, which were screened to determine if they met predetermined criteria for inclusion. Phase III comprised a first evaluation, in which two authors assessed each module, followed by a second evaluation of the top-scoring modules by five representatives from different health sciences units. Results: The rubric's 28 questions were categorized into 4 sections: content, design, interactivity, and usability. After retrieving 170 online modules and closely screening 91, 42 were in the first evaluation and 8 modules were in the second evaluation. Modules in the first evaluation earned, on average, 59% of available points; modules in the second earned an average of 68%. Both evaluations had a moderate level of inter-rater reliability. Conclusions: The rubric was effective and reliable in evaluating the modules. Most modules followed best practices for content and usability but not for design and interactivity. Implications: By systematically collecting and evaluating instructional modules, the authors found many potentially useful elements for module creation. Also, by reviewing the limitations of the evaluated modules, the authors were able to anticipate and plan ways to overcome potential issues in module design. PMID:24415917
Evidence-based medicine aims to apply the best available evidence gained from the scientific method to medical decision making. It is a practice that uses statistical analysis of scientific methods and outcomes to drive further experimentation and diagnosis. The profusion of evidence-based medicine in medical practice and clinical research has produced a need for life scientists and clinical researchers to assimilate biostatistics into their work to meet efficacy and practical standards. Practical Biostatistics provides researchers, medical professionals, and students with a friendly, practica
Shadish, William R.; Rindskopf, David M.
Good quantitative evidence does not require large, aggregate group designs. The authors describe ground-breaking work in managing the conceptual and practical demands in developing meta-analytic strategies for single subject designs in an effort to add to evidence-based practice. (Contains 2 figures.)
Wentworth, Laura; Mazzeo, Christopher; Connolly, Faith
Background: In the United States, an emphasis on evidence-based decision-making in education has received renewed interest with the recent passage of the Every Student Succeeds Act. However, how best, in practice, to support the use of evidence in educational decision-making remains unclear. Research Practice Partnerships (RPPs) are a popular…
Indonesia is continuously among the top ten countries worldwide in the number of people living with diabetes. Evidence-based practice (EBP) has the potential to improve the effectiveness and efficiency of diabetes care. However, the strategy to efficiently translate the best evidence into practice
André, Beate; Aune, Anne G; Brænd, Jorunn A
Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.
Doran, Diane; Lefebre, Nancy; O'Brien-Pallas, Linda; Estabrook, Carole A; White, Peggy; Carryer, Jennifer; Sun, Winnie; Qian, Gan; Bai, Yu Qing; Li, Mingyang
Background There are gaps in knowledge about the extent to which home care nurses’ practice is based on best evidence and whether evidence-based practice impacts patient outcomes. Aim The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines. Methods The Nursing Role Effectivene...
Full Text Available Abstract Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice, commercial and consumer organisations on the meso-level (institutions, organisations and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community. Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed.
, individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to ...
Bradshaw, Wanda G
Our patients depend on us to do the best on their behalf. If we do not take accountability for our practice, continually examining what is the best way to deliver care, we are limiting our role to technical skills and not fully actualizing our professional role. [Evidence-based practice] is essential to practicing safely as nurses (p. 53).1.
Diaz, Clive; Drewery, Sian
In this article the authors consider how effective social work has been in terms of evidence-based policies and practice. They consider the role that "evidence" plays in policy making both in the wider context and, in particular, in relation to social work. The authors argue that there are numerous voices in the policy-making process and evidence only plays a minor role in terms of policy development and practice in social work.
of atopic eczema in general practice. Atopic eczema is a common chronic condition characterised by dry, itchy skin associated with flares and remissions. .... atopy. This effect is lessened in the general population and neg- ligible in children without first- order atopic relatives. Breast- feeding should be strongly rec-.
N. P. Kutishenko
Full Text Available Data of multicenter clinical trials on assessment of angiotensin converting enzyme inhibitor, lisinopril efficacy in therapy of patients with arterial hypertension, heart failure, myocardial infarction complicated with left ventricle dysfunction and diabetes (GISSI-3, ATLAS, ALLHAT, EUCLID are presented in the review. The results of these trials establish more active usage of lisinopril in clinical practice.
Hauck, Sheila; Winsett, Rebecca P; Kuric, Judy
To assess the impact of leadership facilitation strategies on nurses' beliefs of the importance and frequency of using evidence in daily nursing practice and the perception of organizational readiness in an acute care hospital. Integrating evidence in practice is a prominent issue for hospital nursing as knowledge and skills, beliefs, organizational infrastructure and nursing leadership must all be addressed. Prospective, descriptive comparative. Three surveys were used in this prospective descriptive comparative study. Evidence-Based Practice Beliefs Scale, the Implementation Scale and Organizational Culture & Readiness for System-Wide Integration Survey measured change before and after facilitating strategies for evidence-based practice enculturation. Data were collected in December 2008 (N = 427) and in December 2010 (N = 469). Leadership facilitated infrastructure development in three major areas: incorporating evidence-based practice outcomes in the strategic plan; supporting mentors; and advocating for resources for education and outcome dissemination. With the interventions in place, the total group scores for beliefs and organizational readiness improved significantly. Analyses by job role showed that direct care nurses scores improved more than other role types. No differences were found in the implementation scores. Successful key strategies were evidence-based practice education and establishing internal opportunities to disseminate findings. Transformational nursing leadership drives organizational change and provides vision, human and financial resources and time that empowers nurses to include evidence in practice. © 2012 Blackwell Publishing Ltd.
Reviewed by Yasin OZARSLAN
EFFECTIVE BLENDED LEARNING PRACTICES:Evidence-based Perspectives in ICT-facilitated EducationEdited by Elizabeth Stacey and Philippa Gerbic, Information ScienceReference; 1 edition (March 30, 2009), ISBN-10: 1605662968, 358...
This feature considers models of teaching and learning and how these can be used to support evidence based practice. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.
Olsen, Nina R; Bradley, Peter; Lomborg, Kirsten; Nortvedt, Monica W
.... Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students' use of evidence-based practice in clinical physiotherapy education among students, clinical...
The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site.
Bellamy, Jennifer L.; Mullen, Edward J.; Satterfield, Jason M.; Newhouse, Robin P.; Ferguson, Molly; Brownson, Ross C.; Spring, Bonnie
Evidence based practice (EBP) is reflected in social work publications, accreditation standards, research, and funding opportunities. However, implementing EBP in social work practice and education has proven challenging, highlighting the need for additional resources. This paper describes the Transdisciplinary Model of EBP, a model based on…
For questions related to diagnosis, prognosis or causation, other study designs such as longitudinal studies, cohort studies or case-control studies are more appropriate. The present article discusses the levels and quality of evidence, and basic concepts of clinical research design in evidence-based dental practice based ...
Pearce, Linda C
This article summarizes the evidence-based nutrition recommendations for diabetes published first in 2002 by the ADA, and identifies diet information that now should be recognized as misconception or myth. Home care clinicians must become cognizant of evidence-based guidelines and update clinical practices, care paths, and teaching materials accordingly.
DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn
Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…
Juan Carlos Fernández-Domínguez
Full Text Available Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP, for measuring the construct EBP in Health Sciences professionals.A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach's alpha coefficient and intraclass correlations (ICC. Latent structure was contrasted using confirmatory factor analysis (CFA following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19.Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99. Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity.Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional. The tool could be useful for EBP
Fernández-Domínguez, Juan Carlos; de Pedro-Gómez, Joan Ernest; Morales-Asencio, José Miguel; Sastre-Fullana, Pedro; Sesé-Abad, Albert
Introduction Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals. Methods A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach’s alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19). Results Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity. Conclusions Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The
Background Health care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students’ use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers. Methods In total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process. Results Four integrative themes emerged from the analysis: “attempt to apply evidence-based practice”, “novices in clinical practice”, “prioritize practice experience over evidence-based practice” and “lack role models in evidence-based practice”. Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice. Conclusions Clinical instructors are in a position to influence students during clinical
Burgess, Alexandra M; Okamura, Kelsie H; Izmirian, Sonia C; Higa-McMillan, Charmaine K; Shimabukuro, Scott; Nakamura, Brad J
Despite the accumulated research support for the use of evidence-based practices (EBPs) with youth, these treatment approaches remain underutilized in community settings. Therapist attitudes towards EBPs play a pivotal role in their adoption and implementation of these practices. The present investigation employs joint exploratory factor analysis to evaluate the structure of two measures of therapist attitudes, the Evidence-Based Practices Attitudes Scale and the Modified Practice Attitude Scale. Results suggest three factors including (a) importance of clinical experience over EBPs, (b) clinician openness to change, and (c) problems with EBPs. Recommendations are provided for future evaluation of therapist attitudes and associated characteristics.
Schmidt, Nola A; Brown, Janet M
The purpose of this article is to describe the innovation-decision process teaching strategy (I-DPTS) based on the model of diffusion of innovations [Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press]. A goal of baccalaureate nursing education is to develop competencies required for evidence-based practice. Such practice merges clinician expertise, patient preferences, and critical evaluation of the literature to improve patient outcomes and reduce health care costs [Melnyk, B. M. (2005). A primer on evidence-based practice. Paper presented at the Purdue School of Nursing Seventh Annual Helen R. Johnson Leadership Conference, West Lafayette, IN]. Several strategies to promote evidence-based practice have appeared in the literature. However, when they are examined in light of the innovation-decision process (Rogers, 2003), they do not address all the essential steps for adoption to occur. The I-DPTS allows students to achieve competencies necessary to overcome barriers associated with implementing best practices. This strategy was successfully implemented in a senior-level introductory nursing research class. Community representatives identified practice issues that could be addressed by student groups. After conducting a search of the literature, students analyzed the evidence, determined best practice based on the evidence, and developed a policy for implementation in clinical settings. At course end, representatives were invited to attend oral and poster presentations. Use of the I-DPTS better prepares students to implement best practice as they embark on their professional careers.
Maricutoiu, Laurentiu P.
Full Text Available The present paper discusses the status of evidence-based practice in Occupational Health Psychology (OHP. After several searches on large online databases, we have found that OHP papers that discuss interventions are less than 10% of the overall literature. Furthermore, quantitative reviews research that reports interventions on major OHP topics are generally absent. In the last part of the paper, we formulate some reccomendations for increasing the number of papers relevant for evidence-based practice in OHP.
Kim, Son C; Brown, Caroline E; Fields, Willa; Stichler, Jaynelle F
This paper is a report of a study to evaluate the effectiveness of the evidence-based practice (EBP)-focused interactive teaching (E-FIT) strategy. Although EBP is a mandatory competency for all healthcare professionals, little is known about the effectiveness of E-FIT in nursing. Aquasi-experimental, controlled, pre- and post-test study involving senior, 4th-year nursing students (N = 208) at two nursing schools in the USA was carried out from August 2007 to May 2008. The experimental group (n = 88) received the E-FIT strategy intervention and the control group (n = 120) received standard teaching. A Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice was used to assess the effectiveness of the E-FIT strategy. Independent t-tests showed that the experimental group had statistically significant higher post-test Evidence-Based Practice Knowledge (mean difference = 0.25; P = 0.001) and Evidence-Based Practice Use (mean difference = 0.26; P = 0.015) subscale scores compared to the control group, but showed no statistically significant differences in Attitudes toward Evidence-Based Practice and Future Use of Evidence-Based Practice (mean difference = 0.12; P = 0.398 and mean difference = 0.13; P = 0.255 respectively). Hierarchical multiple regression analyses of the post-test data indicated that the intervention explained 7.6% and 5.1% of variance in Evidence-Based Practice Knowledge and Evidence-Based Practice Use respectively. The EBP-focused interactive teaching strategy was effective in improving the knowledge and use of EBP among nursing students but not attitudes toward or future use of EBP.
Full Text Available AIM:To investigate the effect of problem-based learning(PBLused in the teaching of medical students' evidence-based medicine(EBM.METHODS: Five classes(total 147 studentswere randomly selected as experimental(PBLgroup, at the same time, another 5 classes(total 149 studentswere also randomly selected as control group, using traditional teaching method(lecture-based learning, LBLin 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self-administered questionnaire to obtain their evaluation for PBL practice. SPSS13.0 software was used for statistical analysis.RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable(P>0.05. Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students(P>0.05, for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re-evaluating the evidence, and the total scores between the two groups, there were significant statistically differences(PP>0.05in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference(PPCONCLUSION:PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.
Ireland. They proposed that EBP cannot be achieved unless the accuracy of nurses' diagnoses is addressed because all other care-related decisions are based on nurses' interpretations of patient-related cues. If nurses' interpretations of patient data are flawed, subsequent decisions regarding outcomes and inter- ventions ...
There is growing international acceptance of the notion that participation in the creative arts can be beneficial for well-being and health. For over 30 years practical arts for health projects have been developed to support health care and promote health and well-being in communities. An increasing body of evaluation and research evidence lends weight to the value of such initiatives. However, the field of arts and health is complex and multi-faceted and there are challenges in moving beyond 'practice-based' research, towards building a progressive body of knowledge that can provide a basis for future 'evidence-based' practice in health care and public health. This paper reviews some of the population-level evidence from epidemiological studies on cultural participation and health, before considering research on active initiatives that draw on the creative arts in health care settings and communities to support health and well-being. The notion of a hierarchy of evidence is discussed in relation to arts for health initiatives and a plea is made for recognising the value of concrete case studies, qualitative research and the testimonies of participants and professionals alike in assessing both the value of creative arts activities and for understanding their impacts. Nevertheless, the need for robust controlled studies with precise measurable health outcomes is clear if we are to move towards the scaling up of arts interventions to achieve public health-level impacts from creative arts participation. A brief account of the current programme of research on singing and health that is underway at the Sidney De Haan Research Centre for Arts and Health is presented as a possible model for future research on arts and health.
Varaei, Shokoh; Salsali, Mahvash; Cheraghi, Mohammad Ali
Evidence-based nursing is recognized as an indicator of quality in nursing practice, a basis for accountability and the gold standard of professional nursing care. The aim of this study was to explore nurses' experiences and perceptions about evidence-based nursing practice in giving care to patients with diabetic foot ulcers. A qualitative research design was adopted, and content analysis was used to analyse data. Semistructured interviews were held with 19 bachelor-degree nurses working in a teaching hospital in an urban area of Iran. During data analysis, two main themes developed: 'structural backgrounds of the organization' and 'empowerment'. Accordingly, it was concluded that successful implementation of evidence-based nursing requires the reconfiguration of the administrative structure in the hospital. In addition, it requires the support of nurse leaders to facilitate the implementation of evidence-based nursing in the practice. © 2013 Wiley Publishing Asia Pty Ltd.
Kirk, Jeanette W.; Nilsen, Per
BACKGROUND: An emergency department is typically a place of high activity where practitioners care for unanticipated presentations, which yields a flow culture so that actions that secure available beds are prioritised by the practitioners. OBJECTIVES: How does the flow culture in an emergency...... department influence nurses' use of a research-based clinical guideline and a nutrition screening routine. METHODS: Ethnographic fieldwork was carried out over three months. The first author followed nurses, medical secretaries and doctors in the emergency department. Data were also collected by means...
Gardner, Kevin; Kanaskie, Mary Louise; Knehans, Amy C; Salisbury, Sarah; Doheny, Kim K; Schirm, Victoria
The outcomes based emphasis in nursing and health care delivery requires identification of best available evidence in order to produce quality, safe, and effective patient care. Finding, critiquing, and ultimately implementing the best available evidence for practice is a formidable task for many clinical nurses. Development and implementation of a nursing journal club (NJC) became one organization's successful attempt to help clinical nurses better understand and use best available evidence in actual practice. The process and structure for the NJC evolved from an additional activity scheduled outside of work to a fully established endeavor of Nursing Research and Evidence Based Practice Council (NR&EBP). The Nursing Professional Practice Model was foundational to establishing the NJC as a formal component within the NR&EBP Council shared governance structure. Efforts to embed the NJC included taking advantage of resources available at an academic medical center and incorporating them into the council structure. Successful outcomes of the NJC include a quarterly schedule, with topics selected in advance that are based on nursing department as well as organizational driven goals and initiatives. The structure and process in place has eliminated frequently mentioned deterrents to evidence based practice such as not enough time, lack of knowledge, or no immediate application to practice. Incorporating the NJC as a component of NR&EBP Council has provided clinical nurses time away from clinical care that supports scholarship for nursing practice. Committed leadership and garnering of available resources have been key factors for success. Copyright © 2016 Elsevier Inc. All rights reserved.
Khalil, Karima; Elnoury, Amr; Cherine, Mohamed; Sholkamy, Hania; Hassanein, Nevine; Mohsen, Lamia; Breebaart, Miral; Aziz Shoubary, Abdel
Little is known of common normal labor hospital practices in Egypt or of their relationship to evidence-based obstetrics. This study documented facility-based practices for normal labor and delivery in Egypt for the first time by categorizing 44 practices observed in a busy obstetric teaching hospital according to the World Health Organization (WHO) Technical Working Group on Normal Birth classification of normal birth practices. A multidisciplinary approach combined directly observing practices that were applied to individual laboring women and their newborns, observing ward activities, interviews, and focus groups. One hundred seventy-five normal births were observed in their entirety, over 28 days and nights, by medically trained observers using an observation checklist that documented 537 variables for each woman. Mothers were interviewed postpartum, and findings were shared with practitioners for their feedback. Observed practices were categorized according the 1999 WHO classification of 59 practices for normal birth, depending on their usefulness, effectiveness, or harmfulness. There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately, and practices of unproved benefit were also documented, some of which are potentially harmful to childbearing mothers and their babies. Hospital practices for normal labor were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying, given the increasing proportion of hospital-based births in Egypt and the country's improved but relatively high maternal and neonatal mortality rates. Obstacles to following evidence-based protocols for normal labor require examination.
Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D
In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.
Ubbink, Dirk T.; Guyatt, Gordon H.; Vermeulen, Hester
Objectives: Evidence-based practice (EBP) may help improve healthcare quality. However, not all healthcare professionals and managers use EBP in their daily practice. We systematically reviewed the literature to summarise self-reported appreciation of EBP and organisational infrastructure solutions
DeWire, Tom; McKithen, Clarissa; Carey, Rebecca
What can the Investing in Innovation (i3) grantees tell us about scaling innovative educational practices? The newly released white paper "Scaling Up Evidence-Based Practices: Strategies from Investing in Innovation (i3)" captures the experiences of nine grantees whose projects collectively have reached over 1.2 million students across…
Wang, Mian; Lam, Yeana
Many issues arise in the discussion of the evidence-based practice (EBP) movement and implementation science in special education and specific educational practices for students with severe disabilities. Yet cultural adaptations of EBPs, which have emerged as an area of research in other fields, are being left out as a focus of EBP discourse. The…
Wilczynski, Susan M.
Evidence-based practice (EBP) represents an important approach to educating and treating individuals diagnosed with disabilities or disorders. Understanding research findings is the cornerstone of EBP. The methodology of systematic reviews, which involves carefully analyzing research findings, can result a practice guideline that recommends…
LeRoy, Adam Scott
Prior concerns have been raised about the ability of schools to access evidence-based practices, however, these practices are instrumental for addressing behavior concerns. This is particularly true at the secondary level, where students are more likely to be disproportionately identified for school removal. This review investigates studies of…
Kozleski, Elizabeth B.
This article offers a rationale for the contributions of qualitative research to evidence-based practice in special education. In it, I make the argument that qualitative research encompasses the ability to study significant problems of practice, engage with practitioners in the conduct of research studies, learn and change processes during a…
Bauer, Michael G.; Peck, Chauney; Studebaker, Aubrey; Yu, Naomi
The purpose of this study was to examine the attitudes of practicing art therapists toward evidence-based practices (EBPs). EBPs, which have become an integral part of the managed care mental health system, refer to the use of empirically validated research to make clinical decisions that best meet the needs of each client. We used mixed methods…
Ballard, Susan D.
The author reveals in this article that her action research journey in the land of evidence-based practice was not her own idea. She writes that she was lured by the profession's finest scholars who advocated for reflective dispositions for practitioners to improve their practice and demonstrate the school librarian's critical role in teaching and…
Vahideh Zareh Gavgani
Background and Objectives: Evidence based librarianship (EBL) was defined as “use of best available evidence from qualitative and quantitative research results and rational experience and decisions acquired from the daily practice of library”. However there are controversies about if the nature of EBL deals with library services or professional practice and if it needs a formal education or informal continuing education is enough? To shed light on this ambiguity, the aim of this study was to...
Sandrey, Michelle A.; Bulger, Sean M.
Objective: The growing importance of evidence based practice in athletic training is necessitating academics and clinicians to be able to make judgments about the quality or lack of the body of research evidence and peer-reviewed standards pertaining to clinical questions. To assist in the judgment process, consensus methods, namely brainstorming,…
Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite
Keus, S.H.; Bloem, B.R.; Hendriks, E.J.M.; Bredero-Cohen, A.B.; Munneke, M.
Physical therapy is often prescribed in Parkinson's disease. To facilitate the uniformity and efficacy of this intervention, we analyzed current evidence and developed practice recommendations. We carried out an evidence-based literature review. The results were supplemented with clinical expertise
Becker, Sara J.; Spirito, Anthony; Vanmali, Roshani
Objective: Several national organisations in the USA have recently developed educational materials that encourage substance use disorder treatment consumers to seek out approaches supported by scientific evidence in order to promote the use of "evidence-based practice" (EBP). This study aimed to explore how adolescents (young people aged…
Al-Almaie, Sameeh M.; Al-Baghli, Nadira
Introduction: Tremendous advances in health care have been made through the development of evidence-based medicine (EBM). Studies show that physicians face barriers in practice, preventing the effective use of the best evidence available. Insight into these barriers should pave the way for an action plan to remove them. The aim of this study was…
Stapleton, Drue; Hawkins, Andrew
Objective: The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and…
Muttiah, Nimisha; Georges, Katie; Brackenbury, Tim
Purpose: Evidence-based practice (EBP) involves the incorporation of research evidence, clinical expertise, and client values in clinical decision making. One case in which these factors conflict is the use of nonspeech oral motor treatments (NSOMTs) for children with developmental speech sound disorders. Critical reviews of the research evidence…
Barth, Richard P.; Lee, Bethany R.; Lindsey, Michael A.; Collins, Kathryn S.; Strieder, Frederick; Chorpita, Bruce F.; Becker, Kimberly D.; Sparks, Jacqueline A.
Social work is increasingly embracing evidence-based practice (EBP) as a decision-making process that incorporates the best available evidence about effective treatments given client values and preferences, in addition to social worker expertise. Yet, social work practitioners have typically encountered challenges with the application of…
Price, Christopher P; Christenson, Robert H
The purpose of laboratory medicine is to facilitate better decision making in clinical practice and healthcare delivery. Decision making implies an unresolved issue, problem or unmet need. The most important criterion for any investigation to be of value in clinical practice is that it addresses an unmet need. The different ways in which laboratory investigations are utilized in patient care can be represented in the form of questions. It is important that these questions are articulated to highlight the variables that will impact on the effectiveness of the investigation in the scenario being considered. These variables include the characteristics of the patient (or population) and clinical setting, the nature of the decision and action taken on receipt of the test result and the expected outcome. Asking a question is the first step of the evidence-based laboratory medicine (EBLM) cycle, the other steps being acquiring the evidence, critically appraising the evidence, applying the evidence and auditing use of the evidence. Getting the question right determines the quality of the whole process, thus, defines the quality in practice of laboratory medicine. Whilst the main focus of the EBLM cycle is to provide a strong evidence base for use in clinical practice, it is clear that the five steps are equally applicable in commissioning, delivery and audit (performance management) of services. Asking the right question is crucial to improving the quality of evidence, and practice, in laboratory medicine, and should be used in routine laboratory medicine practice and management throughout healthcare.
Philipsen, Nanya C
Childbirth educators have a duty to promote and implement best practices. Best practices are individualized and evidence-based, using quality research to optimize outcomes. This requires addressing change. The childbirth educator must model evidence-based practices by systematically engaging in activities to improve his or her own changing curriculum. The childbirth educator is also a professional in a core position to play an active role as a change agent in the system through evaluation and dissemination of information to parents, fellow childbirth educators, and other professionals on the health-care team. This information provides the basis for important health-care decisions for self and others.
Full Text Available Background: The application of the concept of Evidenced Based Practice into clinical decision-making and practicehas outstanding benefits both to clinicians and the patient. However, the utilization of this concept has not been copiously utilized in most health facilities by the physiotherapists in Kenya. Therefore, the objectives for this study was to determine the level of awareness of evidence based practice among Physiotherapist, establish the availability of resource for Evidence Based Practice and to assess the challenges encountered by physiotherapist in engaging in evidence based practice at Moi Teaching and Referral Hospital. Methods: All physiotherapists working in Moi Teaching and Referral Hospital (42 took part in a cross-sectional descriptive survey. Questionnaires were used for data collection and analyzed by SPSS version 22. Results: there was high level of awareness on Evidence Based Practice (95 % and confidence in EBP (72.5 %. However, lack of information resources, poor skills to implement EBP, poor organization support 90%, insufficient authority to induct change in the practice setting 85%, inadequate facilities 74% and lack of time were identified as the major challenges in implementation of EBP Conclusion: Strategies should be developed to provide PTs with EBP resources, such as access to databases or links to guidelines, and continuous education regarding specific topics. Professional organizations and Associations should aim at changing the current practice to ensure full utilization of EBP.
Tolson, Debbie; Booth, Jo; Lowndes, Andrew
To determine the impact of the Caledonian Development Model, designed to promote evidence-based practice. The model features practice-development activities, benchmarking, knowledge pooling and translation through membership of a community of practice and a virtual college. Twenty-four nurses, from 18 practice sites formed three communities of practice, each selecting evidence-based guidance to implement. A modified group supervision framework empowered nurses to champion local implementation. Outcomes were determined at 6 months. Eighty per cent of the patient-related criteria and 35% of the facilities criteria were achieved. The Revised Nursing Work Index indicated these nurses experienced greater autonomy (P = 0.019) and increased organizational support (P = 0.037). Focus groups revealed a deepening organizational support for the initiative over time, illuminated work-based learning challenges and overall enthusiasm for the approach. Implementation of the model effectively promoted evidence-based practice, most notably at the level of the individual patient. Time and budgetary constraints necessitate smart, value for money approaches to developing evidence-based practice and improved care standards. This work demonstrates an effective model that strikes a balance between individual and group learning, virtual and real-time activities, coupled with resource pooling across organizations and sectors.
In this paper the author gives his opinion about the problems of getting practices to change systems in order to institute clinical governance. There are many reasons why practices need to change and for this change to be monitored. This paper explains the need for change and the use of the evidence-based portfolio, which is produced by candidates for the Membership of the Faculty of General Dental Practice (UK) [MFGDP(UK)] examination. It can also be produced by individuals who are not taking the MFGDP(UK) examination in conjunction with the Faculty of General Dental Practice (UK)'s key skills programme. It provides a mechanism for demonstrating change and for assessing the quality of care provided by a general dental practice. The author concludes that the evidence-based portfolio will enable a practitioner to apply clinical governance in a practical way.
Jiang, Guoqian; Ogasawara, Katsuhiko; Endoh, Akira; Sakurai, Tsunetaro
We conducted a survey among 100 clinicians in a university hospital to determine the clinician’s attitudes and the relevant computer-based information needs towards the practice of evidence-based medicine in outpatient setting. PMID:14728387
Hew, Khe Foon; Cheung, Wing Sum
Evidence-based practice in education entails making pedagogical decisions that are informed by relevant empirical research evidence. The main purpose of this paper is to discuss evidence-based pedagogical approaches related to the use of Web 2.0 technologies in both K-12 and higher education settings. The use of such evidence-based practice would…
Matthieu, Monica M.; Carter, Lorien; Casner, Robert W.; Edmond, Tonya E.
This study evaluated a continuing education training program designed to increase field educators' capacities to support students in their application of the evidence-based practice (EBP) process. A cohort of social work field instructors and task supervisors from agency-based settings (N = 186) attended a 1-day interactive skill-based training.…
Shahtahmasebi, Said; Villa, Luis; Nielsen, Helen; Graham-Smith, Hilary
In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors) with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of "local knowledge" complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify "best" practices, such as the "Stop Youth Suicide Campaign" (www.stopyouthsuicide.com).
Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.
van Twillert, Sacha; Geertzen, Jan; Hemminga, Titia; Postema, Klaas; Lettinga, Ant
A divide is experienced between producers and users of evidence in prosthetic rehabilitation. To discuss the complexity inherent in establishing evidence-based practice in a prosthetic rehabilitation team illustrated by the case of prosthetic prescription for elderly dysvascular transfemoral amputee patients. A qualitative research design was used, in which data from multiple sources was triangulated to extract themes for discussion. This discussion paper draws on empirical material gathered by individual and focus-group interviews with members of a prosthetic rehabilitation team, information on technological advancements presented on websites of orthopaedic industry, guidelines and literature study. A prosthetic rehabilitation team needs to deal with lack of evidence, contradictory results, various classification systems, diverging interests of different stakeholders and many modifying factors, and all of this in a continuous technological changing environment. Integrating research designs with different strengths but not sharing the same biases may help researchers to deal with the multimorbidity and multifaceted disability of the target group. Articulating clinical knowledge, patients' needs and values in a systematic way provides depth, detail, nuance and context for evidence-based practice issues in prosthetic rehabilitation. Reconsidering the relationship between evidence, technology and rehabilitation practice is an imperative shared enterprise for clinicians and researchers. Scientific, clinical and patient-related knowledge are seen as important knowledge practices that should inform and strengthen each other. This discussion paper puts the academic clinical debate on evidence-based practice in prosthetics and orthotics in another light. By demonstrating the complexities surrounding evidence-based practice, it is argued and illustrated how both researchers and clinicians can contribute to optimal patient care in which evidence, technology and
Alladin, Assen; Sabatini, Linda; Amundson, Jon K
This paper briefly surveys the trend of and controversy surrounding empirical validation in psychotherapy. Empirical validation of hypnotherapy has paralleled the practice of validation in psychotherapy and the professionalization of clinical psychology, in general. This evolution in determining what counts as evidence for bona fide clinical practice has gone from theory-driven clinical approaches in the 1960s and 1970s through critical attempts at categorization of empirically supported therapies in the 1990s on to the concept of evidence-based practice in 2006. Implications of this progression in professional psychology are discussed in the light of hypnosis's current quest for validation and empirical accreditation.
Canada, Amanda N
HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based
Lennon, Shannon L; DellaValle, Diane M; Rodder, Susan G; Prest, Melissa; Sinley, Rachel C; Hoy, M Katherine; Papoutsakis, Constantina
Hypertension (HTN) or high blood pressure (BP) is among the most prevalent forms of cardiovascular disease and occurs in approximately one of every three adults in the United States. The purpose of this Evidence Analysis Library (EAL) guideline is to provide an evidence-based summary of nutrition therapy for the management of HTN in adults aged 18 years or older. Implementation of this guideline aims to promote evidence-based practice decisions by registered dietitian nutritionists (RDNs), and other collaborating health professionals to decrease or manage HTN in adults while enhancing patient quality of life and taking into account individual preferences. The systematic review and guideline development methodology of the Academy of Nutrition and Dietetics were applied. A total of 70 research studies were included, analyzed, and rated for quality by trained evidence analysts (literature review dates ranged between 2004 and 2015). Evaluation and synthesis of related evidence resulted in the development of nine recommendations. To reduce BP in adults with HTN, there is strong evidence to recommend provision of medical nutrition therapy by an RDN, adoption of the Dietary Approaches to Stop Hypertension dietary pattern, calcium supplementation, physical activity as a component of a healthy lifestyle, reduction in dietary sodium intake, and reduction of alcohol consumption in heavy drinkers. Increased intake of dietary potassium and calcium as well as supplementation with potassium and magnesium for lowering BP are also recommended (fair evidence). Finally, recommendations related to lowering BP were formulated on vitamin D, magnesium, and the putative role of alcohol consumption in moderate drinkers (weak evidence). In conclusion, the present evidence-based nutrition practice guideline describes the most current recommendations on the dietary management of HTN in adults intended to support the practice of RDNs and other health professionals. Copyright © 2017 Academy of
Full Text Available Angela Dunsford1, Saravana Kumar1,2, Sarah Clarke1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia Abstract: Low back pain (LBP is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas, which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. Keywords: low back pain, McKenzie method, directional
Walker, Sarah Cusworth; Lyon, Aaron R; Aos, Steve; Trupin, Eric W
As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge. In this paper we review the development of the Washington State Inventory of Evidence-Based, Research-Based and Promising Practices as a case study for the process of defining evidence-based practice in a policy context. As part of this study we also present a comparison of other well-known evidence-based practice inventories and examine consistencies and differences in the process of identifying and developing program ratings.
Case, Christina Anne
Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking. The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility. This educational intervention took place at a 286-bed community hospital certified by the Joint Commission as a primary stroke center. Bedside registered nurse (RN) staff from 4 units received a poster presentation linking the American Heart Association's and American Stroke Association's current evidence-based clinical practice guidelines to standardized stroke order sets and bedside nursing care. The 90-second oral poster presentation was delivered by a graduate nursing student during preshift huddle. The poster and supplemental materials remained in the unit break room for 1 week for RN viewing. After the pilot unit, a pdf of the poster was also delivered via an e-mail attachment to all RNs on the participating unit. A preintervention online survey measured nurses' self-perceived likelihood of performing an ordered intervention based on whether they were confident the order was evidence based. The preintervention survey also measured nurses' self-reported confidence in their ability to explain how the standardized order sets are derived from current evidence. The postintervention online survey again measured nurses' self-reported confidence level. However, the postintervention survey was modified midway through data collection, allowing for the final 20 survey respondents to retrospectively rate their confidence
Moher, David; Ravaud, Philippe
Biomedical journals continue to be the single most important conduit for disseminating biomedical knowledge. Unlike clinical medicine, where evidence is considered fundamental to practice, journals still operate largely in a 'black box' mode without sufficient evidence to drive their practice. We believe there is an immediate need to substantially increase the amount and quality of research by journals to ensure their practice is as evidence based as possible. To achieve this goal, we are proposing the development of an international 'best practice journal research network'. We invite journals and others to join the network. Such a network is likely to improve the quality of journals. It is also likely to address many unanswered questions in publication science, including peer review, which can provide robust and generalizable answers.
Jameson, Jodi; Walsh, M Eileen
Information literacy is essential in facilitating evidence-based practice (EBP) activities. In vascular nursing, the implementation of EBP is of utmost importance. Best practice grounded in research evidence can contribute to improved patient care outcomes for individuals with vascular disease. The following paper discusses information literacy competencies for nurses to develop in the context of EBP, with an emphasis on formulating a clinical question and searching for evidence. Relevant health science information resources are described, including their value and purpose in the 6S model of evidence. Also discussed are practical and supportive solutions with proven effectiveness in ensuring nurses' success with EBP. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.
Pearce, Warren; Raman, Sujatha; Turner, Andrew
Randomised trials can provide excellent evidence of treatment benefit in medicine. Over the last 50 years, they have been cemented in the regulatory requirements for the approval of new treatments. Randomised trials make up a large and seemingly high-quality proportion of the medical evidence-base. However, it has also been acknowledged that a distorted evidence-base places a severe limitation on the practice of evidence-based medicine (EBM). We describe four important ways in which the evidence from randomised trials is limited or partial: the problem of applying results, the problem of bias in the conduct of randomised trials, the problem of conducting the wrong trials and the problem of conducting the right trials the wrong way. These problems are not intrinsic to the method of randomised trials or the EBM philosophy of evidence; nevertheless, they are genuine problems that undermine the evidence that randomised trials provide for decision-making and therefore undermine EBM in practice. Finally, we discuss the social dimensions of these problems and how they highlight the indispensable role of judgement when generating and using evidence for medicine. This is the paradox of randomised trial evidence: the trials open up expert judgment to scrutiny, but this scrutiny in turn requires further expertise.
Bernstein, Adam; Chorpita, Bruce F; Daleiden, Eric L; Ebesutani, Chad K; Rosenblatt, Abram
This study empirically examined options for building an evidence-informed service array, comparing strategies to maximize the application of evidence-based treatment literature in a clinical service system. The overall goal was to determine the smallest set of treatments that could serve the largest percentage of clients. Solutions to this problem differ depending on how one defines "treatment." Treatments were conceptualized as (a) programs (integrated treatments produced by specific research laboratories or investigators), and (b) collections of their constituent common procedures, referred to as practice elements. Programs listed by 2 separate government-sanctioned registries were selected to illustrate the effects of "program" conceptualizations, and all available clinical trials testing the programs were analyzed. Practice elements were identified from these same studies and from studies of other treatments that met a standard of evidence but had not been organized into programs on these lists. Relevance mapping methodology was used to identify optimal sets of programs and practice elements. Among a large, diverse clinical population, results identified 11%-22% of youths for whom practice elements provide an evidence-informed treatment option whereas no programs meeting the standard of evidence were available on the registries. Results for the practice elements were able to be matched by a hybrid combination: "best" programs, which were then extended by practice elements. These results demonstrated that there are multiple ways to conceptualize treatments when planning a service array, and these options have significant implications regarding who can be served by treatments supported by evidence. (c) 2015 APA, all rights reserved).
Drinkwater, Michael J.; Matthews, Kelly E.; Seiler, Jacob
While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. PMID:28232589
Vandeweerd, Jean-Michel; Kirschvink, Nathalie; Clegg, Peter; Vandenput, Sandrine; Gustin, Pascal; Saegerman, Claude
Evidence-based medicine (EBM) refers to the conscientious, explicit and judicious use of current best evidence from research for the care of an individual patient. The concept of EBM was first described in human medicine in the early 1990s and was introduced to veterinary medicine 10 years later. However, it is not clear that the EBM approach promulgated in human medicine can be applied to the same extent to veterinary medicine. EBM has the potential to help veterinarians to make more informed decisions, but obstacles to the implementation of EBM include a lack of high quality patient-centred research, the need for basic understanding of clinical epidemiology by veterinarians, the absence of adequate searching techniques and accessibility to scientific data bases and the inadequacy of EBM tools that can be applied to the busy daily practise of veterinarians. This review describes the development of EBM in the veterinary profession, identifies its advantages and disadvantages and discusses whether and how veterinary surgeons should further adopt the EBM approach of human medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.
Madhavji, Asha; Araujo, Eustaquio A; Kim, Ki Beom; Buschang, Peter H
The purpose of this study was to evaluate the attitudes, awareness, and barriers toward evidence-based practice. A survey consisting of 35 questions pertaining to the use of scientific evidence in orthodontics was sent to 4771 members of the American Association of Orthodontists in the United States. Each respondent's age, attainment of a master's degree, and whether he or she was currently involved with teaching were ascertained. To minimize bias, the survey questions were phrased as an examination of the use of scientific literature in orthodontics. A total of 1517 surveys were received (response rate, 32%). Most respondents had positive attitudes toward, but a poor understanding of, evidence-based practice. The major barrier identified was ambiguous and conflicting research. Younger orthodontists were more aware, had a greater understanding, and perceived more barriers than did older orthodontists. Orthodontists involved in teaching were more aware, had a greater understanding, and reported fewer barriers than those not involved with teaching. Those with master's degrees had a greater understanding of evidence-based practice than those without degrees. Educational initiatives are needed to increase the understanding and use of evidence-based practice in orthodontics. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and…
Abdelkarim, Ahmad; Sullivan, Donna
The study aimed at evaluating attitudes and perceptions of dental students and faculty toward evidence-based practice, integration of technology and social media, general practitioners' and specialists' scope of practice, and dental practice rewards and disadvantages. A survey instrument was designed with 10 statements rated on a five-point Likert scale (strongly agree to strongly disagree) and an optional comment section. The survey instrument was delivered through SurveyMonkey, whereby 401 students and 182 faculty members from ten U.S. dental schools participated (16% estimated response rate). Null hypotheses regarding the equality between the responses of the two groups were statistically tested using Mann-Whitney U test. Statistical significance was set at .05. Evidence-based practice is positively perceived by both groups, but with significantly higher support by faculty than students (P = 0.002). Both groups agreed that technological advancements are advantageous (P = 0.95), but do not constitute good dentistry and cannot mask poor clinical skills. Students showed higher support for social media than faculty (P = 0.000). Both groups perceived group practices positively. Faculty members showed higher agreement than students toward limitation of dental specialists' practices to their specialties (P = 0.000). Both groups are aware of practice disadvantages, such as increased litigation, health risks, and detriment to the dentist's posture. However, they both perceive dental practice positively despite all these challenges. Students and faculty share generally comparable perspectives toward dental practice. They are both in agreement with evidence-based practice and adoption of technology. They both acknowledge practice limitations. Copyright © 2014 Elsevier Inc. All rights reserved.
Choma, Kim; McKeever, Amy E
The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.
Beth S. Brodsky
Full Text Available Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods.
Mary, Sidebotham; Julie, Jomeen; Jennifer, Gamble
The international world of higher education is changing with universities now offering students flexible delivery options that allow them to study away from campus and at a time convenient to them. Some students prefer on line learning while others prefer face to face contact offered through a traditional lecture and tutorial delivery modes. The response by many universities is to offer a blend of both. While online and blended mode of delivery may be suitable for some subjects there is little knowledge of the efficacy of blended learning models to teach evidence based practice and research (EBPR) to undergraduate midwifery students. EBPR is a challenging, threshold level subject upon which deeper knowledge and skills are built. This paper describes the design, delivery, and evaluation of an undergraduate EBPR course delivered in blended mode to first year midwifery students. Components of the blended learning innovation included: novel teaching strategies, engaging practical activities, role play, and e-learning strategies to maintain engagement. University-based course evaluation outcomes revealed very positive scores and the course was rated within the top ten percent of all courses offered within the Health Group at the host University. Copyright © 2013 Elsevier Ltd. All rights reserved.
Jablonski, Anita; Ersek, Mary
The purpose of this study was to determine the extent to which nursing home staff adhere to current evidence-based guidelines to assess and manage persistent pain experienced by elderly residents. A retrospective audit was conducted of the medical records of 291 residents of 14 long-term care facilities in western Washington State. Data revealed a gap between actual practice and current best practice. Assessment of persistent pain was limited primarily to intensity and location. Although pres...
S9 MOW CRD Graduate Health Sciences Education (GHSE) (SGS O&M); SGS R&D; Tri-Service Nursing Research Program (TSNRP): Defense Medical Research...Practice Program Implementation presented at/published to 2017 Triservice Nursing Research and Evidence-Based Practice Dissemination Course, Ellicott...residency programs. 3. Please know that if you are a Graduate Health Sciences Education student and your department has told you they cannot fund your
Marshall, Joanne Gard
The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.
Maricutoiu, Laurentiu P.; Sava, Florin A.
The present paper discusses the status of evidence-based practice in Occupational Health Psychology (OHP). After several searches on large online databases, we have found that OHP papers that discuss interventions are less than 10% of the overall literature. Furthermore, quantitative reviews research that reports interventions on major OHP topics are generally absent. In the last part of the paper, we formulate some reccomendations for increasing the number of papers relevant for evidence-bas...
Potomkova, Jarmila; Mihal, Vladimir; Zapletalova, Jirina; Subova, Dana
Bedside teaching with evidence-based practice elements, supported by e-learning activities, can play an important role in modern medical education. Teachers have to incorporate evidence from the medical literature to increase student motivation and interactivity. An integral part of the medical curricula at Palacky University Olomouc (Czech Republic) are real paediatric scenarios supplemented with a review of current literature to enhance evidence-based bedside teaching & learning. Searching for evidence is taught through librarian-guided interactive hands-on sessions and/or web-based tutorials followed by clinical case presentations and feedback. Innovated EBM paediatric clerkship demonstrated students' preferences towards web-based interactive bedside teaching & learning. In two academic years (2007/2008, 2008/2009), learning-focused feedback from 106 and 131 students, resp. was obtained about their attitudes towards evidence-based bedside teaching. The assessment included among others the overall level of instruction, quality of practical evidence-based training, teacher willingness and impact of instruction on increased interest in the specialty. There was some criticism about excessive workload. A parallel survey was carried out on the perceived values of different forms of information skills training (i.e. demonstration, online tutorials, and librarian-guided interactive search sessions) and post-training self-reported level of search skills. The new teaching/learning paediatric portfolio is a challenge for further activities, including effective knowledge translation, continuing medical & professional development of teachers, and didactic, clinically integrated teaching approaches.
Higa-McMillan, Charmaine; Kotte, Amelia; Jackson, David; Daleiden, Eric L
This study compared consistencies and discrepancies in usual care with practices derived from the evidence-base (PDEB) for youth anxiety in a public mental health system. Youth-level factors (diagnosis, functional impairment) as predictors of the discrepancies were also examined. Psychosocial and service data from 2485 youth with an anxiety disorder and/or receiving services for an anxiety treatment target were extracted. Therapists (N = 616) identified the treatment targets and practices youth received. Although many PDEB for youth anxiety were used by therapists in this sample, Exposure was only used in 15% of cases. Practices not consistent with youth anxiety treatment were also reported and included: PDEB for other conditions, practices common to all therapies, and practices that are not consistent with evidence-based care. Age and diagnosis predicted the delivery of PDEB for youth anxiety. Usual care incorporated many components of evidence-based care but was more diffuse and less focused on well-supported practices.
Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton
Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context.
Mohide, E Ann; Coker, Esther
Organizational interventions are being suggested to increase the rate of quality research dissemination and uptake. This article describes how one tertiary institution is using an evidence-based nursing (EBN) committee as an organizational strategy to shift its nursing culture toward clinical scholarship. A number of approaches and activities that have stimulated the movement toward evidence-based practice (EBP) are examined: organizational commitment to EBP, strategic positioning of the EBN committee within nursing's administrative structure, articulation of a mission, conceptualization of a model for EBN practice, learning on the job, selection and adoption of an evidence-based model for implementing change, marketing for a change in culture toward clinical scholarship, and other selected examples of projects undertaken by the committee. Action-oriented principles associated with committee experiences are related to the approaches and activities.
Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M
In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other
Farmer, Tod Allen
The study assessed the need for learning organizations to implement evidence-based policies and practices designed to enhance the academic and social success of Hispanic learners. Descriptive statistics and longitudinal data from the National Center for Educational Statistics (NCES) and the National Clearinghouse for English Language Acquisition…
Horner, Robert H.; Carr, Edward G.; Halle, James; McGee, Gail; Odom, Samuel; Wolery, Mark
Single-subject research plays an important role in the development of evidence-based practice in special education. The defining features of single-subject research are presented, the contributions of single-subject research for special education are reviewed, and a specific proposal is offered for using single-subject research to document…
Provan, K.; Beagles, J.; Mercken, L.; Leischow, S.J.
This research examines the awareness of evidence-based practices by the public organizations that fund services in the North American Quitline Consortium (NAQC). NAQC is a large, publicly funded, goal-directed “whole network,” spanning both Canada and the United States, working to get people to quit
Medical and health sciences libraries have incorporated the elements of evidence-based practice (EBP) into their reference services, instruction, and online resource development for years. While EBP focuses on the use of medical and health sciences literature in the clinical environment (i.e., making decisions about how to treat a particular…
Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph
This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support…
Bouffard, Marcel; Reid, Greg
The evidence-based practice (EBP) movement has been extremely influential over the last 20 years. Fields like medicine, physiotherapy, occupational therapy, nursing, psychology, and education have adopted the idea that policy makers and practitioners should use interventions that have demonstrated efficiency and effectiveness. This apparently…
Background: Current models of evidence-based practice marginalize and even silence the voices of those who are the potential beneficiaries of assessment and intervention. These missing voices can be found in the reflections of clients on their own life-world experiences. Aims: This paper examines how voices from the life-world are silenced in…
Leathers, Sonya J.; Strand, Tonya C.
Objective: This pilot study examined the effect of increasing field instructors access to information about evidence-based practices (EBPs) on their level of knowledge and attitudes about EBPs. Method: Eighteen field instructors received training and access to a library with extensive online journals. Half were randomly selected to also receive a…
Baker, Elise; McLeod, Sharynne
Purpose: This article provides a comprehensive narrative review of intervention studies for children with speech sound disorders (SSD). Its companion paper (Baker & McLeod, 2011) provides a tutorial and clinical example of how speech-language pathologists (SLPs) can engage in evidence-based practice (EBP) for this clinical population. Method:…
Griffiths, Yvonne; Stuart, Morag
There is now a strong evidence base from theory and research providing a "template" to inform practice at Wave 2, guiding the design and implementation of time-limited effective early intervention programmes for pupils identified as "at risk" of reading difficulties following initial literacy instruction (Rose, 2009). In…
Gromoske, Andrea N.; Berger, Lisa K.
Objective: To replicate the results of Parrish and Rubin's continuing education workshop in the evidence-based practice (EBP) process utilizing different workshop facilitators with participants in a different geographic location. Methods: We used a replicated, one-group pretest-posttest design with 3-month follow-up to evaluate the effectiveness…
Spooner, Fred; McKissick, Bethany R.; Knight, Victoria F.
The use of evidence-based practices (EBPs) was mandated with the passage of the No Child Left Behind Act of 2001 (NCLB), and continues with the Every Student Succeeds Act (ESSA). Accordingly, all children, including those with severe disabilities, must be taught both daily living and academic skills using EBPs. In this article, we synthesize,…
Background: The research on evidence-based practices (EBP) in special education has shifted over the last decade from identifying efficacious interventions to exploring issues that impede implementation in the classroom. Common barriers to implementation include absence of training and resources, limited collaboration between researchers and…
Renshaw, Tyler L.; Young, K. Richard; Caldarella, Paul; Christensen, Lynnette
Researchers invested in school-wide positive behavior support (SWPBS) have been attempting to answer an important question: Is SWPBS an evidence-based practice (EBP; e.g., Sugai & Horner, 2007)? Given the context of educational policy, this question appears to be reasonable, as its answer could significantly influence funding and adoption of SWPBS…
Mitten, H. Rae
Evidence-based Practice Guidelines for Fetal Alcohol Spectrum Disorder (FASD) and Literacy and Learning are derived from an inductive analysis of qualitative data collected in field research. FASD is the umbrella term for a spectrum of neurocognitive and physical disabilities caused by prenatal exposure to alcohol. Data from a sample of N =150 was…
Collins, Belva C.; Tekin-Iftar, Elif; Olcay-Gul, Seray
This article explores how international collaboration among researchers can contribute to developing evidence-based practices and disseminating knowledge in the field of special education. A review of a sample of special education journals published in English to identify articles written in collaboration by researchers from different countries is…
Wike, Traci L.; Bledsoe, Sarah E.; Bellamy, Jennifer L.; Grady, Melissa D.
Websites represent a visible medium for social work programs to communicate information about social work research, academics, and professional training priorities, including evidence-based practice (EBP). However, few studies have examined the content of social work program websites. This exploratory study aimed to answer the question: Are EBP…
Gillespie, Ann; Partridge, Helen; Bruce, Christine; Howlett, Alisa
Introduction: This paper presents the findings from a project that investigated the lived experiences of library and information professionals in relation to evidence-based practice within an Australian public library. Method: The project employed ethnography, which allows holistic description of people's experiences within a particular community…
Reddy, Linda A.; Forman, Susan G.; Stoiber, Karen C.; Gonzalez, Jorge E.
The present investigation examined 460 school psychology trainers' attitudes and beliefs about the conditions for the education and training of evidence-based practices (i.e., assessments and interventions) in training programs in the United States and Canada using an online survey. Trainer attitudes and beliefs about education and training in…
Troia, Gary A.; Olinghouse, Natalie G.
Although writing plays an important role in the academic, psychosocial, and economic success of individuals, typical writing instruction and assessment in the United States generally does not reflect evidence-based practices. The Common Core State Standards (CCSS) place a great deal of emphasis on written expression and may encourage an increased…
Cucciare, Michael A.; Weingardt, Kenneth R.
Information technology (IT) is increasingly being used to facilitate, complement, and support the implementation of evidence-based practices (EBP) in psychology. This article reviews recent randomised trials that evaluate the integration of IT applications into the process of delivering EBP. More specifically, we review 11 studies that illustrate…
Evidence-based treatments are increasingly important and necessary parts of many disciplines when working with very young children and their families. In using them, it is advantageous to be grounded in the principles and practices that research has shown are critical to children's healthy development, particularly the importance of supporting the…
Zaboski, Brian A.; Schrack, Anna P.; Joyce-Beaulieu, Diana; MacInnes, Jann W.
The proliferation of unsubstantiated or discredited interventions underscores the importance of the evidence-based practice (EBP) movement in school psychology. Although researchers have conducted several surveys on discredited interventions in counseling and clinical psychology, no studies have investigated the use of these treatments in school…
Hoffman, LaVae M.; Ireland, Marie; Hall-Mills, Shannon; Flynn, Perry
Purpose: This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010-2011. Method: Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP…
Yue, Liqing; Fan, Xuegong; Peng, Huan
To explore the abilities and barriers of practicing evidence-based nursing (EBN) for burn specialist nurses so as to provide rationales for its clinical training and practice. From January 2016 to March 2016, a cross-sectional survey was conducted with a self-designed questionnaire among burn specialist nurses in Hunan Province. Data analysis was performed with SPSS software (version 20). Burn specialist nurses in Hunan Province had diminished EBN abilities. The three procedures of EBN with the lowest score were "summarizing evidence through systematic reviews", "rigorous evaluations of evidence" and "systematic literature searches". And the three procedures of "clarifying problems", "disseminating evidence" and "introducing evidence" scored the highest. The systematic literature retrieval ability of nurses at class III general hospitals was higher than that of class II counterparts (P=0.001). Thus EBN ability was positively correlated with barriers to practicing EBN, English proficiency, research experiences and educator status. Burn specialist nurses at classes III & II general hospitals in Hunan Province had poor EBN abilities. Influencing factors of EBN ability included barriers to practicing EBN, English proficiency, research experiences and educator status. Therefore it is imperative to implement targeted trainings and integrated managements for improved ability of practicing EBN. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.
Sánchez-García, Inmaculada; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L
To examine the obstacles perceived by nurses to implement an evidence-based clinical practice. A qualitative study through semi-structured interviews conducted in 2010-2011 including 11 nurses purposively selected from public hospitals and community centres in Jaén and Córdoba (Spain). A content analysis was performed, using Miles and Huberman as a reference and comprising the following steps: data reduction, data presentation, and data conclusion/verification. Data saturation was reached in these categories (obstacles). The obstacles perceived by nurses to introduce an evidence-based clinical practice (EBCP) were grouped into 3 major categories: obstacles related with professionals (routine-based practice, unwilling and stagnant attitudes, and lack of training in EBCP), obstacles related to the social context (reluctance from other professionals and from patients or families), and obstacles related to the organization (obsolete cultures that do not promote innovation in nursing care). This study highlights the persistence of various factors that hinder the use of research findings in clinical practice. The results underline the need to change the culture of healthcare organizations, to motivate professionals, and to break some of the resistance attitudes that hinder the implementation of evidence-based practice. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Fernandez, Ritin S; Tran, Duong Thuy; Ramjan, Lucie; Ho, Carey; Gill, Betty
The aim of this study was to compare four teaching methods on the evidence-based practice knowledge and skills of postgraduate nursing students. Students enrolled in the Evidence-based Nursing (EBN) unit in Australia and Hong Kong in 2010 and 2011 received education via either the standard distance teaching method, computer laboratory teaching method, Evidence-based Practice-Digital Video Disc (EBP-DVD) teaching method or the didactic classroom teaching method. Evidence-based Practice (EBP) knowledge and skills were evaluated using student assignments that comprised validated instruments. One-way analysis of covariance was implemented to assess group differences on outcomes after controlling for the effects of age and grade point average (GPA). Data were obtained from 187 students. The crude mean score among students receiving the standard+DVD method of instruction was higher for developing a precise clinical question (8.1±0.8) and identifying the level of evidence (4.6±0.7) compared to those receiving other teaching methods. These differences were statistically significant after controlling for age and grade point average. Significant improvement in cognitive and technical EBP skills can be achieved for postgraduate nursing students by integrating a DVD as part of the EBP teaching resources. The EBP-DVD is an easy teaching method to improve student learning outcomes and ensure that external students receive equivalent and quality learning experiences. Copyright © 2012 Elsevier Ltd. All rights reserved.
Avsar, Ummu Zeynep; Avsar, Umit; Cansever, Zeliha; Acemoglu, Hamit; Cayir, Yasemin; Khan, Abdul Sattar
To assess the level of understanding related to the significance of evidence-based medicine among physicians. The cross-sectional study was conducted between March and October 2012 using an online questionnaire that was sent out to physicians and academics working as faculty at training hospitals across Turkey. The questionnaire consisted of questions about the knowledge, attitude and behaviour towards evidence-based medicine. Seven of the questions pertained to the learning of evidence-based medicine, six were about teaching evidence-based medicine, and six were about its practice. SPSS 20 was used for statistical analyses. The questionnaire was returned duly filled by 79 physicians. Of them, 41 (51.9%) were males; and 57 (72.2%) were part of the faculty. Only 1(1.2%) participant had attended a course about evidence-based medicine during undergraduate education, while 19 (24.05)had attended one after graduation. Besides, 26 (32.9%) academics were teaching some concepts of evidence-based medicine, and 21 (26.6%) were giving some information about clinical guidelines. The study found that levels of learning and teaching of evidence-based medicine among physicians were inadequate. They should be emphasised at both pre- and post-graduate tiers.
Full Text Available Background: An experience serving jury duty prompted reflection on the parallels between evidenced based medicine and our legal system. Findings: The steps of the legal system can be tied to each step of the practice of evidenced based medicine. Implications: Patients should be included in evidence based decisions. Pharmacists can act as resources for other providers practicing evidenced based medicine. Educators can use this analogy to teach evidence based medicine. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Commentary
Rosenberg, Stephen A; Baschnagel, Andrew M; Bagley, Stephen J; Housri, Nadine
The landscape of non-small cell lung cancer (NSCLC) treatment has rapidly evolved over the past decade. This is exemplified by the use of molecular targeted agents, immunotherapies, and newer technologies such as stereotactic body radiotherapy (SBRT). As the translation of preclinical discoveries into clinical practice continues, the effective dissemination and implementation of evidence-based treatment of NSCLC will remain a foremost challenge for oncologists. To further extend evidence-based medicine into the community setting, community oncologists are being engaged on multiple fronts including leadership and participation in national clinical trials and utilization of internet-based resources.
Harper, Nevin J.
Evidence-based practice is an approach that narrowly classifies research results by utilising a hierarchy of evidence. This process renders much available knowledge and experience redundant within its value structure. Currently a dominating ideology across medical and health fields, evidence-based practice is now being promoted in adventure…
Markulin, Helena; Petrak, Jelka
It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice.
Full Text Available Abstract Background To assess the effectiveness (change in knowledge and skills measured by the Fresno test of a short course in Evidence Based Practice (EBP carried out in a group of family medicine residents Methods Before-after study. Participants' were 152 Family Medicine residents in their second year of the training programme. Settings were Primary Care Teaching Units in Catalonia. Intervention was comprised of a four half-day training course designed to develop the knowledge and skills required to practice evidence-based care. The main outcome measure was change in EBP knowledge and skills, measured using the Spanish version of the Fresno test (score range, 0-212 Results The mean difference between pre-test and post-test was 47.7, a statistically significant result with 95% CI of 42.8-52.5 (p Conclusions The study provides evidence for responsiveness to changes in knowledge and skills in EBP after an educational intervention.
Herr, Keela; Titler, Marita; Fine, Perry; Sanders, Sara; Cavanaugh, Joe; Swegle, John; Forcucci, Chris; Tang, Xiongwen
The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index (CPPI), a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of the those key evidence-based practices (EBPs) that were applicable to their situation. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps including: additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the Pain Treatment Plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by pain medication increases (15.8%); monitoring of analgesic- induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both non-pharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices. PMID:20471542
Malik, Gulzar; McKenna, Lisa; Griffiths, Debra
This paper is drawn from a grounded theory study that aimed to investigate processes undertaken by academics when integrating evidence-based practice into undergraduate curricula. This paper focuses on how nurse academics facilitated students to apply evidence-based practice in theory and practice. Facilitating undergraduate nursing students to develop skills within an evidence-based practice framework is vital to achieving evidence-based care. Studies on evidence-based practice conducted globally suggests that there is a need to investigate approaches used by nurse academics in facilitating students' understanding and use of evidence-based practice during their nurse education. Employing constructivist grounded theory approach, 23 nurse academics across Australian universities were interviewed and nine observed during their teaching. Some study participants shared their unit guides to enrich analysis. Data analysis was performed by following Charmaz's approach of coding procedures; as a result, four categories were constructed. This paper focuses on the category conceptualised as Envisaging the use of evidence-based practice. Findings revealed that most academics-assisted students to use evidence in academic-related activities. Recognising the importance of evidence-based practice in practice, some also expected students to apply evidence-based practice during clinical experiences. However, the level of students' appreciation for evidence-based practice during clinical experiences was unknown to participants and was influenced by practice-related barriers. Acknowledging these challenges, academics were engaged in dialogue with students and suggested the need for academia-practice collaboration in combating the cited barriers. Ensuring academics are supported to emphasise clinical application of evidence-based practice requires strategies at school and practice levels. Faculty development, engagement of clinical nurses with evidence-based practice, supportive
Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M
Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.
Pipe, Teri Britt
An emerging challenge for nursing leadership is how to convey the importance of both evidence-based practice (EBP) and theory-driven care in ensuring patient safety and optimizing outcomes. This article describes a specific example of a leadership strategy based on Rosswurm and Larrabee's model for change to EBP, which was effective in aligning the processes of EBP and theory-driven care.
Manchester, Julianne; Gray-Miceli, Deanna L; Metcalf, Judith A; Paolini, Charlotte A; Napier, Anne H; Coogle, Constance L; Owens, Myra G
Evidence based practices (EBPs) in clinical settings interact with and adapt to host organizational characteristics. The contextual factors themselves, surrounding health professions' practices, also adapt as practices become sustained. The authors assert the need for better planning models toward these contextual factors, the influence of which undergird a well-documented science to practice gap in literature on EBPs. The mechanism for EBP planners to anticipate contextual effects as programs Unfreeze their host settings, create Movement, and become Refrozen (Lewin, 1951) is present in Lewin's 3-step change model. Planning for contextual change appears equally important as planning for the actual practice outcomes among providers and patients. Two case studies from a Geriatric Education Center network will illustrate the synthesis of Lewin's three steps with collaborative evaluation principles. The use of the model may become an important tool for continuing education evaluators or organizations beginning a journey toward EBP demonstration projects in clinical settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
Boisvert, Isabelle; Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M
Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in audiologists, published in 1989. The present questionnaire was completed by 96 audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices.
Full Text Available Abstract Background Many authors, as well as the American Physical Therapy Association, advocate that physical therapists adopt practice patterns based on research evidence, known as evidence-based practice (EBP. At the same time, physical therapists should be capable of integrating EBP within the day-to-day practice of physical therapy. The purpose of this study was to determine the extent to which personal characteristics and the characteristics of the social system in the workplace influence the propensity of physical therapists to adopt EBP. Methods The study used a 69 item mailed self-completion questionnaire. The questionnaire had four major sections. The first three sections were each drawn from a different theoretical framework and from different authors' work. The instrument was developed to capture the propensity of physical therapists to adopt EBP, characteristics of the social system in the workplace of physical therapists, personal characteristics of physical therapists, and selected demographic variables of physical therapists. The eligible population consisted of 3,897 physical therapists licensed by the state of Georgia in the United States of America. A random sample of 1320 potential participants was drawn. Results 939 questionnaires were returned for a response rate of 73%. 831 of the participants' questionnaires were useable and became the basis for the study. There was a moderate association between desire for learning (r = .36, r2 = .13, highest degree held (r = .29, r2 = .08, practicality (r = .27, r2 = .07 and nonconformity (r = .24, r2 = .06 and the propensity to adopt EBP. A negative correlation was found between age, years licensed and percentage of time in direct patient care. The findings demonstrated that the best three variables for predicting the propensity to adopt EBP in physical therapy were: desire for learning, highest degree held, and practicality. Conclusion The study confirms there is no single factor to
Côrtes, Clodoaldo Tentes; Santos, Rafael Cleison Silva Dos; Caroci, Adriana de Souza; Oliveira, Sheyla Guimarães; Oliveira, Sonia Maria Junqueira Vasconcelos de; Riesco, Maria Luiza Gonzalez
Presenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence. An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%. The vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made. The study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.
Newhouse, Robin P
Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.
Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.
Full Text Available The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP, patient care, and therapist personal development.
Tucker, Jalie A; Reed, Geoffrey M
This paper examines the utility of evidentiary pluralism, a research strategy that selects methods in service of content questions, in the context of rehabilitation psychology. Hierarchical views that favor randomized controlled clinical trials (RCTs) over other evidence are discussed, and RCTs are considered as they intersect with issues in the field. RCTs are vital for establishing treatment efficacy, but whether they are uniformly the best evidence to inform practice is critically evaluated. We argue that because treatment is only one of several variables that influence functioning, disability, and participation over time, an expanded set of conceptual and data analytic approaches should be selected in an informed way to support an expanded research agenda that investigates therapeutic and extra-therapeutic influences on rehabilitation processes and outcomes. The benefits of evidentiary pluralism are considered, including helping close the gap between the narrower clinical rehabilitation model and a public health disability model. KEY WORDS: evidence-based practice, evidentiary pluralism, rehabilitation psychology, randomized controlled trials.
Kenny, Deborah J; Goodman, Petra
Care of patients with enteral feeding tubes often is based on tradition and textbook guidance rather than best evidence. Care practices can vary widely both between and within institutions, and this was the case at a northeastern military medical center that served as the site for this evidence-based protocol development and implementation project. The purpose of this study was to describe the development and implementation of an evidence-based clinical protocol for care of patients with enteral feeding tubes. This was an evidence-based implementation project with pretest-posttest measures. Protocol data collection occurred both before and after implementation of the protocol. Data collection tools were based on the literature review and included three domains: (a) documentation of patient procedures, (b) nursing knowledge of each of the specific procedures, and (c) environment of care. Descriptive statistics and data were analyzed using independent samples t tests. Overall staff knowledge of enteral feedings and methods used to unclog both large- and small-bore feeding tubes differed significantly before and after implementation (p tubes. There was a 10% improvement in documentation of patient family education and a 15% improvement in recording fluid flushes during medication administration. After implementation, environment of care data collection showed 100% of patients with head of bed elevated and with functioning suction available, an improvement over levels before implementation. Care must be taken in the interpretation of these findings because it was generally not the same nurses who answered both surveys. High staff turnover within this military hospital also affected sustainment of the protocol implementation. Maintenance activities must be constant and visible within the organization. A champion for evidence-based practice greatly enhances uptake and maintenance of nursing practice change.
Fujimoto, Shuhei; Kon, Noriko; Takasugi, Jun; Nakayama, Takeo
[Purpose] This study aimed to investigate Japanese physical therapists' attitudes of evidence-based practice and clinical practice guidelines. [Subjects and Methods] In 2014, a cross-sectional postal mail survey using a self-administered questionnaire was conducted. Of 2,982 physical therapists belonging to the Chiba Prefecture Physical Therapist Association, 1,000 were randomly selected. The questionnaire comprised 42 items pertaining to the attitudes of and behavior toward evidence-based practice and clinical practice guidelines. It was investigated to reveal the relationship between clinical practice guidelines/evidence-based practice and therapist characteristics. [Results] The response rate was 39.6%, and 384 questionnaires were available. The main results were as follows: 83.3% participants agreed to the importance of evidence-based practice, 77.1% agree to that evidence-based practice supports clinical decision of physical therapists, and about 11% agreed to have been educated about evidence-based practice. Then, 29.2% used, 54.9% agreed to the importance of, and 13.3% agreed to the utility of clinical practice guidelines. An important factor related mostly to a positive attitude, knowledge and behavior of evidence-based practice and clinical practice guidelines was participating in research activities. [Conclusion] Many of physical therapists do not use and understand the importance of clinical practice guidelines. Participating in research activities may partially contribute to improving these conditions.
Ramos-Morcillo, Antonio J; Fernández-Salazar, Serafín; Ruzafa-Martínez, María; Del-Pino-Casado, Rafael
Barriers to the implementation of evidence-based practice (EBP) by nursing professionals include a lack of knowledge, inadequate skills in searching for and appraising evidence, and consulting research articles. However, few studies have addressed the effectiveness of educational interventions to improve their competence. To evaluate the effectiveness of a brief basic online and face-to-face educational intervention to promote EBP attitudes, knowledge and skills, and practice in clinical care nurses. This study was quasi-experimental, pretest-posttest design with a comparison group. The sample included registered nurses enrolled in the free continuing education courses offered in 2013 by the Nursing Council of Jaén (Spain). The study included 109 participants (54 in the intervention group and 55 in the comparison group). The intervention was a brief, basic EBP course with online and face-to-face learning. The comparison group received an educational intervention with different content. The evidence-based practice questionnaire (EBPQ) was used to evaluate EBP attitude, knowledge and skills, and practice before the intervention, and at 21 and 60 days following the intervention. Two-way mixed analysis of variance was conducted. There was a significant difference between intervention and comparison groups in the knowledge and skills dimension. The difference between groups was not significant in the EBP practice dimension. Both groups had high scores in the attitude dimension that did not change after the intervention. A brief basic educational intervention on EBP with online and face-to-face learning can produce improvements in the knowledge and skills of clinical nurses. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.
Marshall, Joanne Gard
Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915
Murphy, Tamara H; Labonte, Paula; Klock, Monica; Houser, Larry
The purpose of this article is to describe and measure the impact of a multifaceted program developed to reduce the falls rate on an acute medical unit at an academic tertiary care center. According to national benchmarks, this unit was one of the hospital's top 3 units for numbers of falls for several years. That distinction drove the hospital and unit leadership and a staff-led unit practice council to develop an evidence-based intervention plan. Interventions included a campaign to raise geriatric awareness, creation of "falls tool boxes," education of staff and family, and implementation of a structured hourly patient rounds schedule. The success of these interventions is discussed, including the effect on the falls rate benchmark. The discussion addresses implications and outcomes associated with the empowerment of nursing staff to respond to benchmarking measures, implement evidence-based practices, and use the same benchmarking procedure to measure outcomes.
Park, Jee-Won; Ahn, Jeong-Ah; Park, Mi-Mi
The purpose of this study was to describe Korean nurses' perceptions, attitudes and utilization intention for evidence-based nursing (EBN), and to explore what factors influence utilization intention. We conducted a cross-sectional survey in 2012. Registered nurses directly involved in clinical practice were recruited at a medical centre in Korea. A total of 420 nurses completed a self-report questionnaire. Results showed that participants reported moderate scores regarding their perceptions and attitudes towards EBN, and rated themselves as higher than the median for utilization intention. Furthermore, this study revealed that perceptions of and attitudes towards EBN, occupational view and previous EBN education were significant factors affecting utilization intention. Nurse educators and managers should encourage nurses to have better attitudes towards EBN, help them be more satisfied with their work and provide them with appropriate education for EBN to establish evidence-based practice as a part of daily nursing care. © 2014 Wiley Publishing Asia Pty Ltd.
Rath, Ana; Salamon, Valérie; Peixoto, Sandra
literature searches without meta-analyses and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. RESULTS: Barriers specific to rare....... CONCLUSIONS: Evidence-based clinical practice for rare diseases should start by collecting clinical data in databases and registries; defining measurable patient-centred outcomes; and selecting appropriate study designs adapted to small study populations. Rare diseases constitute one of the most paradigmatic...... fields in which multi-stakeholder engagement, especially from patients, is needed for success. Clinical research infrastructures and expertise networks offer opportunities for establishing evidence-based clinical practice within rare diseases....
Caputo, Richard K; Mason, Susan E
This article examines the complexities of working with an evidence-based model to design intervention strategies benefiting individuals and families. It addresses the question, to what extent should the evidence of economic advantage for female children raised in two-parent families influence social work support for practices and policies that encourage marriage? The article reviews current research findings indicating benefits of two-parent families on children's well-being and contemporary policy prescriptions promoting marriage. It presents findings of the authors' study which considers the effects of being raised in an intact family on the economic future of young women. The evidence presented in the literature and found in our own study suggests that promotion of marriage may be a sound intervention strategy for parents interested in the economic advantages for their children later in life. For others, it may be the wrong choice based on women's personal circumstances. The association between early family structure and future well-being is further complicated by large gaps in the data on cultural and family diversity. Suggestions for social work practice are based on the synthesis of the evidence-based model and the values of the profession.
Friesen-Storms, Jolanda H H M; Moser, Albine; van der Loo, Sandra; Beurskens, Anna J H M; Bours, Gerrie J J W
To describe the process of implementing evidence-based practice in a clinical nursing setting. Evidence-based practice has become a major issue in nursing, it is insufficiently integrated into daily practice and its implementation is complex. Participatory action research. The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of evidence-based practice were that nurses had little knowledge of evidence-based practice and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of evidence-based practice was adapted. Nurses worked according to the evidence-based practice discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Action research provides an opportunity to empower nurses and to tailor evidence-based practice to the practice context. Applying and implementing evidence-based practice is difficult for front-line nurses with limited evidence-based practice competencies. Adaptation of the academic model of evidence-based practice to a more pragmatic approach seems necessary to introduce evidence-based practice into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice
Romero, Lisa M; Middleton, Dawn; Mueller, Trisha; Avellino, Lia; Hallum-Montes, Rachel
The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement. Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy. Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were "always" available to adolescents. The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities. Published by Elsevier Inc.
Ashktorab; Pashaeypoor; Rassouli; Alavi-Majd
Background Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students’ competencies in EBP. Objectives This study aimed to investigate the nursing students’ knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran. ...
Reviewed by Yasin OZARSLAN
EFFECTIVE BLENDED LEARNING PRACTICES:Evidence-based Perspectives in ICT-facilitated EducationEdited by Elizabeth Stacey and Philippa Gerbic, Information ScienceReference; 1 edition (March 30, 2009), ISBN-10: 1605662968, 358 pp.Reviewed by Yasin OZARSLANFaculty of Education,Eskisehir Osmangazi University,Eskisehir-TURKEYBlended learning refers to the integration of faceto-face and online learning activities with the goal of maximizing the value of students' experiences in both settings. This b...
da Luz, Clarissa Medeiros; Deitos, Julia; Siqueira, Thais Cristina; Palú, Marina; Heck, Ailime Perito Feiber
Abstract Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search wa...
Rangachari, Pavani; Rissing, Peter; Rethemeyer, Karl
This article offers a scholarly review and perspective on the potential of "implementation research" to generate incremental, context-sensitive, evidence-based management strategies for the successful implementation of evidence-based practices (EBPs) (such as the "central line bundle"). Many hospitals have difficulty consistently implementing EBPs at the unit level. This problem has been broadly characterized as "change implementation failure" in health care organizations. The popular hospital response to this challenge has been to raise clinician awareness of EBPs through mandated educational programs. However, this approach has not always succeeded in changing practice. The health services research literature has emphasized the role of several organizational variables (eg, leadership, safety culture, organizational learning, teamwork and communication, and physician/staff engagement) in successful change implementation. Correspondingly, this literature has developed broad frameworks and programs for change in health care organizations. While these broad change frameworks have been successfully applied by some facilities to change practice, they are not incrementally actionable. As such, several facilities have not leveraged broad change frameworks because of resource and/or contextual limitations; a majority of hospitals continue to resort to mandated clinician education (awareness-building) for change implementation. The recent impetus toward "implementation research" in health care has the potential to generate incremental, context-sensitive, evidence-based management strategies for practice change. Authors discuss specific insights from a recently completed study on central line bundle implementation in 2 intensive care units in an academic health center. The study demonstrates that awareness of EBPs alone does not translate to implementation. More importantly, the study also identifies incremental, context-sensitive, evidence-based management strategies for
The objective of the author in this article was to examine possible differences in knowledge and attitudes toward evidence-based practice (EBP) among social workers across geographic regions. A random national sample of 180 NASW members was obtained from mail and Internet groups. MANOVA analysis was performed to determine possible differences in knowledge and attitudes toward EBP among these social workers. Findings suggest that knowledge and attitude toward EBP did not differ among these practitioners. Despite increasing efficacy and widespread knowledge of EBPs, there is little or no empirical evidence to support any differences in attitudes and knowledge of EBP among social workers across geographic regions.
M. Amparo Pérez-Campos
Full Text Available Objective. to determine the evidence-based practice (EBP competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. Methodology: An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ and Practice Environment Scale of the Nursing Work Index (PES-NWI and socio-demographics and professional variables. Results: 314 questionnaires were obtained (76.96%. The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14. The variables associated with a higher competence in EBP were academic level, (p<03001, professional category (p=0.001, country of work (p<0.001, perception of practice environment (p=0,018 and research activities (p<0,036. Conclusions: These nurses showed a moderate level of EBP competence. They revealed a positive attitude towards EBP and achieved intermediate scores in both EBP-related skills and knowledge and their implementation. Higher academic levels and professional categories were associated with greater EBP competence. A practice environment perceived to be unfavorable has a negative influence on EBP implementation.
Solomons, Nan M; Spross, Judith A
The purpose of the present study is to examine the barriers and facilitators to evidence-based practice (EBP) using Shortell's framework for continuous quality improvement (CQI). EBP is typically undertaken to improve practice. Although there have been many studies focused on the barriers and facilitators to adopting EBP, these have not been tied explicitly to CQI frameworks. CINAHL, Academic Search Premier, Medline, Psych Info, ABI/Inform and LISTA databases were searched using the keywords: nurses, information literacy, access to information, sources of knowledge, decision making, research utilization, information seeking behaviour and nursing practice, evidence-based practice. Shortell's framework was used to organize the barriers and facilitators. Across the articles, the most common barriers were lack of time and lack of autonomy to change practice which falls within the strategic and cultural dimensions in Shortell's framework. Barriers and facilitators to EBP adoption occur at the individual and institutional levels. Solutions to the barriers need to be directed to the dimension where the barrier occurs, while recognizing that multidimensional approaches are essential to the success of overcoming these barriers. The findings of the present study can help nurses identify barriers and implement strategies to promote EBP as part of CQI. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
Lavoie-Tremblay, Mélanie; Bonneville-Roussy, Arielle; Richer, Marie-Claire; Aubry, Monique; Vezina, Michel; Deme, Mariama
This article describes the contribution of a Transition Support Office (TSO) in a health care center in Canada to supporting changes in practice based on evidence and organizational performance in the early phase of a major organizational change. Semistructured individual interviews were conducted with 11 members of the TSO and 13 managers and clinicians from an ambulatory sector in the organization who received support from the TSO. The main themes addressed in the interviews were the description of the TSO, the context of implementation, and the impact. Using the Competing Value Framework by Quinn and Rohrbaugh [Public Product Rev. 1981;5(2):122-140], results revealed that the TSO is a source of expertise that facilitates innovation and implementation of change. It provides material support and human expertise for evidence-based projects. As a single organizational entity responsible for managing change, it gives a sense of cohesiveness. It also facilitates communication among human resources of the entire organization. The TSO is seen as an expertise provider that promotes competency development, training, and evidence-based practices. The impact of a TSO on change in practices and organizational performance in a health care system is discussed.
Evidence-based practice requires that clinical decisions be based on evidence from rigorously controlled research studies. At this time, very few studies have directly examined the efficacy of clinical intervention methods for bilingual children. Clinical decisions for this population cannot, therefore, be based on the strongest forms of research evidence, but must be inferred from other sources. This article reviews the available intervention research on bilingual children, the current clinical recommendations for this population, and the strength of the empirical and theoretical support on which these recommendations are based. Finally, future directions are suggested for documenting current methods of intervention and developing optimal methods for different groups of bilingual children. Although the current research base is limited, the few studies available to date uniformly suggest that interventions that include a focus on both languages are superior to those that focus on only one language. The available research offers little guidance, however, as to the particular treatment methods that may be most appropriate. Further research is required to examine efficacy with larger numbers of children and children of various bilingual backgrounds. It is suggested that efforts to develop and test intervention methods for bilingual children must carefully consider the linguistic heterogeneity of bilingual children and the cultural variation in communication styles, child rearing practices, and child rearing beliefs. This will lead to the development of methods that may involve treatment methods that are more suitable for other languages and cultures. Readers will become familiar with current recommendations for the treatment of bilingual children with language impairment, including which language or languages to use, the requirement for cultural sensitivity, and specific procedures that may be beneficial for bilingual populations. The heterogeneity of the bilingual
Afrashtehfar, Kelvin I; Assery, Mansour K
It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.
Skela-Savič, Brigita; Hvalič-Touzery, Simona; Pesjak, Katja
To establish the connection between values, competencies, selected job characteristics and evidence-based practice use. Nurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies. A cross-sectional, non-experimental quantitative explorative research design. Standardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015. The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low. Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association. © 2017 John Wiley & Sons Ltd.
Ficarra, Laura; Quinn, Kevin
In the present investigation, teachers' self-reported knowledge and competency ratings for the evidence-based classroom management practices were analysed. Teachers also reflected on how they learned evidence-based classroom management practices. Results suggest that teachers working in schools that implement Positive Behavioural Interventions and…
Aarons, Gregory A.; Glisson, Charles; Hoagwood, Kimberly; Kelleher, Kelly; Landsverk, John; Cafri, Guy
The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure…
Neldon, Gayle B.
Evidence-based practice (EBP) is a strategy for the provision of high quality health care. The use of journals to document clinical experiences and reflection has been used in speech-language pathology as well as nursing and psychology. This study uses qualitative analysis to study what AuD students learn about evidence-based practice from writing…
Szucs, Kimberly A; Benson, Jeryl D; Haneman, Brianne
Journal clubs are used in both clinical and academic settings in order for clinicians and students to utilize current best-practices, become competent in evidence based practice and develop critical appraisal skills. Journal clubs encourage students to practice searching for relevant research, critically appraising articles, and contributing to open discussions with peers. Establishing the practice of reading and critiquing literature in the classroom can enable the creation of a habit of using current evidence when students enter practice. This article describes a strategy for delivering a structured academic journal club to support the learning of evidence based practice skills and students' perception of the journal club, including their overall satisfaction, knowledge base skills, and presentation skills. Students had an overall positive experience and perception of the guided journal club activity. From the instructor's perspective, this assignment was an excellent opportunity to engage students in learning the process of evidence based practice.
Rosen, Raymond C; Ruzek, Josef I; Karlin, Bradley E
There is a pressing global need for trained and competent mental health clinicians to deliver evidence-based psychological therapies to millions of trauma survivors in need of care. Three model, large-scale training programs were initiated a decade ago, one in the United Kingdom (U.K.), and two in the United States (U.S.), to disseminate high-quality, evidence-based psychological care to traumatized children and adults in need of assistance. Milestone contributions to implementation science have been made by each of these training programs, although limitations and challenges remain to be considered. In contrast, culturally adapted and simplified PTSD interventions and therapy training programs have also been developed and tested during the past decade, three of which show particular promise for broader implementation. These simplified but evidence-based interventions have been developed for use by lay counsellors or health technicians with minimal or no prior mental health training. Finally, a growing range of technology-based and technology-assisted training models for PTSD providers have also been developed and disseminated in the past decade. This trend is expected to accelerate as more providers become accustomed to acquiring clinical training in this modality or format, although significant barriers to technology-based training will need to be overcome. Copyright © 2016. Published by Elsevier Ltd.
Sommerfeld David H
Full Text Available Abstract Background The goal of this study is to extend research on evidence-based practice (EBP implementation by examining the impact of organizational type (public versus private and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170. Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in
Van Biervliet, Jérôme
The practice of equine neurology has special challenges posed by the size of the animal being examined. Many diagnostic procedures routinely used in small animal practice are unsafe when applied to the equine patient or unavailable to the equine practitioner. Therefore, astute observation is the mainstay of making a neuroanatomic diagnosis, and detailed evidence on the deficits present may be difficult to obtain. Because clinical observation can sometimes be ambiguous and somewhat subjective, it is even more important to approach equine neurology from an evidence-based point of view. Here, such an approach is outlined for the diagnosis of cervical vertebral compressive myelopathy (CVCM), one of the most common noninfectious causes of equine neurologic disease. This article is an attempt to summarize all aspects of making a diagnosis of CVCM on the basis of signalment, clinical examination, ancillary diagnostic tests, and pathologic examination. Each of these considerations has inherent limitations regarding diagnostic accuracy, which are discussed.
National governments use evidence selectively to argue that a successful policy intervention in one local area should be emulated in others ("evidence-based best practice"). However, the value of such evidence is always limited because there is: disagreement on the best way to gather evidence of policy success, uncertainty regarding the…
Daniel L. Moody
Full Text Available In most professional (applied disciplines, research findings take a long time to filter into practice, if they ever do at all. The result of this is under-utilisation of research results and sub-optimal practices. There are a number of reasons for the lack of knowledge transfer. On the "demand side", people working in professional practice have little time available to keep up with the latest research in their field. In addition, the volume of research published each year means that the average practitioner would not have time to read all the research articles in their area of interest even if they devoted all their time to it. From the "supply side", academic research is primarily focused on the production rather than distribution of knowledge. While they have highly developed mechanisms for transferring knowledge among themselves, there is little investment in the distribution of research results be-yond research communities. The World Wide Web provides a potential solution to this problem, as it provides a global information infrastructure for connecting those who produce knowledge (researchers and those who need to apply this knowledge (practitioners. This paper describes two projects which use the World Wide Web to make research results directly available to support decision making in the workplace. The first is a successful knowledge management project in a health department which provides medical staff with on-line access to the latest medical research at the point of care. The second is a project currently in progress to implement a similar system to support decision making in IS practice. Finally, we draw some general lessons about how to improve transfers of knowledge from research and practice, which could be applied in any discipline.
Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap
The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use
Pérez-Campos, M Amparo; Sánchez-García, Inmaculada; Pancorbo-Hidalgo, Pedro L
to determine the evidence-based practice (EBP) competence of Spanish and Latin-American nurses participating in professional forums on the Internet and estimate the influence of socio-demographic and professional factors on their competence, which was defined as knowledge of, attitude towards, and implementation of EBP. An online survey was administered to a convenience sample of nurses active in Internet forums, comprising validated Spanish versions of the Evidence-Based Practice Questionnaire (EBPQ) and Practice Environment Scale of the Nursing Work Index (PES-NWI) and socio-demographics and professional variables. 314 questionnaires were obtained (76.96%). The mean EBPQ score was 5.02 out of 7 (95%CI, 4.89-5.14). The variables associated with a higher competence in EBP were academic level, (pnurses showed a moderate level of EBP competence. They revealed a positive attitude towards EBP and achieved intermediate scores in both EBP-related skills and knowledge and their implementation. Higher academic levels and professional categories were associated with greater EBP competence. A practice environment perceived to be unfavorable has a negative influence on EBP implementation.
Argimon-Pallàs, Josep M; Flores-Mateo, Gemma; Jiménez-Villa, Josep; Pujol-Ribera, Enriqueta
To assess the effectiveness (change in knowledge and skills measured by the Fresno test) of a short course in Evidence Based Practice (EBP) carried out in a group of family medicine residents Before-after study. Participants' were 152 Family Medicine residents in their second year of the training programme. Settings were Primary Care Teaching Units in Catalonia. Intervention was comprised of a four half-day training course designed to develop the knowledge and skills required to practice evidence-based care. The main outcome measure was change in EBP knowledge and skills, measured using the Spanish version of the Fresno test (score range, 0-212) The mean difference between pre-test and post-test was 47.7, a statistically significant result with 95% CI of 42.8-52.5 (p questions related to calculations such as sensitivity, specificity, the absolute risk reduction or the number needed to treat. A more modest increase was found in the residents' knowledge and skills in finding the best clinical evidence, and appraising the validity and applicability of an article. Finally, a weak and non-statistically significant improvement was found in formulating a clinical question. The study provides evidence for responsiveness to changes in knowledge and skills in EBP after an educational intervention.
Correa-Bautista, Jorge Enrique; Muñoz-Rodríguez, Diana Isabel; Ramírez, Lorena; González-Ruíz, Katherine; Domínguez-Sánchez, María Andrea; Durán-Palomino, Diana; Girabent-Farrés, Montserrat; Flórez-López, María Eugenia; Bagur-Calafat, M Caridad
Objective: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. Methods: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. Results: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. Conclusion: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice. PMID:26019383
Roberts, Michael C; Blossom, Jennifer B; Evans, Spencer C; Amaro, Christina M; Kanine, Rebecca M
Evidence-based practice (EBP) has become a central focus in clinical child and adolescent psychology. As originally defined, EBP in psychology is the integration of the best available research evidence, patient characteristics, and clinical expertise. Although evidence-based perspectives have garnered widespread acceptance in recent years, there has also been some confusion and disagreement about the 3-part definition of EBP, particularly the role of research. In this article, we first provide a brief review of the development of EBP in clinical child and adolescent psychology. Next, we outline the following 4 points to help clarify the understanding of EBP: (a) knowledge should not be confused with epistemic processes, (b) research on clinician and client factors is needed for EBP, (c) research on assessment is needed for EBP, and (d) the 3-part conceptualization of EBP can serve as a useful framework to guide research. Based on these principles, we put forth a slightly revised conceptualization of EBP, in which the role of research is expanded and more clearly operationalized. Finally, based on our review of the literature, we offer illustrative examples of specific directions for future research to advance the evidence base for EBP in clinical child and adolescent psychology.
Chen, Zheng-guang; Luo, Hui; Xu, Shan; Yang, Yan; Wang, Shou-chuan
At present, evidence-based clinical practice guideline (EBCPG) is the main mode of developing clinical practice guidelines (CPGs) in the world, but in China, most of CPGs of Chinese medicine (CM) are still guidelines based on expert consensus. The objective of this study is to construct initially the methodology of developing EBCPGs of CM and to promote the development of standardization of CM. Based on the development of "Guideline for Diagnosis and Treatment of Common Pediatric Diseases in CM", the methodology of developing EBCPG of CM was explored by analyzing the pertinent literature and considering the characteristics of CM. In this study, the key problem was to put forward the suggestion and strategies. However, due to the methodology study of developing EBCPG of CM is still in the initial stage, there are still some problems which need further study.
This guest feature from Suzanne Lewis, a long-time advocate of evidence based library and information practice (EBLIP) in Australia, discusses a current trend within the movement that focuses on the skills, knowledge and competencies of health librarians. In particular, the feature describes three specific Australia-based research projects, on expert searching, indigenous health and future skills requirements for the health library workforce respectively, that exemplify this trend. These projects illustrate how the evidence base can be strengthened around the skills and knowledge required to deliver services that continue to meet the changing needs of health library and information users. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.
Aarons, Gregory A.; Sommerfeld, David H.
Objective Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Methods Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader member exchange with innovation climate and attitudes toward adoption and use of EBP. Results Transformational leadership predicted higher innovation climate during implementation while leader member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Conclusions Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. PMID:22449648
Kegel, Gary; Marshall, Astrid; Barron, O Alton; Catalano, Louis W; Glickel, Steven Z; Kuhn, Margaret
A survey regarding upper-extremity steroid injection practices was distributed to all active members of the American Society for Surgery of the Hand (ASSH) and American Shoulder and Elbow Surgeons (ASES) using SurveyMonkey. Response rates for the ASSH and ASES were 26% and 24%, respectively. The potency-adjusted dose of steroid injected for common hand and wrist injections ranged from 0.375 to 133.33 mg and for shoulder injections ranged from 0.375 to 250 mg. These ranges span 356-fold and 667-fold differences, respectively. Potency-adjusted doses differed significantly between steroid types for all injections evaluated in this study. American Society for Surgery of the Hand members gave significantly smaller doses of steroid for the glenohumeral and acromioclavicular joints than ASES members. Only 9% of respondents based injection practice on a scientific reference. Sixteen percent of ASSH and 31% of ASES respondents reported no specific rationale for their steroid injection practice; 78% of ASSH and 52% of ASES respondents attributed their rationale to some kind of instruction from their mentors or colleagues. Upper-extremity surgeons demonstrate substantial variability in their practice of steroid injections, with up to a 667-fold range in steroid dose. Experienced clinical opinion is the principal rationale for these injection practices; little rationale is based on formal scientific evidence. Copyright 2013, SLACK Incorporated.
Suárez, Natalia; Sánchez, Carmen R; Jiménez, Juan E; Anguera, M Teresa
The main goal of this study was to analyze whether primary teachers use evidence-based reading instruction for primary-grade readers. The study sample consisted of six teachers whose teaching was recorded. The observation instrument used was developed ad hoc for this study. The recording instrument used was Match Vision Studio. The data analysis was performed using SAS, GT version 2.0 E, and THEME. The results indicated that the teaching practices used most frequently and for the longest duration were: feedback (i.e., correcting the student when reading); fluency (i.e., individual and group reading, both out loud and silently, with and without intonation); literal or inference comprehension exercises (i.e., summarizing, asking questions); and use of educational resources (i.e., stories, songs, poems). Later, we conducted analyses of T-Patterns that showed the sequence of instruction in detail. We can conclude that teaching practices used by the majority of teachers were based on the recommendations of the National Reading Panel (NRP). Only one teacher followed best practices. The same was the case for instructional time spent on the five essential components of reading, with the exception of teacher E., who dedicated 70.31% of class time implementing best practices. Teaching practices (i.e., learners' activities) designed and implemented to exercise and master alphabetic knowledge and phonological awareness skills were used less frequently in the classroom.
Full Text Available The main goal of this study was to analyze whether primary teachers use evidence-based reading instruction for primary-grade readers. The study sample consisted of six teachers whose teaching was recorded. The observation instrument used was developed ad hoc for this study. The recording instrument used was Match Vision Studio. The data analysis was performed using SAS, GT version 2.0 E, and THEME. The results indicated that the teaching practices used most frequently and for the longest duration were: feedback (i.e., correcting the student when reading; fluency (i.e., individual and group reading, both out loud and silently, with and without intonation; literal or inference comprehension exercises (i.e., summarizing, asking questions; and use of educational resources (i.e., stories, songs, poems. Later, we conducted analyses of T-Patterns that showed the sequence of instruction in detail. We can conclude that <50% of the teaching practices used by the majority of teachers were based on the recommendations of the National Reading Panel (NRP. Only one teacher followed best practices. The same was the case for instructional time spent on the five essential components of reading, with the exception of teacher E., who dedicated 70.31% of class time implementing best practices. Teaching practices (i.e., learners' activities designed and implemented to exercise and master alphabetic knowledge and phonological awareness skills were used less frequently in the classroom.
Vortherms, Jane; Spoden, Brenda; Wilcken, Jill
Reliable and valid outpatient oncology acuity-based staffing systems are lacking. The existing staffing model in a midwestern cancer center demonstrated inefficiencies related to unpredictable patient flow, treatment regimen complexity, and physician practice variation. A project was initiated to implement an evidence-based oncology outpatient staffing system maximizing patient satisfaction, employee engagement, and equity in workload distribution. The strength of evidence for 34 articles and 12 additional documents was moderate to strong, supporting development of an acuity-based staffing system. Evidence indicates that nursing assignments directly contribute to patient flow efficiency. An acuity point system was established. A six-month pilot was completed comparing a control group to a pilot group, with defined maximum acuity points per nurse. Inter-group comparison included acuity scores, patient satisfaction, wait time, employee engagement, nurse overtime, and turnover. Resultant changes included scheduled nurse time (preparation, charting, lunch breaks), revised acuity-based patient scheduling, and a revised nursing care delivery model. Implementation of the acuity-based system provided consistent staffing, improved efficiency, reduced overtime, and improved patient and staff satisfaction. Recommendations include adaptation of the acuity-based system to other outpatient settings and development of staffing level benchmarks.
Robinson, Deborah; Schulz, Ginny; Langley, Rachel; Donze, Kevin; Winchester, Kari
Hemorrhagic cystitis is a known complication of cyclophosphamide, an anti-neoplastic agent used to treat a variety of oncologic diseases in children. Hydration can prevent hemorrhagic cystitis; however, use varies in clinical practice. A team was assembled to develop evidence-based practice recommendations to address the following question: in a population of children with cancer, what is the appropriate pre and post hydration for the administration of different dose levels of intravenous cyclophosphamide to prevent bladder toxicity? The purpose was to identify the appropriate rate, duration and route of hydration to prevent bladder toxicity with low, intermediate and high dose cyclophosphamide. After a systematic search of the literature, 15 pieces of evidence were evaluated and used. There is a moderate level of quality evidence related to hydration for high dose cyclophosphamide and very low quality evidence related to intermediate or low dose cyclophosphamide. Three general recommendations were made for hydration associated with cyclophosphamide. There is a need for further research related to the prevention of bladder toxicity in children with cancer receiving cyclophosphamide. PMID:24799445
Highfield, Martha E F; Collier, Andrea; Collins, Mara; Crowley, Melanie
Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.
Everett, Linda Q; Sitterding, Mary Cathryn
In a pay-for-performance environment, implementing and sustaining evidence-based practice (EBP) is no longer a luxury but a necessity. A critical driving force for EBP is that our communities-the people we serve-expect to receive care based on the best available evidence. Transformational nursing leadership is required to create an infrastructure that influences organizational factors, processes and expectations, thus enabling the sustainability of EBP. The American Nurses Credentialing Center and the American Organization of Nurse Executives provide a framework for nursing leaders to consider when designing EBP implementation structures. This exemplar illustrates nursing leadership competencies with regard to implementation and sustainability of EBP within a multihospital system.
Full Text Available Abstract Background While the potential of clinical practice guidelines (CPGs to support implementation of evidence has been demonstrated, it is not currently being achieved. CPGs are both poorly developed and ineffectively implemented. To improve clinical practice and health outcomes, both well-developed CPGs and effective methods of CPG implementation are needed. We sought to establish whether there is agreement on the fundamental characteristics of an evidence-based CPG development process and to explore whether the level of guidance provided in CPG development handbooks is sufficient for people using these handbooks to be able to apply it. Methods CPG development handbooks were identified through a broad search of published and grey literature. Documents published in English produced by national or international organisations purporting to support development of evidence-based CPGs were included. A list of 14 key elements of a CPG development process was developed. Two authors read each handbook. For each handbook a judgement was made as to how it addressed each element; assigned as: 'mentioned and clear guidance provided', 'mentioned but limited practical detail provided ', or 'not mentioned'. Results Six CPG development handbooks were included. These were produced by the Council of Europe, the National Health and Medical Research Council of Australia, the National Institute for Health and Clinical Excellence in the UK, the New Zealand Guidelines Group, the Scottish Intercollegiate Guideline Network, and the World Health Organization (WHO. There was strong concordance between the handbooks on the key elements of an evidence-based CPG development process. All six of the handbooks require and provide guidance on establishment of a multidisciplinary guideline development group, involvement of consumers, identification of clinical questions or problems, systematic searches for and appraisal of research evidence, a process for drafting
Sanneke de la Rie
Full Text Available Neighbourhood deprivation monitoring in Rotterdam and London: exploring barriers to evidence-based policy and practice There is ample evidence that area-based approaches to tackling health inequalities, as part of a wider policy of community regeneration, are effective. Nevertheless, embedding this evidence in the routine practice of health professionals has not followed automatically. One of the barriers to the uptake of research is the process by which evidence is generated and its usability, or “stickiness”. This paper draws on the concept of stickiness to explore the role of deprivation monitoring data in creating an evidence base for neighbourhood health policies and intervention. The study was undertaken as part of a Knowledge Exchange Programme aimed at sharing learning to improve the participation and health of disadvantaged people in deprived neighbourhoods in Rotterdam and London. The two cities are similar in that they both have highly diverse populations and government health and social policies that employ area-based approaches to tackle deprivation. Documentary analysis and in-depth interviews with health professionals and policymakers in the two cities have explored the construction of health policy, the congruence between data on deprivation and the contextual experience of practitioners, and the factors that influenced the usability of the data. Monitoren van achterstand op wijkniveau in Rotterdam en Londen: een verkenning van obstakels binnen “evidence-based” beleid en praktijk Een gebiedsgerichte aanpak om achterstandswijken te vernieuwen is effectief gebleken om ongelijkheid op het gebied van gezondheid aan te pakken. Toch wordt het bewijs voor de werkzaamheid van deze aanpak niet automatisch ingebed in de dagelijkse werkpraktijk van professionals in de gezondheidssector. Een van de factoren waardoor kennis uit onderzoek niet wordt opgenomen ligt besloten in het proces van kennisverwerving en de bruikbaarheid van de
Lefebvre, Hélène; Roy, Odette; Sahtali, Sarah; Rothan-Tondeur, Monique
Nurses in clinical settings still do not fully rely on scientific knowledge to guide their practices and only rarely resort to the literature to find answers to their questions or clinical concerns. The sustainable implementation of projects that use knowledge founded on scientific evidence presents an important challenge that nursing research must address. The goal of this article is to present a strategy adopted by the Réseau infirmier et partenaires de soins (RI-PS) of the Université de Montréal (Québec). The strategy's aim is to promote the optimal and perennial use of scientific knowledge in clinical settings and to incorporate the use of best practices based on scientific evidence to their operating procedure. First, we will present a brief overview of the evolution of nursing research and its impacts, followed by an inventory of the success factors of the use of scientific knowledge in practical settings, and finally the presentation of a model, Implementation Science, on which the RI-PS strategy relies for its projects. We also outline the network and one of its developments, the knowledge transfer portal and healthcare partners (PES).
Lilienfeld, Scott O; Ritschel, Lorie A; Lynn, Steven Jay; Cautin, Robin L; Latzman, Robert D
Psychotherapists are taught that when a client expresses resistance repeatedly, they must understand and address its underlying sources. Yet proponents of evidence-based practice (EBP) have routinely ignored the root causes of many clinical psychologists' reservations concerning the use of scientific evidence to inform clinical practice. As a consequence, much of the resistance to EBP persists, potentially widening the already large scientist-practitioner gap. Following a review of survey data on psychologists' attitudes toward EBP, we examine six sources underpinning resistance toward EBP in clinical psychology and allied domains: (a) naïve realism, which can lead clinicians to conclude erroneously that client change is due to an intervention itself rather than to a host of competing explanations; (b) deep-seated misconceptions regarding human nature (e.g., mistaken beliefs regarding the causal primacy of early experiences) that can hinder the adoption of evidence-based treatments; (c) statistical misunderstandings regarding the application of group probabilities to individuals; (d) erroneous apportioning of the burden of proof on skeptics rather than proponents of untested therapies; (e) widespread mischaracterizations of what EBP entails; and (f) pragmatic, educational, and attitudinal obstacles, such as the discomfort of many practitioners with evaluating the increasingly technical psychotherapy outcome literature. We advance educational proposals for articulating the importance of EBP to the forthcoming generation of clinical practitioners and researchers, and constructive remedies for addressing clinical psychologists' objections to EBP. Copyright © 2013 Elsevier Ltd. All rights reserved.
Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Stein, Janice Gross; White, Eleanor
To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. An "extraction" team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of "conservative" care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to, or better than the published evidence. REPORTED
Full Text Available In the nursing profession, EBP makes a positive contribution to healthcare outcomes, care delivery, clinical teaching and research. The research objective was to determine the nurses' knowledge, attitude, practice towards EBP and barriers to use EBP in four (4 Government Hospitals in Malaysia, Hospital Universiti Sains Malaysia (HUSM, Hospital Pulau Pinang (HPP, Hospital Sultan Abdul Halim (HSAH and Hospital Seberang Jaya (HSJ. A cross-sectional study was conducted from January until December 2012 among (n=600 nurses working in all disciplines, on shift or day time duties in four selected hospitals. The questionnaire was adapted from a Singapore study (Majid, 2011. Results showed that among the nurses working in 4 different Malaysian hospitals, close to fifty percent (53 % knew what the evidence based practice meant. The items assessing the attitude showed a large number nurses responding that they did neither agree nor disagree with statements provided. The majority of the remaining nurses tended to show a rather positive attitude except when asked about how the workload interfered with their EBP practice. The practice level of EBP scored a mean of more than 3 out of maximal five for most items. Most nurses recognized there were many barriers to EBP in their working place. In conclusion, this study may have helped to increase our understanding of knowledge, attitudes, practice and barriers towards to use of EBP to the utilization of research by nurses through an exploration of perceived barriers and facilitators on the part of nurses.
Toche-Manley, L; Grissom, G; Dietzen, L; Sangsland, S
Converting the findings from addictions studies into information actionable by (non-research) treatment programs is important to improving program outcomes. This paper describes the translation of the findings of studies on Patient-Services matching, prediction of patient response to treatment (Expected Treatment Response) and prediction of dropout to provide evidence-based decision support in routine treatment. The findings of the studies and their application to the development of an outcomes management system are described. Implementation issues in a network of addictions treatment programs are discussed. The work illustrates how outcomes management systems can play an important role in translating research into practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
Current theories of bereavement are available and complex and suggest that for the bereaved there is no single pathway through grief. This challenges ethically motivated bereavement counselors to integrate theory into evidence-based practice. The Assimilation of Problematic Experiences Sequence offers a way forward for evaluating the effectiveness of bereavement counseling. Parallels are drawn between grief as disrupted self-narrative and grief as the dissociated voices of unassimilated experience. This assimilation sequence is proposed as a means of tracking psychological change in bereaved clients.
Heck, Nicholas C
Although there are descriptions of transgender-affirmative group psychotherapy services in the literature, there is limited research on the topic. Mental health professionals who plan to offer such services should draw on evidence-based treatments, where appropriate, and have a working knowledge of current standards of care, practice guidelines, and counseling competencies. This article reviews and synthesizes the existing research and scholarship on this topic, placing an emphasis on group-specific competencies and intervention components that can be integrated into psychotherapy groups for transgender and gender nonconforming clients. Copyright © 2016 Elsevier Inc. All rights reserved.
Green, Amy E; Aarons, Gregory A
The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.
Gama, Zenewton A S; Medina-Mirapeix, Francesc; Saturno, Pedro J
To evaluate the effectiveness of an ad hoc multifaceted program to improve structure, professional behavior, and outcomes related to falls prevention. Internal quality improvement cycle. Nursing home in Spain. An institution with 130 residents. Local building of quality criteria, audit and feedback, and a specific intervention to improve based on educational and sensitization activities and changes in the process and recording systems. Quality of falls prevention was assessed using reliable evidence-based criteria (4 of structure and 9 of process), at baseline and 6 months after a specific intervention to improve. Number of falls was recorded in a random sample (n = 60) of residents (≥ 65 years) during a 1-year follow-up and summarized fortnightly as an indicator analyzed using a statistical control chart. Baseline structure and fall prevention practices were poor. After the intervention, all structure criteria were present and 8 of 9 process criteria improved significantly. Thirty-two falls occurred 6 months before and 21 after the intervention started, showing a significant decrease in the fortnightly incidence (P < .01). Adherence to evidence-based recommendations was poor in our setting, but the internal quality improvement cycle was useful in ensuring safe practices and in achieving better outcomes. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
Choi, Mona; Kim, Hee Sun; Chung, Su Kyoung; Ahn, Mee Jung; Yoo, Jae Yong; Park, Ok Sun; Woo, So Rah; Kim, So Sun; Kim, Sun Ah; Oh, Eui Geum
The purpose of this study is to implement an evidence utilization project using an audit and feedback approach to improve cancer pain management. A three-phased audit and feedback approach was used. A 46-bed oncology nursing unit in the university's cancer centre was selected as a research site. Nursing records extracted from 137 patients (65 for the baseline assessment and 72 for the follow-up audit) were used to examine nurse compliance with four audit criteria derived from best practice guidelines related to the assessment and management of pain. We observed a significant improvement in compliance from baseline to follow-up for the following criteria: documenting the side effects of opioids (2-83%), use of a formalized pain assessment tool (22-75%), and providing education for pain assessment and management to patients and caregivers (0-47%). The audit and feedback method was applicable to the implementation of clinical practice guidelines for cancer pain management. Leadership from both administrative personnel and staff nurses working together contributes to the spread of an evidence-based practice culture in clinical settings. As it was conducted in a single oncology nursing unit and was implemented over a short period of time, the results should be carefully interpreted. © 2013 Wiley Publishing Asia Pty Ltd.
Brody, Abraham Aizer; Barnes, Kathi; Ruble, Cheryl; Sakowski, Julie
This study aimed to examine the effects of participation in staff nurse-led practice councils on nurse job satisfaction and professional development. Although evidence-based practice (EBP) has become a key component of improving the quality of care, few studies have examined how implementation of staff nurse led councils model affect the involved nurses. A 3-stage evaluation involving ethnography, semi-structured phenomenological private interviews and a 10-item survey were conducted with nurses, managers and executives participating in or involved with EBP councils tasked with improving patient outcomes at 6 community hospitals in a single non-profit hospital system. Five themes were identified as outcomes: empowerment, meaningfulness, leadership growth, exposure to quality improvement, and vision. Staff-led councils have the potential to improve quality of care, job satisfaction, vision and leadership provided that managers and executives are sufficiently prepared to work with and support the councils.
Brimhall, Kim C.; Fenwick, Karissa; Farahnak, Lauren R.; Hurlburt, Michael S.; Roesch, Scott C.
The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care. PMID:26152770
Brimhall, Kim C; Fenwick, Karissa; Farahnak, Lauren R; Hurlburt, Michael S; Roesch, Scott C; Aarons, Gregory A
The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care.
Berke, David M; Rozell, Cassandra A; Hogan, Thomas P; Norcross, John C; Karpiak, Christie P
Evidence-based practice (EBP) requires that practitioners routinely access, appraise, and utilize the best available research. We surveyed a representative sample of the Society of Clinical Psychology; 549 psychologists (response rate = 46%) reported their frequency of engaging in EBP when offering psychological services, rated their current knowledge of 12 online research resources, and evaluated their current knowledge of 12 research methods and designs. These psychologists reported, on average, using EBP in 73.1% of their psychological services. With the exception of PsycINFO and MEDLINE, clinical psychologists related low to moderate knowledge of online research resources. By contrast, these psychologists reported considerable knowledge of most research methods and designs, except for odds ratios and structural equation modeling. Psychologists' theoretical orientation, clinical experience, and employment setting predicted knowledge of both online resources and research designs. We discuss the educational and practice ramifications of these results. © 2011 Wiley Periodicals, Inc.
Austin, Michael J; Claassen, Jennette
Evidence-based practice (EBP) seeks to integrate the expertise of individual practitioners with the best available evidence within the context of the values and expectations of clients. Prior to implementing EBP, it is important to understand the significance that organizational change and organizational culture play. This article seeks to explore the literature associated with both organizational change and organizational culture. The analysis of organizational culture and change draw upon findings from both the private, for-profit sector, and the public, non-profit field. It is divided into four sections: organizational change and innovation, organizational culture, managing organizational culture and change, and finally, applying the findings to the implementation of EBP. While the audience for this analysis is managers in public and nonprofit human service organizations who are considering implementing EBP into their work environment, it is not intended to provide a "how to" guide, but rather a framework for critical thinking.
Jakubec, Sonya L; Astle, Barbara J
This article describes the implementation of an innovative research literacy teaching-learning activity. The Research in Practice Challenge activity promoted the importance and relevance of evidence-based practice with second-year nursing students in an undergraduate research course. Students appraised the evidence within policies and practice guidelines identified by managers in practice. Collaboration among students, faculty, managers, and the librarian enabled completion of the activity. Essential skills of identifying research problems in practice, searching the literature, and critically evaluating evidence were applied. Ultimately, students were asked to respond to the question: "Does this policy or guideline need revision, and how, based upon current evidence?" Effectiveness of this activity was garnered from the students' responses to course evaluations and analysis of teaching notes. Course evaluation revealed that students valued how the activity highlighted the relevance of research literacy for their practice. Further recommendations for research literacy teaching and learning are suggested. Copyright 2012, SLACK Incorporated.
Straub-Morarend, Cheryl L; Marshall, Teresa A; Holmes, David C; Finkelstein, Michael W
Academic dental institutions today seek to provide curricular content and learning opportunities for students to develop an essential skill set for evidence-based practice. To support that effort, studies that explore current practice patterns are valuable in identifying factors that influence the evidence-based habits and behaviors of dental school graduates. The purpose of this study was to explore the knowledge, perceptions, and behavior of private practice dentists in the state of Iowa with respect to evidence-based dentistry and to determine the influence of the dentist's education and the scope of his or her practice on those opinions and habits. A questionnaire addressing practitioners' familiarity with, understanding of, and adoption of an evidence-based philosophy of practice was mailed in September 2009 to all dentists licensed and practicing in Iowa. Questionnaires were returned by 518 practitioners, for an overall response rate of 38.4 percent. The majority of respondents reported awareness, understanding, and adoption of an evidence-based approach to their practice of dentistry. Recent graduates were more likely to report insufficient time as the primary obstacle to practicing evidence-based dentistry. Dental specialists indicated a higher level of comfort in assessing scientific information, as well as implementing current reliable, valid published research in practice, than did general practitioners.
Full Text Available When designing interventions and policies to implement evidence based healthcare, tailoring strategies to the targeted individuals and organizations has been recommended. We aimed to gather insights into the ideas of a variety of people for implementing evidence-based practice for patients with chronic diseases, which were generated in five European countries.A qualitative study in five countries (Germany, Netherlands, Norway, Poland, United Kingdom was done, involving overall 115 individuals. A purposeful sample of four categories of stakeholders (healthcare professionals, quality improvement officers, healthcare purchasers and authorities, and health researchers was involved in group interviews in each of the countries to generate items for improving healthcare in different chronic conditions per country: chronic obstructive pulmonary disease, cardiovascular disease, depression in elderly people, multi-morbidity, obesity. A disease-specific standardized list of determinants of practice in these conditions provided the starting point for these groups. The content of the suggested items was categorized in a pre-defined framework of 7 domains and specific themes in the items were identified within each domain.The 115 individuals involved in the study generated 812 items, of which 586 addressed determinants of practice. These largely mapped onto three domains: individual health professional factors, patient factors, and professional interactions. Few items addressed guideline factors, incentives and resources, capacity of organizational change, or social, political and legal factors. The relative numbers of items in the different domains were largely similar across stakeholder categories within each of the countries. The analysis identified 29 specific themes in the suggested items across countries.The type of suggestions for improving healthcare practice was largely similar across different stakeholder groups, mainly addressing healthcare
Kao Uyen H
Full Text Available Abstract Background Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Methods Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73. Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Results Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Conclusion Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to
Veniegas, Rosemary C; Kao, Uyen H; Rosales, Ricki
Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73). Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to ensure that reinventions are evaluated and consistent with the
Full Text Available Patricia PoirierUniversity of Maine School of Nursing, Orono, ME, USAAbstract: It has been estimated that 50%–60% of patients diagnosed with cancer will receive radiation therapy at some point in their treatment. Although radiation therapy can play a significant role in the cure or control of cancer, and the palliation of symptoms, it also has side effects. Side effects of radiation therapy can interfere with patient quality of life and daily functioning. Severe side effects can lead to delays in treatment, potentially affecting the outcome of treatment. All patients receiving radiation therapy are at risk of fatigue and skin reactions in the area of the body being treated. Other side effects of radiation therapy are specific to the part of the body being treated. Radiation therapy to the head and neck area may cause oral mucositis, dryness, and nutritional deficiencies. Radiation therapy to the chest or lung area may lead to difficulty in swallowing and eating. Radiation therapy to the pelvis frequently causes diarrhea. There are many nursing interventions available to manage the side effects of treatment based on best available evidence and expert opinion. Nurses in all settings are essential in helping patients manage the side effects of treatment and maintain their quality of life. The purpose of this review is to provide nurses with evidence-based recommendations and suggestions for managing common acute side effects of radiation therapy.Keywords: evidence-based practice, radiation therapy, side effects, nursing management
Rye, Marte; Torres, Elisa M; Friborg, Oddgeir; Skre, Ingunn; Aarons, Gregory A
Short and valid instruments for measuring factors facilitating or hindering implementation efforts are called for. This article describes (1) the adaptation of a shorter version of the Evidence-based Practice Attitude Scale (EBPAS-50 items), and (2) the psychometric properties of the shortened version in both US and Norwegian data. The US participants were mental health service providers (N = 418) recruited from clinics providing mental health services in San Diego County, California. The Norwegian participants were psychologists, psychiatric nurses, and psychology students (N = 838) recruited from the Norwegian Psychological Association and the Norwegian Nurses Organization. A confirmatory factor analysis (CFA) approach was used. The reduction resulted in 36 items named EBPAS-36, and the original 12 factor model was maintained. The EBPAS-36 had acceptable model fit, as indicated by a low degree of misspecification errors in both the US (RMSEA = .045 (CI 90% .040-.049); SRMR = .05) and the Norwegian data (RMSEA = .052 (CI 90% .047-.056, SRMR = .07). Incremental model fit was fair in the US (CFI = .93, TLI = .91) and in the Norwegian samples (CFI = .91, TLI = .89). The internal consistency (Cronbach's α) in the US and the Norwegian samples were good for the total EBPAS-36 score (.79 and .86, respectively) and were ranged from adequate to excellent for the subscales (US .60-.91 and Norway .61-.92). The EBPAS-36 has adequate psychometric properties both in US and Norwegian samples, hence indicating cross-cultural validity. It is a brief, pragmatic, and more user-friendly instrument than the EBPAS-50, yet maintains a broad scope by retaining the original 12 measurement domains.
Tilson Julie K
Full Text Available Abstract Background Teaching the steps of evidence-based practice (EBP has become standard curriculum for health professions at both student and professional levels. Determining the best methods for evaluating EBP learning is hampered by a dearth of valid and practical assessment tools and by the absence of guidelines for classifying the purpose of those that exist. Conceived and developed by delegates of the Fifth International Conference of Evidence-Based Health Care Teachers and Developers, the aim of this statement is to provide guidance for purposeful classification and development of tools to assess EBP learning. Discussion This paper identifies key principles for designing EBP learning assessment tools, recommends a common taxonomy for new and existing tools, and presents the Classification Rubric for EBP Assessment Tools in Education (CREATE framework for classifying such tools. Recommendations are provided for developers of EBP learning assessments and priorities are suggested for the types of assessments that are needed. Examples place existing EBP assessments into the CREATE framework to demonstrate how a common taxonomy might facilitate purposeful development and use of EBP learning assessment tools. Summary The widespread adoption of EBP into professional education requires valid and reliable measures of learning. Limited tools exist with established psychometrics. This international consensus statement strives to provide direction for developers of new EBP learning assessment tools and a framework for classifying the purposes of such tools.
Full Text Available Intractable cancer pain not amenable to standard oral or parenteral analgesics is a horrifying truth in 10-15% of patients. Interventional pain management techniques are an indispensable arsenal in pain physician′s armamentarium for severe, intractable pain and can be broadly classified into neuroablative and neuromodulation techniques. An array of neurolytic techniques (chemical, thermal, or surgical can be employed for ablation of individual nerve fibers, plexuses, or intrathecalneurolysis in patients with resistant pain and short life-expectancy. Neuraxial administration of drugs and spinal cord stimulation to modulate or alter the pain perception constitutes the most frequently employed neuromodulation techniques. Lately, there is a rising call for early introduction of interventional techniques in carefully selected patients simultaneously or even before starting strong opioids. After decades of empirical use, it is the need of the hour to head towards professionalism and standardization in order to secure credibility of specialization and those practicing it. Even though the interventional management has found a definite place in cancer pain, there is a dearth of evidence-based practice guidelines for interventional therapies in cancer pain. This may be because of paucity of good quality randomized controlled trials (RCTs evaluating their safety and efficacy in cancer pain. Laying standardized guidelines based on existing and emerging evidence will act as a foundation step towards strengthening, credentialing, and dissemination of the specialty of interventional cancer pain management. This will also ensure an improved decision-making and quality of life (QoL of the suffering patients.
Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven
Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.
Melnyk, Bernadette Mazurek; Hawkins-Walsh, Elizabeth; Beauchesne, Michelle; Brandt, Patricia; Crowley, Angela; Choi, Myunghan; Greenburg, Edward
The incidence of mental health/behavioral and developmental problems in children and teens is escalating. However, many primary care providers report inadequate skills to accurately screen, identify, and manage these problems using an evidence-based approach to care. Additionally, educational programs that prepare pediatric nurse practitioners (PNPs) have been slow to incorporate this content into their curriculums. The purpose of this project was to implement and evaluate a strengthened curriculum in 20 PNP programs from across the United States that focused on: (a) health promotion strategies for optimal mental/behavioral health and developmental outcomes in children, and (b) screening and evidence-based interventions for these problems. An outcomes evaluation was conducted with faculty and graduating students from the participating programs along with faculty and students from 13 PNP programs who did not participate in the project. Participating schools varied in the speed at which components of the strengthened curriculum were incorporated into their programs. Over the course of the project, faculty from participating programs increased their own knowledge in the targeted areas and reported that their students were better prepared to assess and manage these problems using an evidence-based approach. Although reports of screening for certain problems were higher in the graduating students from the participating schools than the non-participating schools, the overall use of screening tools by students in clinical practice was low. There is a need for educational programs to strengthen their curricula and clinical experiences to prepare students to screen for, accurately identify, prevent, and provide early evidence-based interventions for children and teens with mental health/behavioral and developmental problems. This project can serve as a national model for curriculum change.
Papadopoulos, Moschos A.
Introduction: Aim of this systematic review was to assess the orthodontic related issues which currently provide the best evidence as documented by meta-analyses, by critically evaluating and discussing the methodology used in these studies. Material and Methods: Several electronic databases were searched and handsearching was also performed in order to identify the corresponding meta-analyses investigating orthodontic related subjects. In total, 197 studies were retrieved initially. After applying specific inclusion and exclusion criteria, 27 articles were identified as meta-analyses treating orthodontic-related subjects. Results: Many of these 27 papers presented sufficient quality and followed appropriate meta-analytic approaches to quantitatively synthesize data and presented adequately supported evidence. However, the methodology used in some of them presented weaknesses, limitations or deficiencies. Consequently, the topics in orthodontics which currently provide the best evidence, include some issues related to Class II or Class III treatment, treatment of transverse problems, external apical root resorption, dental anomalies, such as congenital missing teeth and tooth transposition, frequency of severe occlusal problems, nickel hypersensitivity, obstructive sleep apnea syndrome, and computer-assisted learning in orthodontic education. Conclusions: Only a few orthodontic related issues have been so far investigated by means of MAs. In addition, for some of these issues investigated in the corresponding MAs no definite conclusions could be drawn, due to significant methodological deficiencies of these studies. According to this investigation, it can be concluded that at the begin of the 21st century there is evidence for only a few orthodontic related issues as documented by meta-analyses, and more well-conducted high quality research studies are needed to produce strong evidence in order to support evidence-based clinical practice in orthodontics. PMID
Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation
McEvoy, Maureen P; Crilly, Mike; Young, Taryn; Farrelly, Jane; Lewis, Lucy Kate
PHENONENON: In many developed countries, accreditation documents, which reflect the practice standards of health professions, form the basis for evaluation of education programs for meeting the requirements for registration. The 2005 Sicily statement proposed a 5-step model of training in evidence-based practice (ask, access, appraise, apply, and assess). A key recommendation was that evidence-based practice should be incorporated into entry-level health professional training and registration. No previous research has assessed the extent to which this has occurred. We undertook a systematic audit of the accreditation documents for the registered health professions in Australia. The 11 health professional disciplines included in the audit were medicine, nursing and midwifery, pharmacy, physiotherapy, dentistry, psychology, occupational therapy, optometry, podiatry, osteopathy, and chiropractic. Two investigators independently identified the occurrence of the term evidence that related to "evidence-based practice" and the occurrences of terms related to the 5 steps in the accreditation documents. Occurrence of the term evidence as it relates specifically to "evidence-based practice" ranged from 0 (pharmacy, dentistry and occupational therapy) to 8 (physiotherapy) in the accreditation documents. Overall, there were 77 occasions when terms relating to any of the 5 steps of evidence-based practice were used across all 11 accreditation documents. All 5 steps were included in the physiotherapy and psychology documents; 4 steps in medicine and optometry; 3 steps in pharmacy; 2 steps each in documents for chiropractic, osteopathy, and podiatry; and 1 step for nursing. There was no inclusion of terms relating to any of the 5 steps in the dentistry and occupational therapy documents. Insights: Terminology relating explicitly to evidence-based practice and to the 5 steps of evidence-based practice appears to be lacking in the accreditation documents for health professions
Fox, Anthony W; Lewison, Grant
Background This is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN). Methods A total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests. Results ESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant. Conclusions We showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe. PMID:29344408
Pallari, Elena; Fox, Anthony W; Lewison, Grant
This is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN). A total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests. ESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant. We showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.
Molfenter, Todd; Kim, Jee-Seon; Quanbeck, Andrew; Patel-Porter, Terry; Starr, Sandy; McCarty, Dennis
.... The Advancing Recovery Framework offers a multi-level approach to evidence-based practice implementation by aligning purchasing and regulatory policies at the payer level with organizational change...
Amorin-Woods, Lyndon G; Losco, Barrett E
.... Results "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice...
Hamilton, John D.
The child and adolescent psychiatry community has been using large systems of information and new technologies to improve its performance.Evidence-based approach is used by practitioners to find and implement feasible therapies and medication. The different procedures involved of evidence-based practice, as used in child and adolescent psychology,…
Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie
population based observational study. SETTING: 19 regions from 11 European countries covering 850 000 annual births participating in the EPICE (Effective Perinatal Intensive Care in Europe for very preterm births) project. PARTICIPANTS: 7336 infants born between 24+0 and 31+6 weeks' gestation in 2011...... of death or severe morbidity, or both. We modelled associations using risk ratios, with propensity score weighting to account for potential confounding bias. Analyses were adjusted for clustering within delivery hospital. RESULTS: Only 58.3% (n=4275) of infants received all evidence based practices...... ratio 0.72, 95% confidence interval 0.60 to 0.87) and in-hospital mortality or severe morbidity, or both (0.82, 0.73 to 0.92), corresponding to an estimated 18% decrease in all deaths without an increase in severe morbidity if these interventions had been provided to all infants. CONCLUSIONS: More...
Rangachari, Pavani; Madaio, Michael; Rethemeyer, R Karl; Wagner, Peggy; Hall, Lauren; Roy, Siddharth; Rissing, Peter
Many hospitals are unable to successfully implement evidence-based practices. For example, implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs), is often challenging. This problem is broadly characterized as a "change implementation failure." A prospective study was conducted in 2 intensive care units (ICUs), a medical ICU (MICU) and a pediatric ICU (PICU), within an academic health center. Both units had low baseline adherence to CLB and higher-than-expected CRBSIs. The study sought to promote CLB implementation in both units through periodic quality improvement (QI) interventions over a 52-week period. Simultaneously, it examined (1) the content and frequency of communication related to CLB through weekly "communication logs" completed by physicians, nurses, and managers, and (2) outcomes, that is, CLB adherence rates through weekly medical record reviews. The aim of the study was 2-fold: (1) to examine associations between QI interventions and communication content and frequency at the unit level, and (2) to examine associations between communication content and frequency and outcomes at the unit level. The periodic QI interventions were expected to increase CLB adherence and reduce CRBSIs through their influence on communication content and frequency. A total of 2638 instances of communication were analyzed. Both units demonstrated a statistically significant increase in "proactive" communications-that is, communication intended to reduce infection risk between physicians and nurses over time. Proactive communications increased by 68% in the MICU (P declines in (1) catheter days: 34% decline in the MICU (P decline in the MICU (P communication dynamics and enabling practice change. The prospective design provides insights into communication content and frequency associated with collective learning and culture change. The study identifies evidence-based management strategies for positive practice
Seshia, Shashi S
The Users' Guides to the Medical Literature Manual has been a major influence on the teaching and practice of health care globally. The 3rd edition of the multi-authored Manual was reviewed using the principles outlined in Evidence-based Medicine (EBM) texts. One 'clinical scenario' was selected for critical appraisal, as were several chapters; objectivity was enhanced by citing references to support opinions. RESULTS (SUMMARY OF THE APPRAISAL): (1) Strengths: Clinical pearls, too numerous to list. (i) evidence is never enough to drive clinical decision making; (ii) do not rush to adopt new interventions; and (iii) question efficacy data based only on surrogate markers. (2) Weaknesses: The Manual shares shortcomings of textbooks discussed by Straus et al.: (i) references may not be current, important ones may be excluded and citations may be selective; (ii) often, opinion-based; and (iii) delays between revisions. (3) Notable omissions: Little or no discussion of: (i) important segments of the population: those 65 years of age and those with multimorbidity; (ii) surgical disciplines; (iii) Greenhalgh et al.'s essay on EBM; (iv) alternate views on the hierarchy of evidence; and (vi) critical thinking. (4) Additional issues: (i) Omission of important references on dabigatran (clinical scenario: chapter 13.1); (ii) authors' advice (Chapter 13.3) to 'bypass the discussion section of published research'; and (iii) the advocacy of pre-appraised sources of evidence and network meta-analysis without warnings about limitations, are critiqued. The Manual has several clinical pearls but readers should also be aware of shortcomings. © 2016 John Wiley & Sons, Ltd.
Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H
The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.
Pereira, Rui Pedro Gomes; Peixoto, Maria; Martins, Maria Alice Correia dos Santos Cardoso
Background: The lack of cultural and linguistically sensitive instruments prevents the opportunity of assessing attitudes and barriers of health care staff towards evidence-based practice. The aim of this communication is to report the validation process in the Portuguese context of the Attitudes to Evidence Based Practice Questionnaire. Methods: We developed a cross-sectional, descriptive psychometric validation study. For cultural adaptation, a bidirectional translation was carried out, acc...
Anuradha, Chandramohan, E-mail: firstname.lastname@example.org [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Jacob, K.S., E-mail: email@example.com [Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Specialist Mental Health Service for Older People, Suite 106, 64–68 Derby Street, Kingswood, Penrith 2750 (Australia); Shyamkumar, N.K., E-mail: firstname.lastname@example.org [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Sridhar, Gibikote, E-mail: email@example.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India)
Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured
Do knowledge infrastructure facilities support evidence-based practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses.
Hugenholtz, Nathalie I R; Nieuwenhuijsen, Karen; Sluiter, Judith K; van Dijk, Frank J H
Evidence-Based Medicine (EBM) is an important method used by occupational physicians (OPs) to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice. Thirty-six OPs from ten countries, planning to attend an EBM course and to a large extent recruited via the European Association of Schools of Occupational Medicine (EASOM), participated in a cross-sectional study. Research and development institutes, and knowledge products and tools are used by respectively more than 72% and more than 80% of the OPs and they are rated as being important for EBM practice (more than 65 points (range 0-100)). Conventional knowledge access facilities, like traditional libraries, are used often (69%) but are rated as less important (46.8 points (range 0-100)) compared to the use of more novel facilities, like question-and-answer facilities (25%) that are rated as more important (48.9 points (range 0-100)). To solve cases, OPs mostly use non evidence-based sources. However, they regard the evidence-based sources that are not often used, e.g. the Cochrane library, as important enablers for practising EBM. The main barriers are lack of time, payment for full-text articles, language barrier (most texts are in English), and lack of skills and support. This first exploratory study shows that OPs use many knowledge infrastructure facilities and rate them as being important for their EBM practice. However, they are not used to use evidence-based sources in their practice and face many barriers that are comparable to the barriers physicians face in primary health care.
Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses
van Dijk Frank JH
Full Text Available Abstract Background Evidence-Based Medicine (EBM is an important method used by occupational physicians (OPs to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice. Methods Thirty-six OPs from ten countries, planning to attend an EBM course and to a large extent recruited via the European Association of Schools of Occupational Medicine (EASOM, participated in a cross-sectional study. Results Research and development institutes, and knowledge products and tools are used by respectively more than 72% and more than 80% of the OPs and they are rated as being important for EBM practice (more than 65 points (range 0–100. Conventional knowledge access facilities, like traditional libraries, are used often (69% but are rated as less important (46.8 points (range 0–100 compared to the use of more novel facilities, like question-and-answer facilities (25% that are rated as more important (48.9 points (range 0–100. To solve cases, OPs mostly use non evidence-based sources. However, they regard the evidence-based sources that are not often used, e.g. the Cochrane library, as important enablers for practising EBM. The main barriers are lack of time, payment for full-text articles, language barrier (most texts are in English, and lack of skills and support. Conclusion This first exploratory study shows that OPs use many knowledge infrastructure facilities and rate them as being important for their EBM practice. However, they are not used to use evidence-based sources in their practice and face many barriers that are comparable to the barriers physicians face in primary health care.
Pereira, Rui Pedro Gomes; Guerra, Ana Cristina Pinheiro; Cardoso, Maria José da Silva Peixoto de Oliveira; dos Santos, Alzira Teresa Vieira Martins Ferreira; de Figueiredo, Maria do Céu Aguiar Barbieri; Carneiro, António Cândido Vaz
OBJECTIVES: to describe the process of translation and linguistic and cultural validation of the Evidence Based Practice Questionnaire for the Portuguese context: Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). METHOD: a methodological and cross-sectional study was developed. The translation and back translation was performed according to traditional standards. Principal Components Analysis with orthogonal rotation according to the Varimax method was used to verify the QECPBE's psychometric characteristics, followed by confirmatory factor analysis. Internal consistency was determined by Cronbach's alpha. Data were collected between December 2013 and February 2014. RESULTS: 358 nurses delivering care in a hospital facility in North of Portugal participated in the study. QECPBE contains 20 items and three subscales: Practice (α=0.74); Attitudes (α=0.75); Knowledge/Skills and Competencies (α=0.95), presenting an overall internal consistency of α=0.74. The tested model explained 55.86% of the variance and presented good fit: χ2(167)=520.009; p = 0.0001; χ2df=3.114; CFI=0.908; GFI=0.865; PCFI=0.798; PGFI=0.678; RMSEA=0.077 (CI90%=0.07-0.08). CONCLUSION: confirmatory factor analysis revealed the questionnaire is valid and appropriate to be used in the studied context. PMID:26039307
Romero, Lisa M; Olaiya, Oluwatosin; Hallum-Montes, Rachel; Varanasi, Balalakshmi; Mueller, Trisha; House, L Duane; Schlanger, Karen; Middleton, Dawn
The purposes of this study were to describe changes in implementation of evidence-based clinical practices among health center partners as part of a multicomponent, community-wide teen pregnancy prevention initiative; to better understand the barriers to and facilitators of implementation of the evidence-based clinical practices; and to describe the technical assistance and training provided to the health center partners and key lessons learned. Health center data from the second and third years (2012 and 2013) of the teen pregnancy prevention community-wide initiative were analyzed from 10 communities (the first year was a planning year; program implementation began in the second year). Data were analyzed from 48 health center partners that contributed data in both years to identify evidence-based clinical practices that were being implemented and opportunities for improvement. In addition, data were analyzed from a purposive sample of 30 health center partners who were asked to describe their experiences in implementing evidence-based clinical practices in adolescent reproductive health care and barriers and facilitators to implementation. Across 48 health centers in the 10 communities, 52% reported an increase in the implementation of evidence-based clinical practices from 2012 to 2013, mostly in providing contraceptive access (23%) and offering Quick Start (19%). Among health centers that reported no change (13%), the majority reported that practices were already being implemented before the initiative. Finally, among health centers that reported a decrease in implementation of evidence-based clinical practices (35%), most reported a decrease in having either hormonal contraception or intrauterine devices available at every visit (15%), having HIV rapid testing available (10%), or participating in the federal 340B Drug Discount Program (2%). In addition, health systems and community-level factors influence health center implementation of evidence-based
For the treatment of patients with advanced dementia, we could not find any evidence based guidelines to help in decision making. Individual values and expected quality of life must be the leading goals of any intervention. Symptom control and relieving suffering are core values of palliative care, but the recognition of discomfort needs qualified assessment skills. Pain assessment with common tools like the VAS fails in patients with cognitive impairment and inability to communicate; instruments like Doloplus and ECPA can be helpful to assess behavioral changes as expression of pain. The treatment of acute and chronic pain in advanced dementia is still not sufficient and needs improvement. Oral feeding in advanced dementia becomes more and more difficult. No randomized controlled study has found evidence that tube feeding will reduce the risk of aspiration or prolong life expectancy. Eating may be the only meaningful activity that remains for the patient; artificial feeding cannot serve the same function. All final complications, like pneumonia, call for a decision making process. Those who care for and care about these patients must make decisions. The feelings of the family have to be considered, but the probable will of the patient, his dignity and quality of life must not be overridden.
Green Amy E
Full Text Available Abstract Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.
Vidyarthi, Arpana R; Kamei, Robert; Chan, Kenneth; Goh, Sok-Hong; Lek, Ngee
To identify the factors associated with medical students' clinical reasoning (CR) use and evidence-based medicine (EBM) use in the clinical setting. Our cross-sectional study surveyed 44 final-year medical students at an emerging academic medical center in Singapore. We queried the students' EBM and CR value and experiences in the classroom and clinical settings. We compared this to their perceptions of supervisors' value and experiences using t-tests. We developed measures of teaching culture and practice culture by combining relevant questions into summary scores. Multivariate linear regression models were applied to identify factors associated with the students' CR and EBM clinical use. Eighty-nine percent of students responded (n=39). Students reported valuing CR (p=0.03) and EBM (p=0.001) more than their supervisors, but practiced these skills similarly (p=0.83; p=0.82). Clinical practice culture and classroom CR experience were independently associated with students' CR clinical use (p=0.05; p=0.04), and classroom EBM experience was independently associated with students' EBM clinical use (p=0.03). Clinical teaching culture was not associated with students' CR and EBM clinical use. Our study found that medical students' classroom experience and the clinical practice culture influenced their CR and EBM use. The clinical teaching culture did not. These findings suggest that in order to increase student CR and EBM use, in addition to providing classroom experience, medical educators may need to change the hospital culture by encouraging supervisors to use these skills in their clinical practice.
Zeitlin, Jennifer; Manktelow, Bradley N; Piedvache, Aurelie
OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity. DESIGN: Prospective multinational populat...
There are increasing calls for policy and practice to be "evidence informed." At surface value, there may appear much to commend such an approach. However, it is important to understand that "evidence" and "knowledge" are being mobilised in very particular ways. The danger is that rather than promote a rich and lively…
related problem and searching for reliable evidence to provide an answer. Once potential evidence has been found, it is necessary to determine whether the information is credible and whether it is useful in one's practice by using the technique of ...
Grol, R.P.T.M.; Wensing, M.J.P.
To bridge the gap between scientific evidence and patient care we need an in-depth understanding of the barriers and incentives to achieving change in practice. Various theories and models for change point to a multitude of factors that may affect the successful implementation of evidence. However,
Aronoff, Nell; Stellrecht, Elizabeth; Lyons, Amy G; Zafron, Michelle L; Glogowski, Maryruth; Grabowski, Jeremiah; Ohtake, Patricia J
The research assessed online learning modules designed to teach health professions students evidence-based practice (EBP) principles in an interprofessional context across two institutions. Students from nine health professions at two institutions were recruited to participate in this pilot project consisting of two online learning modules designed to prepare students for an in-person case-based interprofessional activity. Librarians and an instructional designer created two EBP modules. Students' competence in EBP was assessed before and after the modules as well as after the in-person activity. Students evaluated the online learning modules and their impact on the students' learning after the in-person session. A total of 39 students from 8 health professions programs participated in the project. Average quiz scores for online EBP module 1 and module 2 were 83% and 76%, respectively. Following completion of the learning modules, adapted Fresno test of competence in EBP scores increased ( p =0.001), indicating that the modules improved EBP skill competence. Student evaluations of the learning modules were positive. Students indicated that they acquired new information skills that contributed to their ability to develop a patient care plan and that they would use these information skills in their future clinical practice. Online EBP learning modules were effective in developing EBP knowledge and skills for health professions students. Using the same modules ensured that students from different health professions at different stages of their professional programs had consistent knowledge and enabled each student to fully engage in an interprofessional evidence-based activity. Student feedback indicated the modules were valued and beneficial.
Perdices, Michael; Tate, Robyn L
One could be forgiven for thinking that the only road to evidence-based clinical practice is the application of results from randomised controlled trials (or systematic reviews of such). By contrast, single-subject designs in the context of evidence-based clinical practice are believed by many to be strange bedfellows. In this paper, we argue that single-subject designs play an important role in evidence-based clinical practice. We survey the contents of Neuropsychological Rehabilitation in relation to single-subject designs and tackle the main criticisms that have been levelled against them. We offer practical guidance for rating the methodological quality of single-subject designs and applying statistical techniques to measure treatment efficacy. These guides are equally applicable to research studies and everyday clinical practice with individual patients.
Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki
Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for
Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen
Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.
Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn
An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence-practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings. To provide an understanding of speech pathologists' conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation. This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken. A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists' strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so. Speech pathologists identified a current knowledge-practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense
Cooper, Justin T.; Gage, Nicholas A.; Alter, Peter J.; LaPolla, Stefanie; MacSuga-Gage, Ashley S.; Scott, Terrance M.
A survey study of 248 educators in four states was conducted to identify respondents' formal training, use, and perceived effectiveness of 37 evidence-based classroom management practices within four general categories: (a) antecedent-based, (b) instructionally based, (c) consequence-based, and (d) self-management. Results indicated that, on…
Levin, Rona F; Wright, Fay; Pecoraro, Kathleen; Kopec, Wendy
Unintentional perioperative hypothermia has been shown to cause serious patient complications and, thus, to increase health care costs. In 2009, an evidence-based practice improvement project produced a significant decrease in unintentional perioperative hypothermia in colorectal surgical patients through monitoring of OR ambient room temperature. Project leaders engaged all interdisciplinary stakeholders in the original project, which facilitated the sustainability of the intervention method. An important aspect of sustainability is ongoing monitoring and evaluation of a new intervention method. Therefore, continued evaluation of outcomes of the protocol developed in 2009 was scheduled at specific time points after the initial small test of change with colorectal patients. This article focuses on how attention to sustainability factors during implementation of an improvement project led to the sustainability of a protocol for monitoring OR ambient room temperature with all types of surgical patients five years after the initial project. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Leathers, Sonya J; Spielfogel, Jill E; Blakey, Joan; Christian, Errick; Atkins, Marc S
Children's service systems are faced with a critical need to disseminate evidence-based mental health interventions. Despite the proliferation of comprehensive implementation models, little is known about the key active processes in effective implementation strategies. This proof of concept study focused on the effect of change agent interactions as conceptualized by Rogers' diffusion of innovation theory on providers' (N = 57) use of a behavioral intervention in a child welfare agency. An experimental design compared use for providers randomized to training as usual or training as usual supplemented by change agent interactions after the training. Results indicate that the enhanced condition increased use of the intervention, supporting the positive effect of change agent interactions on use of new practices. Change agent types of interaction may be a key active process in implementation strategies following training.
Kalef, Laura; Reid, Greg; Macdonald, Cathy
The purpose of the research was to conduct a quality indicator analysis of studies investigating peer-tutoring for students with a disability in adapted physical education. An electronic search was conducted among English journals published from 1960 to November 2012. Databases included ERIC, PsycINFO, and SPORTDiscus. Fifteen research studies employing group-experimental (Gersten et al., 2005) or single-subject designs (Horner et al., 2005) met inclusion criteria. Each study was assessed for the presence and clarity of quality indicators. Group designs met an average of 62.5% essential and 69% desirable indicators. An average of 80% of indicators was present for single-subject designs. Results suggest claims of peer-tutoring being an evidence-based practice are premature. Recommendations for clarifying and applying the quality indicators are offered. Copyright © 2013 Elsevier Ltd. All rights reserved.
Amodeo, Maryann; Ellis, Michael A; Samet, Jeffrey H
Dissemination of evidence-based practices (EBPs) in addiction settings is a national priority. We tested Organization Development (OD) methods for dissemination. Using OD in two addiction treatment programs we developed an organization-specific treatment plan using employee work teams with the goals of changes in organizational policies and procedures and improvement in practitioner skills. OD was effectively applied, but EBPs were premature for these addiction programs because they first needed to address more fundamental aspects of client-clinician interaction and agency treatment philosophy. The OD approach in addiction treatment is complementary to other technology transfer efforts by being: (a) "organization-centered," engaging practitioners at all levels; (b) "needs-focused," addressing concerns of the particular organization; (c) flexible in its responsiveness to readiness for change; and (d) relatively affordable. However, before absorbing EBPs, substance abuse treatment organizations must develop strengths in delivering fundamental aspects of care.
Jacob Owusu Sarfo
Full Text Available In the development of psychotherapy, the debate between opting for a specific model as opposed to systems integration has been a growing controversy. In addition, questions have been raised with regards to the consistency of integration approaches, the benchmark for choice of integration approach and the proficiency of practitioners. This article examines the reasons for integration using a systematic review to evaluate the triumphs made since the inception of psychotherapy integration. The authors’ advocates for Miller, Duncan, and Hubble’s in 2004 suggest practice-based evidence approach one of the appropriate innovative way of improving client retention and outcome. To us, this approach will enable the clinician have a better stand in therapy as scientist-practitioners.
Loring, David W; Bowden, Stephen C
Reporting appropriate research detail across clinical disciplines is often inconsistent or incomplete. Insufficient report detail reduces confidence in findings, makes study replication more difficult, and decreases the precision of data available for critical review including meta-analysis. In response to these concerns, cooperative attempts across multiple specialties have developed explicit research reporting standards to guide publication detail. These recommendations have been widely adopted by high impact medical journals, but have not yet been widely embraced by neuropsychology. The STROBE Statement (STrengthening the Reporting of Observational studies in Epidemiology) is particularly relevant to neuropsychology since clinical research is often based on non-funded studies of patient samples. In this paper we describe the STROBE Statement and demonstrate how STROBE criteria, applied to reporting of neuropsychological findings, will maintain neuropsychology's position as a leader in quantifying brain-behavior relationships. We also provide specific recommendations for data reporting and disclosure of perceived conflicts of interest that will further enhance reporting transparency for possible perceived sources of bias. In an era in which evidence-based practice assumes an increasingly prominent role, improved reporting standards will promote better patient care, assist in developing quality practice guidelines, and ensure that neuropsychology remains a vigorous discipline in the clinical neurosciences that consciously aspires to high methodological rigor.
Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D
Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.
Ward, Alyssa M; Regan, Jennifer; Chorpita, Bruce F; Starace, Nicole; Rodriguez, Adriana; Okamura, Kelsie; Daleiden, Eric L; Bearman, Sarah Kate; Weisz, John R
This study sought to evaluate the agreement between therapist report and coder observation of therapy practices. The study sampled session data from a community-based, randomized trial of treatment for youth ages 7 to 13. We used therapist report of session content and coverage gathered using formal Consultation Records and developed complimentary records for coders to use when watching or listening to therapy tape. We established initial reliability between coders and then conducted a random, stratified, and comprehensive sample of sessions across youth (N = 121), therapists (N = 57), conditions (MATCH and Standard Manuals), and study sites (Honolulu and Boston) to code and compare with therapist record reports. Intraclass correlation coefficients (ICCs) representing coder versus therapist agreement on manual content delivered ranged from .42 to 1.0 across conditions and problem areas. Analyses revealed marked variability in agreement regarding whether behavioral rehearsals took place (ICCs from -.01 to 1.0) but strong agreement on client comprehension of therapy content and homework assignments. Overall, the findings indicate that therapists can be accurate reporters of the therapeutic practices they deliver, although they may need more support in reporting subtle but valuable aspects of implementation such as types of behavioral rehearsals. Developing means to support accurate reporting is important to developing future clinical feedback methodology applicable to the implementation of evidence-based treatments in the real world.
O'Connor, Siobhan; Pettigrew, Catharine M
There is currently a paucity of research investigating what speech and language therapists, in particular, perceive are the greatest barriers to implementing evidence-based practice. The purpose of this study was to investigate the perceived barriers that are faced by speech and language therapists in southern Ireland when attempting to implement evidence-based practice. A 34-item questionnaire was sent to 39 therapists working in several counties in southern Ireland. The survey received an 82.1% (n = 32) response rate. The results of the study indicated that certain barriers are perceived to prevent evidence-based practice being implemented successfully. The most significant barrier affecting evidence-based practice implementation was reported to be a lack of time to read research (71.9%). Additional barriers that were found to be the most significant were the research having methodological inadequacies (62.5%) and insufficient time to implement new ideas (59.4%). Other important factors identified as being significant barriers to the implementation of evidence-based practice were those associated with the quality and presentation of the research, workplace setting, and lack of skills of the therapist. Associations between specific barriers and workplace setting or grade were also investigated. Some possible reasons for these barriers and the implications for clinical practice are also discussed. This small study suggests that therapists agreed that evidence-based practice is essential to the practice of speech and language therapy. There are, however, barriers in place that are perceived to prevent its successful implementation. It is hoped that because these barriers have been identified, individual clinicians and organizations can be proactive in aiming to provide an evidence-based service to their clients.
Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen; Gallagher-Ford, Lynn; Kaplan, Louise
This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.
Hutson, Elizabeth; Kelly, Stephanie; Militello, Lisa K
Cyberbullying is a new risk factor for the well-being of pediatric populations. Consequences of cyberbullying include both physical and mental health concerns such as depression, anxiety, and somatic concerns. Adolescents who have been victims of cyberbullying and developed secondary symptoms are often recommended to visit a healthcare provider to obtain effective, evidence-based treatment. To date, no interventions exist in the healthcare setting for adolescents who are victims of cyberbullying. The purpose of this project is to review interventional studies on cyberbullying that have components for adolescents who have been involved with cyberbullying and their parents and to provide recommendations on effective intervention components with the goal of guiding clinical practice. A systematic review was conducted using the Institute of Medicine guidelines. A comprehensive electronic literature search was completed targeting interventions of cyberbullying in any setting. No date limits were used. Literature was searched in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Communication and Mass Media Complete, Education Information Resource Center (ERIC), and PsycINFO databases. The following search terms were applied "cyberbullying" + "intervention" or "treatment" or "therapy" or "program." Only articles with a pediatric population were selected for review. Seventeen cyberbullying intervention programs in 23 articles were found to meet the search criteria. The most frequently used intervention components included education on cyberbullying for the adolescent, coping skills, empathy training, communication and social skills, and digital citizenship. Parent education on cyberbullying was also found to be important and was included in programs with significant outcomes. As youth present to healthcare providers with symptoms related to cyberbullying, effective interventions are needed to guide evidence-based practice. This review
Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J
System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children's service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit.
Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J
Background System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children’s service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. Methods We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Results Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Conclusions Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit. PMID:27512239
Turenne, Jeanne Pigeon; Héon, Marjolaine; Aita, Marilyn; Faessler, Joanne; Doddridge, Chantal
ABSTRACT This article presents the development and evaluation of an educational intervention aiming at an evidence-based practice of skin-to-skin contact at birth among nurses of a maternity care unit. Based on the Iowa Model of Evidence-Based Practice to Promote Quality Care, four educational sessions were developed according to an active-learning pedagogy. Even if the nurses’ practice did not fully meet the recommendations for skin-to-skin contact, a pre- and postintervention evaluation showed some positive results, such as a longer duration of skin-to-skin contact immediately after birth, delivery of some routine care directly on mothers’ chest, and improved parent education. The educational intervention seems to have enacted some evidence-based nursing practice changes regarding skin-to-skin contact at birth. PMID:27445449
Yan, Xiu-feng; Ni, Qing; Wei, Jun-ping; Xu, Hao
An evidence-based practice method according to literature retrieval through PICO (Patients, Intervention, Comparison, Outcome) questions and complementary and alternative medicine (CAM) topics, which can obtain helpful evidence for guiding clinical practice, was introduced with a practical example in this paper. The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question, while searching by CAM topics may provide evidence for Chinese medicine (CM). Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidence-based practice method for integrative Chinese and Western medicine (ICWM). However, since the standard in CM evidence hierarchy is still under study, the value of the CAM thematic retrieval method remains very limited. In the future, studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.
Dugdall, Hayley; Watson, Roger
To investigate qualified nurses' attitudes to evidence-based practice and whether this influenced their selection of wound care products. The literature shows that previous studies on attitudes to evidence-based practice tended to be part of a wider study. The general consensus was that there was a positive attitude to evidence-based practice. However, there appeared to be no published studies specifically addressing nurses' attitudes to evidence-based wound care. Survey design using a questionnaire completed by 156 qualified nurses working in three UK National Health Trusts. A statistically significant difference was seen between those nurses with a tissue viability link nurse role (p = 0.002) and those without a link nurse role; those educated to first degree (p attitude to evidence-based practice (p Nurses who had attained a higher level academic qualification, had a tissue viability link nurse role and those who had received formal tissue viability training scored generally higher in the wound care knowledge tests and in attitude to evidence-based practice. The care received by patients in relation to wound care could be dependent upon factors that are related to the individual characteristics of the nurse providing the care and these factors, in turn, are related to education and training with respect to wound care. Better general education and better specific training in wound care could lead to better wound care.
Lindsay J. Alcock
Full Text Available A Review of: Swanberg, S. M., Dennison, C. C., Farrell, A., Machel, V., Marton, C., O'Brien, K. K., … & Holyoke, A. N. (2016. Instructional methods used by health sciences librarians to teach evidence-based practice (EBP: a systematic review. Journal of the Medical Library Association: JMLA, 104(3, 197-208. http://dx.doi.org/10.3163/1536-5050.104.3.004 Abstract Objective – To determine both the instructional methods and their effectiveness in teaching evidence based practice (EBP by librarians in health sciences curricula. Design – Systematic review. Setting – A total of 16 databases, Google Scholar, and MLA Annual Meeting abstracts. Subjects – There were 27 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching 16 online databases, Google Scholar, and MLA Annual Conference abstracts. Inclusion and exclusion criteria were identified to inform the literature search and determine article eligibility. Duplicates were removed and the remaining search results were divided into sets and assigned to two reviewers who screened first by title/abstract and then by full-text. A third reviewer addressed disagreement in article inclusion. Data extraction, using a validated method described by Koufogiannakis and Wiebe (2006, and critical appraisal, using the Glasgow checklist (1999, were performed concurrently. Main Results – After removal of duplicates 30,043 articles were identified for initial title/abstract screening. Of the 637 articles assessed for full-text screening 26 articles and 1 conference proceeding ultimately met all eligibility criteria. There was no meta-analysis included in the synthesis. There were 16 articles published in library and information science journals and 10 in health sciences journals. Of those studies, 22 were conducted in the United States. A wide range of user groups was identified as participants in the studies with medical
Hafslund, Bjorg [Institute of Radiography, Faculty of Health and Social Sciences, Bergen University College, P.O. Box 7030, N-5020 Bergen (Norway)], E-mail: firstname.lastname@example.org; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica [Centre for Evidence Based Practice, Faculty of Health and Social Sciences, Bergen University College, Bergen (Norway)
Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain.
Middlebrooks, Reginald; Carter-Templeton, Heather; Mund, Angela R
HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Effect of Evidence-Based Practice on Individual Barriers of Workforce Nurses: An Integrative Review" found on pages 398-406, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until August 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Identify individual barriers in the implementation of evidence-based practice (EBP) by nurses
Doran, Diane; Lefebre, Nancy; O'Brien-Pallas, Linda; Estabrook, Carole A; White, Peggy; Carryer, Jennifer; Sun, Winnie; Qian, Gan; Bai, Yu Qing Chris; Li, Mingyang
There are gaps in knowledge about the extent to which home care nurses' practice is based on best evidence and whether evidence-based practice impacts patient outcomes. The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines. The Nursing Role Effectiveness model was used to guide the selection of variables for investigation. Data were collected from administrative records on percent of visits made by Registered Nurses (RN), total number of nursing visits, and consistency of visits by principal nurse. Charts audits were used to collect data on nursing interventions and client outcomes. The sample consisted of 338 nurses from 13 home care offices and 939 de-identified client charts. Hierarchical generalized linear regression approaches were constructed to explore which variables explain variation in client outcomes. The study found documentation of nursing interventions based on best practice guidelines was positively associated with improvement in dyspnea, pain, falls, and pressure ulcer outcomes. Percent of visits made by an RN and consistency of visits by a principal nurse were not found to be associated with improved client outcomes, but the total number of nursing visits was. Implementation of best practice is associated with improved client outcomes in the home care setting. Future research needs to explore ways to more effectively foster the documentation of evidence-based practice interventions. © 2014 The Authors Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.
Joanne Marie Muellenbach
Full Text Available A Review of: Miller, F., Partridge, H., Bruce, C., Yates, C., & Howlett, A. (2017. How academic librarians experience evidence-based practice: A grounded theory model. Library & Information Science Research, 39(2, 124-130. http://dx.doi.org/10.1016/j.lisr.2017.04.003 Abstract Objective – To explore and enhance the understanding of how Australian library and information science (LIS practitioners experience or understand evidence based practice (EBP within the context of their day-to-day professional work. Design – Constructivist grounded theory methodology. Setting – University libraries in Queensland, Australia. Subjects – 13 academic librarians. Methods – Researchers contacted academic librarians by email and invited each participant to take part in a 30-60 minute, semi-structured interview. They designed interview questions to allow participants to explain their process and experience of EBP. Main results – This study identified six categories of experience of EBP using a constructivist grounded theory analysis process. The categories are: Empowering; Intuiting; Affirming; Connecting; Noticing; and Impacting. Briefly, empowering includes being empowered, or empowering clients, colleagues, and institutions through improved practice or performance. Intuiting includes being intuitive, or using one’s own intuition, wisdom, and understanding, of colleagues and clients’ behaviours to solve problems and redesign services. Affirming includes being affirmed through sharing feedback and using affirmation to strengthen support for action. Connecting includes being connected, and building connections, with clients, colleagues, and institutions. Noticing includes being actively aware of, observing, and reflecting on clients, colleagues, and literature within and outside of one’s own university, and noticing patterns in data to inform decision-making. Impacting includes being impactful, or having a visible impact, on clients, colleagues
Sandra van der Loo; Gerrie Bours; Anna Beurskens; Albine Moser; Jolanda Friesen-Storms
Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action
Myers, Laura L.; Wodarski, John S.
In today's climate, it is becoming increasingly important to provide social work students with practice knowledge on research-supported social work interventions. CSWE has placed greater emphasis on using research-based knowledge to inform and guide social work practice, and the field has recognized the value of adhering to the evidence-based…
Introduction: Evidence-based practice has broadened and spread into new areas including librarianship. This reorientation has resulted in increased uncertainty regarding what counts as evidence and has caused a tension between formalised procedures and professional judgment. This theoretical paper aims to extend the knowledge about how…
Gotwals, Amelia Wenk; Songer, Nancy Butler
This article evaluates a validity argument for the degree to which assessment tasks are able to provide evidence about knowledge that fuses information from a progression of core disciplinary ideas in ecology and a progression for the scientific practice of developing evidence-based explanations. The article describes the interpretive framework…
Full Text Available Lance C Dalleck,1 Gary P Van Guilder,2 Tara B Richardson,1 Chantal A Vella3 1Recreation, Exercise, and Sport Science Department, Western State Colorado University, Gunnison, CO, USA; 2Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD, USA; 3Department of Movement Sciences, WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA Background: The purpose of this study was to determine the prevalence of individuals who experienced exercise-induced adverse cardiometabolic response (ACR, following an evidence-based, individualized, community exercise program. Methods: Prevalence of ACR was retrospectively analyzed in 332 adults (190 women, 142 men before and after a 14-week supervised community exercise program. ACR included an exercise training-induced increase in systolic blood pressure of 10 mmHg, increase in plasma triglycerides (TG of >37.0 mg/dL (0.42 mmol/L, or decrease in high-density lipoprotein cholesterol (HDL-C of >4.0 mg/dL (0.12 mmol/L. A second category of ACR was also defined – this was ACR that resulted in a metabolic syndrome component (ACR-risk as a consequence of the adverse response. Results: According to the above criteria, prevalence of ACR between baseline and post-program was systolic blood pressure (6.0%, TG (3.6%, and HDL-C (5.1%. The prevalence of ACR-risk was elevated TG (3.2%, impaired fasting blood glucose (2.7%, low HDL-C (2.2%, elevated waist circumference (1.3%, and elevated blood pressure (0.6%. Conclusion: Evidence-based practice exercise programming may attenuate the prevalence of exercise training-induced ACR. Our findings provide important preliminary evidence needed for the vision of exercise prescription as a personalized form of preventative medicine to become a reality. Keywords: evidence-based research, cardiovascular health, community-based research, metabolic health
Martin, Donna; Albensi, Lisa; Van Haute, Stephanie; Froese, Maria; Montgomery, Mary; Lam, Mavis; Gierys, Kendra; Lajeunesse, Rob; Guse, Lorna; Basova, Nataliya
In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP. This was a mixed methods study. A repeat observational survey discerned if the PUPP reduced PU prevalence. A pre-test post-test design was used to determine whether hospital staff's knowledge of PU prevention was enhanced by the online tutorial. Qualitative interviews were conducted with nurses, allied health professionals, and health care aides to explore staff's perspectives of the PUPP. A comparison of initial and repeat observational surveys (n = 239) identified a statistically significant reduction in the prevalence of PU to 7.53% (p tutorial enhanced staff knowledge level with a statistically significantly higher mean post-test score (n = 80). Thirty-five frontline staff shared their perspectives of the PUPP with "it's definitely a combination of everything" and "there's a disconnect between what's needed and what's available" as the main themes. Incorporating evidence-based PU prevention into clinical practice greatly reduced the prevalence of PUs among hospital in-patients. Due to the small sample size for the pre-test post-test component, the effectiveness of the online tutorial in improving the knowledge level of PU prevention among hospital staff requires further research. Evidence-based PU prevention strategies are facilitated by using a multidisciplinary approach. Educational tools about PU prevention must target all members of the healthcare team including healthcare
Past weight-of-evidence frameworks for adverse ecological effects have provided soft-scoring procedures for judgments based on the quality and measured attributes of evidence. Here, we provide a flexible probabilistic structure for weighing and integrating lines of evidence for e...
The ability to make a sound clinical decision is based largely on the quality of evidence and the practitioner's ability to evaluate this evidence. Clinical evidence are categorized and ranked according to the strength of their freedom from the various biases that beset medical research. Randomized controlled trials (RCTs) are ...
Neuhaus, S J; Thomas, D; Desai, J; Vuletich, C; von Dincklage, J; Olver, I
In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.
The principles of evidence-based medicine have been critiqued by the 'caring' professions, such as nursing and social work, and evidence-informed medicine has been proposed as a more client-centred, integrative approach to practice. The purpose of this study was to explore how Canadian health science librarians who serve nurses and allied health professionals define good service and how they negotiate evidence-based principles in their searching strategies. Twenty-two librarians completed a 30 minute, semi-structured phone interview about strategies for providing good service and supporting evidence-based services. Participants were also asked to respond to three challenging search scenarios. Analysis of results used grounded theory methods. Participants' definitions of good service and strategies for supporting evidence-based practice involved discussions about types of services provided, aspects of the librarian providing the service and aspects of the information provided during the service. Analysis of search scenarios revealed four justifications librarians rely upon when providing evidence that is in opposition to what their patron hopes to receive (evidentiary, ethical, practice-based and boundaries of the profession). The findings of this study suggest that health science librarians are both constrained and enabled by the principles of evidence-based medicine and especially by understandings of 'best evidence'. © 2017 Health Libraries Group.
Kim, Sang Suk; Kim, Eun Joo; Lim, Ji Young; Kim, Geun Myun; Baek, Hee Chong
Evidence-based practice (EBP) is essential for enhancing nurses' quality of care. We identified Korean nursing students' practices, attitudes, and knowledge concerning EBP, as well as their critical thinking disposition (CTD). The EBP Questionnaire (EBPQ) was administered to a convenience sample of 266 nursing students recruited from four nursing schools in Seoul and its metropolitan area. Average EBPQ and CTD total scores were 4.69 ± 0.64 and 3.56 ± 0.32, respectively. Students who were ages ⩾23 years, male, and satisfied with their major demonstrated higher EBPQ and CTD scores. EBPQ scores were significantly correlated with CTD scores (r = .459, p < .01), and CTD was an explanatory factor of EBP (adjusted R2 = 0.200). It is necessary to develop comprehensive teaching strategies to help nursing students improve their CTD and information utilization skills, as well as integrate EBP in undergraduate programs to enhance nurses' EBP abilities. [J Nurs Educ. 2018;57(1):21-27.]. Copyright 2018, SLACK Incorporated.
Boruff, Jill T; Thomas, Aliki
To ensure that physical and occupational therapy graduates develop evidence-based practice (EBP) competencies, their academic training must promote EBP skills, such as posing a clinical question and retrieving relevant literature, and the information literacy skills needed to practice these EBP skills. This article describes the collaborative process and outcome of integrating EBP and information literacy early in a professional physical therapy and occupational therapy programme. The liaison librarian and a faculty member designed an instructional activity that included a lecture, workshop and assignment that integrated EBP skills and information literacy skills in the first year of the programme. The assignment was designed to assess students' ability to conduct a search independently. The lecture and workshop were successful in their objectives, as 101 of the 104 students received at least 8 out of 10 points on the search assignment. The teaching activities developed for the students in this course appear to have achieved the goal of teaching students the EBP research cycle so that they might begin to emulate it. The collaboration between the faculty member and the librarian was integral to the success of this endeavour. Future work will include the evaluation of students' long-term retention of information literacy objectives. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.
Blackman, Ian R; Giles, Tracey M
In order to meet national Australian nursing registration requisites, nurses need to meet competency requirements for evidence-based practices (EBPs). A hypothetical model was formulated to explore factors that influenced Australian nursing students' ability and achievement to understand and employ EBPs related to health care provision. A nonexperimental, descriptive survey method was used to identify self-reported EBP efficacy estimates of 375 completing undergraduate nursing students. Factors influencing participants' self-rated EBP abilities were validated by Rasch analysis and then modeled using the partial least squares analysis (PLS Path) program. Graduating nursing students' ability to understand and apply EBPs for clinical improvement can be directly and indirectly predicted by eight variables including their understanding in the analysis, critique and synthesis of clinically based nursing research, their ability to communicate research to others and whether they had actually witnessed other staff delivering EBP. Forty-one percent of the variance in the nursing students' self-rated EBP efficacy scores is able to be accounted for by this model. Previous exposure to EBP studies facilitates participants' confidence with EBP, particularly with concurrent clinical EBP experiences. © 2017 Sigma Theta Tau International.
Vijay Kumar Chattu
Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.
Nittis, Maria; Stark, Margaret
The importance of having clear, evidence-based guidelines for the taking of forensic samples from suspects detained in police custody (persons of interest) and complainants of crime is essential for forensic practitioners. The need for such guidelines was seen as desirable in New South Wales (NSW) and a working group was set up comprising scientists, practitioners and police. Feedback from the laboratory regarding the results of the specimens taken by forensic practitioners throughout the State was received and analysed. This has resulted in changes to current practice and highlighted the need for further research in this area. It has also highlighted areas that have not changed in response to evidence A quality service demands transparency, process review, relevant research and feedback in order to progress. Examiners need to obtain the results for their cases in order to reinforce the value of the service they provide as well as to monitor and, where necessary, improve their forensic collection skills. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Kyriakoulis, Konstantinos; Patelarou, Athina; Laliotis, Aggelos; Wan, Andrew C; Matalliotakis, Michail; Tsiou, Chrysoula; Patelarou, Evridiki
The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was
Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P
Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Participants' descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel "themes," 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework "Leadership Behaviors Supportive of EBP Institutionalization" (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should "support" EBP. © 2014 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of
Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai
The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care.
Full Text Available Evidence-based medicine (EBM has become a hot topic in medical practice, education, and research. However, a large number of senior doctors did not have an opportunity to learn EBM in medical schools. Firstly, this article addresses the history of EBM and the principle of practicing EBM, i.e., asking, acquiring, appraisal, application, and auditing. Secondly, this article also provides a brief introduction to evidence-based dermatology and compares the introduction of clinical practice guidelines between Europe, the UK, and the US. Finally, this article addresses the present condition and future perspective of evidence-based dermatology in Taiwan.
Cassey, Margaret Z
The National Guideline Clearinghouse (NGC) can be used as a means of integrating the constantly growing and changing body of scientific clinical evidence into the artful practice of nursing. The NGC offers an extensive collection of peer-reviewed, current, scientific standards to support clinical decision making in nursing practice. Nurse leaders should take a leadership role in bringing these relevant resources and new nursing knowledge to policy and procedure committees for active consideration.
Long, Cynthia R; Ackerman, Deborah L; Hammerschlag, Richard; Delagran, Louise; Peterson, David H; Berlin, Michelle; Evans, Roni L
To present the varied approaches of 9 complementary and alternative medicine (CAM) institutions (all grantees of the National Center for Complementary and Alternative Medicine) used to develop faculty expertise in research literacy and evidence-based practice (EBP) in order to integrate these concepts into CAM curricula. A survey to elicit information on the faculty development initiatives was administered via e-mail to the 9 program directors. All 9 completed the survey, and 8 grantees provided narrative summaries of faculty training outcomes. The grantees found the following strategies for implementing their programs most useful: assess needs, develop and adopt research literacy and EBP competencies, target early adopters and change leaders, employ best practices in teaching and education, provide meaningful incentives, capitalize on resources provided by grant partners, provide external training opportunities, and garner support from institutional leadership. Instructional approaches varied considerably across grantees. The most common were workshops, online resources, in-person short courses, and in-depth seminar series developed by the grantees. Many also sent faculty to intensive multiday extramural training programs. Program evaluation included measuring participation rates and satisfaction and the integration of research literacy and EBP learning objectives throughout the academic curricula. Most grantees measured longitudinal changes in beliefs, attitudes, opinions, and competencies with repeated faculty surveys. A common need across all 9 CAM grantee institutions was foundational training for faculty in research literacy and EBP. Therefore, each grantee institution developed and implemented a faculty development program. In developing the framework for their programs, grantees used strategies that were viewed critical for success, including making them multifaceted and unique to their specific institutional needs. These strategies, in conjunction with the
Underhill, Meghan; Roper, Kristin; Siefert, Mary Lou; Boucher, Jean; Berry, Donna
The purpose of evidence-based practice (EBP) in nursing is to improve patient outcomes, providing the best and most up-to-date care practices. In 2011, a nurse-led committee convened to develop an institute-wide initiative to promote EBP with oncology nurses at the Dana-Farber Cancer Institute. Compare and describe oncology nurse beliefs and perceived implementation of EBP and explore beliefs and implementation before and after implementing an institutional EBP initiative. Based on the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBP-B) and Implementation (EBP-I) scales were distributed to all Dana-Farber Cancer Institute registered and advanced practice nurses through an online survey in 2011 (T1) and again in 2013 (T2) after the implementation of an institute-wide nursing EBP initiative (orientation, poster presentations, education). Descriptive and correlation statistics were completed on total scores and demographics. Differences in beliefs and implementation scores based on demographics were analyzed with Mann-Whitney U tests. Open-ended item responses at each time point (T) were summarized for EBP barriers and promoters. Thirty-two percent (n = 112 at T1; n = 113 at T2) of 350 nurses began the survey. A history of formal EBP education and nurse role were associated with higher EBP-B and EBP-I scores (p nurses reported valuing EBP. Respondents acknowledged a lack of full preparation in the EBP process to engage in and implement EBP consistently. Nurse role, formal EBP education, and highest level of education were associated with perceptions of EBP beliefs and implementation. Nurses should be provided the mentorship and support to obtain continuing education about how to engage in EBP and about implementing EBP change. © 2015 Sigma Theta Tau International.
Boisvert, Isabelle; Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M.
Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of ...
Majid, Shaheen; Foo, Schubert; Luyt, Brendan; Zhang, Xue; Theng, Yin-Leng; Chang, Yun-Ke; Mokhtar, Intan A
Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses. PMID:21753915
Jagger, Susan L.; Yore, Larry D.
Science literacy for all is the central goal of science education reforms, and there is a growing importance of the language arts in science. Furthermore, there are strong calls for teacher professionalism and self-directed professional learning that involve evidence-based best practices. This raises questions about whether science teaching journals' recommendations are anchored to high-quality evidence. We found that (a) most National Science Teacher Association journals' science literacy recommendations have weak or no evidence base and (b) those with evidence reference teaching journals, teacher resource books, and literacy education more often than science education research. We concluded that all participants in the knowledge production cycle and transfer process—authors, editors, and reviewers—need to encourage evidence-based practices anchored to ongoing reforms and to literacy and science education research.
Full Text Available Background: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission.Objectives: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi.Methods: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software.Results: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent’s knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses.Conclusion: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.
Mulenga, Chisomo; Naidoo, Joanne R
HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission. The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi. An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software. The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses. Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.
Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael
Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518
This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces. This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the U.S. market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of non-cavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others
Hitch, Danielle; Nicola-Richmond, Kelli
The aim of this study is to update a previous review published in this journal on the effectiveness of teaching and assessment interventions for evidence based practice in health professions, and to determine the extent to which the five recommendations made from that review have been implemented. The Integrating Theory, Evidence and Action method…
Malik, Gulzar; McKenna, Lisa; Griffiths, Debra
The study aimed to explore the processes undertaken by nurse academics when integrating evidence-based practice (EBP) into their teaching and learning practices. This article focuses on pedagogical approaches employed by academics to influence evidence-based practice integration into undergraduate programs across Australian universities. Nursing academics are challenged to incorporate a variety of teaching and learning strategies to teach evidence-based practice and determine their effectiveness. However, literature suggests that there are limited studies available focusing on pedagogical approaches in evidence-based practice education. A constructivist grounded theory methodology, informed by Charmaz was used for this study. Data were collected during 2014 from 23 nurse academics across Australian universities through semi-structured interviews. Additionally, nine were observed during teaching of undergraduate students. Twenty subject outlines were also analysed following Charmaz's approach of data analysis. 'Influencing EBP integration' describes the pedagogical approaches employed by academics to incorporate EBP knowledge and skills into undergraduate curricula. With the use of various teaching and learning strategies, academics attempted to contextualize EBP by engaging students with activities aiming to link evidence to practice and with the EBP process. Although, some strategies appeared to be engaging, others were traditional and seemed to be disengaging for students due to the challenges experienced by participants that impeded the use of the most effective teaching methods. Study findings offer valuable insights into the teaching practices and identify some key challenges that require the adoption of appropriate strategies to ensure future nurses are well prepared in the paradigm of evidence-based practice. © 2016 John Wiley & Sons Ltd.
Full Text Available Angela Kueny,1 Leah L Shever,2 Melissa Lehan Mackin,3 Marita G Titler4 1Luther College, Decorah, IA, 2The University of Michigan Hospital and Health Center, Ann Arbor, MI, 3University of Iowa College of Nursing, Iowa City, IA, 4University of Michigan School of Nursing, Ann Arbor, MI, USA Background/purpose: Nurse managers (NMs play an important role promoting evidence-based practice (EBP on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. Methods: This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. Results: NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality
Gilbert, Dorie J; Harvey, Aminifu R; Belgrave, Faye Z
For over a decade, a number of social work scholars have advocated for an Africentric paradigm shift in social work practice with African Americans; yet the paradigm shift has been slow in coming with respect to infusing Africentric theory and interventions into social work practice, education, and research. Interventions that infuse Africentric values (such as interdependence, collectivism, transformation, and spirituality) have been shown to create significant change across a number of areas important to social work practice with African Americans. However, a barrier to the full integration of Africentric models into social work practice is that Africentric programs lack cohesive documentation and replication and, thus, have limited potential to be established as evidence-based practices. The authors present an overview of various Africentric interventions, including their program components and methods of evaluation, with the aim of establishing guideposts or next steps in developing a discourse on Africentric interventions that are promising best practices or are emerging as evidence-based practices. The authors conclude with implications for social work practice, education, and research and a call for Africentric scholars to engage in increased discussion, dissemination of manualized treatments, and collaborative research to build the evidence-based Africentric knowledge base and foster replication of studies.
Rose, John M.; Townsend, Julie S.; Fonseka, Jamila; Richardson, Lisa C.; Chovnick, Gary
Introduction National Comprehensive Cancer Control Program (NCCCP) awardees are encouraged to work with partners (eg, nonprofit organizations) to develop and implement plans to reduce the cancer burden in their jurisdictions using evidence-based practices (EBPs). However, the extent of EBP use among awardees and their partners is not well understood. Methods From March through July 2012, we conducted a web-based survey of program partners referred by NCCCP program directors who were involved in implementation of cancer control plans. Results Approximately 53% of referred partners (n = 83) completed surveys, 91.6% of whom represented organizations. Most partners reported involvement in helping to identify (80.5%), adapt (81.7%), implement (90.4%), and evaluate (81.9%) EBPs. The factors rated most frequently as very important when selecting EBPs were “consistent with our organization’s mission” (89.2%) and “cost-effective” (81.9%). Although most respondents said that their organizations understood the importance of using EBPs (84.3%) and had adequate access to cancer registry data (74.7%), few reported having sufficient financial resources to develop new EBPs (7.9%). The most frequently mentioned benefit of using EBPs was that they are proven to work. Resource limitations and difficulty adapting EBPs for specific populations and settings were challenges. Conclusions Our findings help indicate how NCCCP partners are involved in using EBPs and can guide ongoing efforts to encourage the use of EBPs for cancer control. The challenges of using EBPs that partners identified highlight the need to improve strategies to translate cancer prevention and control research into practice in real-world settings and for diverse populations. PMID:26182148
Steele, C Brooke; Rose, John M; Townsend, Julie S; Fonseka, Jamila; Richardson, Lisa C; Chovnick, Gary
National Comprehensive Cancer Control Program (NCCCP) awardees are encouraged to work with partners (eg, nonprofit organizations) to develop and implement plans to reduce the cancer burden in their jurisdictions using evidence-based practices (EBPs). However, the extent of EBP use among awardees and their partners is not well understood. From March through July 2012, we conducted a web-based survey of program partners referred by NCCCP program directors who were involved in implementation of cancer control plans. Approximately 53% of referred partners (n = 83) completed surveys, 91.6% of whom represented organizations. Most partners reported involvement in helping to identify (80.5%), adapt (81.7%), implement (90.4%), and evaluate (81.9%) EBPs. The factors rated most frequently as very important when selecting EBPs were "consistent with our organization's mission" (89.2%) and "cost-effective" (81.9%). Although most respondents said that their organizations understood the importance of using EBPs (84.3%) and had adequate access to cancer registry data (74.7%), few reported having sufficient financial resources to develop new EBPs (7.9%). The most frequently mentioned benefit of using EBPs was that they are proven to work. Resource limitations and difficulty adapting EBPs for specific populations and settings were challenges. Our findings help indicate how NCCCP partners are involved in using EBPs and can guide ongoing efforts to encourage the use of EBPs for cancer control. The challenges of using EBPs that partners identified highlight the need to improve strategies to translate cancer prevention and control research into practice in real-world settings and for diverse populations.
Atler, Karen; Gavin, William J
ABSTRACT Education leaders in occupational therapy (OT) propose that active learning is one means to developing critical thinking skills essential for successful integration of knowledge into evidence-based practice. This study examines the impact of one type of active learning, service-learning, on students' perceptions of their knowledge, skills, and confidence in their abilities to provide OT services to adults with neurological conditions. Change in OT students' (n == 43) perceptions before and after engagement in service-learning were assessed using quantitative and qualitative data in a triangulation mixed-methods design. Results support previous studies indicating that service-learning can influence positive gains in student knowledge and confidence.
Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P
Background Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. Aims To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Methods Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Results Participants’ descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel “themes,” 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework “Leadership Behaviors Supportive of EBP Institutionalization” (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Linking Evidence to Action Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should “support” EBP. PMID:24986669
Caroline A. Bonham
Full Text Available Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38 supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities.
Giovanni Abrahao Salum
Full Text Available The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.
Luz, Clarissa Medeiros da; Deitos, Julia; Siqueira, Thais Cristina; Palú, Marina; Heck, Ailime Perito Feiber
Axillary web syndrome is characterized as a physical-functional complication that impacts the quality of life of women who have undergone treatment for breast cancer. The present study aims to verify the physiotherapy treatment available for axillary web syndrome after surgery for breast cancer in the context of evidence-based practice. The selection criteria included papers discussing treatment protocols used for axillary web syndrome after treatment for breast cancer. The search was performed in the MEDLINE, Scopus, PEDro and LILACS databases using the terms axillary web syndrome, lymphadenectomy and breast cancer, focusing on women with a previous diagnosis of breast cancer who underwent surgery with lymphadenectomy as part of their treatment. From the 262 studies found, 4 articles that used physiotherapy treatment were selected. The physiotherapy treatment was based on lymphatic drainage, tissue mobilization, stretching and strengthening. The four selected articles had the same outcome: improvement in arm pain and shoulder function and/or dissipation of the axillary cord. Although axillary web syndrome seems to be as frequent and detrimental as other morbidities after cancer treatment, there are few studies on this subject. The publications are even scarcer when considering studies with an interventional approach. Randomized controlled trials are necessary to support the rehabilitation resources for axillary web syndrome. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.
Mi, Misa; Moseley, James L; Green, Michael L
Many residency programs offer training in evidence-based medicine (EBM). However, these curricula often fail to achieve optimal learning outcomes, perhaps because they neglect various contextual factors in the learning environment. We developed and validated an instrument to characterize the environment for EBM learning and practice in residency programs. An EBM Environment Scale was developed following scale development principles. A survey was administered to residents across six programs in primary care specialties at four medical centers. Internal consistency reliability was analyzed with Cronbach's coefficient alpha. Validity was assessed by comparing predetermined subscales with the survey's internal structure as assessed via factor analysis. Scores were also compared for subgroups based on residency program affiliation and residency characteristics. Out of 262 eligible residents, 124 completed the survey (response rate 47%). The overall mean score was 3.89 (standard deviation=0.56). The initial reliability analysis of the 48-item scale had a high reliability coefficient (Cronbach α=.94). Factor analysis and further item analysis resulted in a shorter 36-item scale with a satisfactory reliability coefficient (Cronbach α=.86). Scores were higher for residents with prior EBM training in medical school (4.14 versus 3.62) and in residency (4.25 versus 3.69). If further testing confirms its properties, the EBM Environment Scale may be used to understand the influence of the learning environment on the effectiveness of EBM training. Additionally, it may detect changes in the EBM learning environment in response to programmatic or institutional interventions.
Molina Mula, Jesús; Muñoz Navarro, Paulina; Vaca Auz, Janeth; Cabascango Cabascango, Carmita; Cabascango Cabascango, Katty
The research raises the need to increase understanding of organizational and personal factors that influence the attitude and aptitude of each professional, with respect to evidence-based clinical practice. The aim of this study is to describe the transfer of knowledge into clinical practice in hospital units in Imbabura (Ecuador) identifying the obstacles to implementing evidence-based clinical practice validated questionnaire EBPQ-19. A cross-sectional observational study was conducted in hospitals of the Ministry of Public Health of Imbabura of Ecuador took place, including a total of 281 nurses and physicians. Nurses and physicians showed positive attitudes toward evidence-based clinical practice (EBCP) and their use to support clinical decision-making. This research evidences perceptions of professionals on strategies for knowledge transfer and obstacles to carry it out. Significant differences between the perception of the use of EBCP strategies between nurses and physicians are observed. Physicians consider they use them frequently, while nurses acknowledge using them less (chi-square: 105.254, P=.018). In conclusion, we can say that these factors should be considered as necessary to improve the quality of care that is provided to users based on the best available evidence. It is necessary to start developing change interventions in this regard to remedy the current situation of clinical practice based not on evidence, but rather on experience only. Experimental studies demonstrating the effectiveness of strategies to eliminate barriers to scientific evidence-based clinical practice should be conducted. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Valcke, Martin; De Wever, Bram
In contrast to traditional meta-analyses of research, an alternative overview and analysis of the research literature on the impact of information and communication technologies (ICT) in medical education is presented in this article. A distinction is made between studies that have been set up at the micro-level of the teaching and learning situation and studies on meso-level issues. At the micro-level, ICT is hypothesized to foster three basic information processing activities: presentation, organization, and integration of information. Next to this, ICT is expected to foster collaborative learning in the medical knowledge domain. Empirical evidence supports the potential of ICT to introduce students to advanced graphical representations but the studies also stress the importance of prior knowledge and the need for real-life tactile and practical experiences. The number of empirical studies focusing on the impact of ICT on information organization is restricted but the results suggest a positive impact on student attitudes and relevant learning gains. However, again, students need a relevant level of prior knowledge. Empirical studies focusing on the impact of ICT on information integration highlight the positive impact of ICT-based assessment and computer simulations; for the latter this is especially the case when novices are involved, and when they master the prerequisite ICT skills. Little empirical evidence is available regarding the impact of computer games. Research results support the positive impact of ICT-based collaboration but care has to be taken when skills development is pursued. At the meso-level, the available empirical evidence highlights the positive impact of ICT to promote the efficiency of learning arrangements. Research grounds the key position of ICT in a state-of-the-art medical curriculum. Recent developments focusing on repositories of learning materials for medical education have yet not been evaluated. The article concludes by
This article analyses some of the common assertions made in the public debate about the merits and disadvantages of faith schools and tests them against actual research findings. It argues that there is a growing body of evidence showing that current policy and practice in faith schools creates social division and that faith schools need to do…
the end of the course may indicate that an effective balance between face‐to‐face and online media was achieved. At the meso‐level, students valued learning in community for developing mutual respect, confidence building, risk taking, deeper and more varied learning, learning with and from their peers, and greater enjoyment in the classes. Students found that the online environments were useful for organizing the class objectives and subject matter, “staying connected” between classes, sharing ideas, keeping track of their work, and preparing them for future work in blended environments. At the macro‐level, the findings of the effects on student growth related to core LIS concepts, practices, professional identity and leadership skills were inconclusive. However, students’ expressed a high regard for the value of collaboration, and there were indications that the model supported differentiated learning of professional knowledge and skills.Conclusion ‐ The findings strongly suggest that the use of the CoP model had positive effects on the learning process. Students’ high regard for the value of collaboration appears to be a clear effect of using the CoP model. The assessment methods were sufficient for testing the efficacy of most aspects of the model under the limited conditions of this study. Student responses led to refinements in both the model and methods. This study contributes to social constructivist learning approaches and LIS curricular development by presenting an innovative model for supporting professional growth among adult learners, as well as a conceptual framework to guide evidence based practice. Further testing and refinement of the model in other contexts and by other educators are needed to ensure that the model is robust and broadly applicable.
Nunan, David; O'Sullivan, Jack; Heneghan, Carl; Pluddemann, Annette; Aronson, Jeffrey; Mahtani, Kamal
In this article we signpost readers to 10 papers we consider essential reading for anyone starting out on an evidence-based medicine journey. We have considered papers consisting a mix of old and new, seminal and cutting-edge that offer insight into what evidence-based medicine is, where it came from, why it matters and what it has achieved. This is balanced against some of the common criticisms of evidence-based medicine and efforts to tackle them. We have also highlighted papers acknowledging the importance of teaching and learning of the principles of evidence-based medicine and how health professionals can better use evidence in clinical decisions with patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Lavoie-Tremblay, Mélanie; Richer, Marie-Claire; Marchionni, Caroline; Cyr, Guylaine; Biron, Alain D; Aubry, Monique; Bonneville-Roussy, Arielle; Vézina, Michel
The recent introduction of a project management office (PMO) in a major healthcare center, led by a nurse, provides a unique opportunity to understand how a PMO facilitates successful implementation of evidence-based practices in care delivery. A case study with embedded units (individuals, projects, and organization). In this study, the case is operationally defined as the PMO deployed in a Canadian healthcare center. The sources of evidence used in this study were diverse. They consisted of 38 individual interviews, internal documents, and administrative data. The data were collected from March 2009 to November 2011. Content analysis was used to analyze the qualitative data. PMO experts help improve practices, and the patients thus receive safer and better quality care. Several participants point out that they could not make the changes without the PMO's support. They mention that they succeeded in changing their practices based on the evidence and acquired knowledge of change management with the PMO members that can be transferred to their practice. With the leadership of the nurse director of the PMO, members provide a range of expertise and fields in evidence-based change management, project management, and evaluation. PMO facilitates the implementation of clinical and organizational practices based on evidence to improve the quality and safety of care provided to patients. © 2012 Sigma Theta Tau International.
Quimbo Stella A
Full Text Available Abstract Background Randomized trials have long been the gold-standard for evaluating clinical practice. There is growing recognition that rigorous studies are similarly needed to assess the effects of policy. However, these studies are rarely conducted. We report on the Quality Improvement Demonstration Study (QIDS, an example of a large randomized policy experiment, introduced and conducted in a scientific manner to evaluate the impact of large-scale governmental policy interventions. Methods In 1999 the Philippine government proposed sweeping reforms in the National Health Sector Reform Agenda. We recognized the unique opportunity to conduct a social experiment. Our ongoing goal has been to generate results that inform health policy. Early on we concentrated on developing a multi-institutional collaborative effort. The QIDS team then developed hypotheses that specifically evaluated the impact of two policy reforms on both the delivery of care and long-term health status in children. We formed an experimental design by randomizing matched blocks of three communities into one of the two policy interventions plus a control group. Based on the reform agenda, one arm of the experiment provided expanded insurance coverage for children; the other introduced performance-based payments to hospitals and physicians. Data were collected in household, hospital-based patient exit, and facility surveys, as well as clinical vignettes, which were used to assess physician practice. Delivery of services and health status were evaluated at baseline and after the interventions were put in place using difference-in-difference estimation. Results We found and addressed numerous challenges conducting this study, namely: formalizing the experimental design using the existing health infrastructure; securing funding to do research coincident with the policy reforms; recognizing biases and designing the study to account for these; putting in place a broad data
Barnes, Sue; Spencer, Maureen; Graham, Denise; Johnson, Helen Boehm
Surgical wound irrigation has long been debated as a potentially critical intraoperative measure taken to prevent the development of surgical site infection (SSI). Unlike many other SSI prevention efforts, there are no official practice guidelines or recommendations from any major medical group for the practice of surgical irrigation. As a result, practitioner implementation of the 3 major irrigation variables (delivery method, volume, and solution additives) can differ significantly. A focus group of key thought leaders in infection prevention and epidemiology convened recently to address the implications of different surgical irrigation practices. They identified an urgent need for well-designed clinical trials investigating surgical irrigation practices, improved collaboration between surgical personnel and infection preventionists, and examination of existing evidence to standardize irrigation practices. The group agreed that current published data are sufficient to support the elimination of antibiotic solutions for surgical irrigation; the avoidance of surfactants for surgical irrigation; and the use of sterile normal saline, sterile water, and 1 medical device containing a sterile 0.05% chlorhexidine gluconate solution followed by sterile saline. Given the current lack of sufficient evidence identifying ideal delivery method and volume choices, expert opinion must be relied on to guide best practice. Copyright © 2014. Published by Mosby, Inc.
Reviews problems identified in previous research on evidence-based nursing practice; discusses conflicts between medical and nursing domains; explores the provenance and status of the clinical guideline as a translation artefact or bridging mechanism based on a social studies of science approach; and presents a case study of Scottish clinical…
Scurlock-Evans, Laura; Upton, Penney; Upton, Dominic
Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent. Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation. Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies. Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included. One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions. Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP. Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias. There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Aasekjaer, Katrine; Waehle, Hilde Valen; Ciliska, Donna; Nordtvedt, Monica Wammen; Hjälmhult, Esther
Even though health professionals have a positive attitude toward evidence-based practice (EBP), they have limited skills when it comes to implementation of EBP. A postprofessional program in EPB has been offered at Bergen University College since 2004. To date, there is limited knowledge of how the graduates of the program implement and make use of the EBP principles in their working environment in different healthcare settings. The aim of the study was to explore the facilitators and strategies to successful implementation of the steps of EBP as experienced by health professionals who had completed a postgraduate program in EBP. Grounded theory was used in gathering and analyzing data from single and focus group interviews of 20 health professionals who had attended a postprofessional program in EBP. Inclusion criteria also required current clinical practice. This study identified a specific set of activities used by health professionals when implementing EBP within their service organization. Creating an interest and understanding of EBP amongst their colleagues appeared to be a challenge, which they addressed by using the generated grounded theory of "tailoring principles." The dominant condition of this theory was management involvement. This study highlighted the importance of middle-range managers' coordinating and supporting role as a decisive component in the process of implementing EBP to clinical settings in Norway. Moreover, the dynamic complex process of "tailoring principles" also showed how the production of a clinical protocol became an outcome of implementation effectiveness as well as input for further intervention effectiveness. Tailoring the principle of EBP to the organizational and cultural context facilitated the implementation of EBP. © 2016 Sigma Theta Tau International.
Shin, Ji In; Lee, Eunjoo
To examine the relationship between evidence-based practice (EBP) adoption and social capital in nurses and to determine how social capital affected EBP adoption in South Korea. A cross-sectional, correlational design was used. In total, 432 registered nurses from two university-affiliated teaching hospitals in South Korea completed the questionnaire, which included demographic items, the Developing Evidence-Based Practice Questionnaire, and the Social Capital Outcomes for Nurses scale. Data were analyzed using hierarchical regression to identify the predictors of EBP adoption. Nurses with higher social capital scores reported fewer perceived barriers to finding and reviewing evidence, and changing practice. Higher social capital scores were associated with higher levels of perceived facilitators of EBP adoption and skills appraisal in finding and reviewing evidence. Social capital was a significant predictor of EBP adoption. Nurses with greater opportunities to exchange and communicate their ideas freely are more likely to accept new evidence through diverse channels and trust-based relationships between nurses, which allows healthcare organizations to promote innovations such as EBP adoption. Therefore, social capital in nurses could serve as a driving force for EBP adoption and should provide a healthy foundation for changes in patient care practices. Nurses with higher social capital are tending to adopt EBP willingly. High trust enables nurses to facilitate and support change in practice. Therefore, to improve EBP adoption in patient care, it needs to be monitored that relationships between nurses are carefully structured and that they foster mutual interaction. © 2017 Sigma Theta Tau International.
Hannes, K; Goedhuys, J; Aertgeerts, B
A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h
Green, Angela; Jeffs, Debra A; Boateng, Beatrice A; Lowe, Gary R; Walden, Marlene
This research examined evidence-based practice (EBP) knowledge and beliefs before and after a 3-month e-learning program was implemented to build EBP capacity at a large children's hospital. Ten clinicians completed the development, implementation, and evaluation of the e-learning education, comprising phase one. Revision and participation by 41 clinicians followed in phase two. Participants in both phases completed the EBP Beliefs and Implementation Scales preintervention, postintervention, and 6 months after postintervention. EBP beliefs and implementation increased immediately and 6 months after postintervention, with statistically significant increases in both phases. Participants in both phases applied knowledge by completing mentor-supported EBP projects. Although EBP beliefs and implementation scores increased and e-learning provided flexibility for clinician participation, challenges arose, resulting in lower-than-expected completion. Subsequent revisions resulted in hybrid education, integrating classroom and e-learning with project mentoring. This funded e-learning research contributes knowledge to the growing specialty of professional development. J Contin Educ Nurs. 2017;48(7):304-311. Copyright 2017, SLACK Incorporated.
Vlada, Adrian C; Schmit, Bradley; Perry, Andrew; Trevino, Jose G; Behrns, Kevin E; Hughes, Steven J
Evidence-based guidelines for the treatment of severe acute pancreatitis have been established. This study was conducted to investigate the hypothesis that deviation from guidelines occurs frequently. With institutional review board approval, the outside medical records of patients with severe pancreatitis who were transferred to the study institution during the period from July 2005 to May 2012 were reviewed. Severe pancreatitis was defined using the Atlanta Classification criteria. Records were reviewed with respect to published guidelines defining the appropriate use of imaging, antibiotics and nutritional support. A total of 538 patients with acute pancreatitis were identified. Of 67 patients with severe acute pancreatitis, 44 (66%) were male. The mean age of the patients was 55 years. Forty-five of 61 (74%) patients for whom relevant data were available were imaged upon admission, but only 15 (31%) patients were imaged appropriately by computerized tomography with i.v. contrast to assess the presence of necrosis or other complications. In patients for whom relevant data were available, prophylactic antibiotics were initiated in the absence of culture data or a specific infectious target in 26 (53%) patients. Total parenteral nutrition (TPN) was administered to 38 (60%) of 63 patients for whom relevant data were available; only 10 (17%) patients received enteric feeding. No nutritional support was provided to 15 (23%) patients. Adherence to best practice guidelines in the treatment of severe pancreatitis is poor. The consistent application of current knowledge might improve outcomes in these patients. © 2013 International Hepato-Pancreato-Biliary Association.
Iwersen, Lisandra Fossari; Sperandio, Fabiana Flores; Toriy, Ariana Machado; Palú, Marina; Medeiros da Luz, Clarissa
Lower limb lymphedema (LLL) is characterized as a physical-functional chronic complication that impacts the quality of life of women who have gone through treatment for gynecological cancer. The present study aims to check the conservative treatments available for lymphedema after gynecological cancer in the context of evidence-based practice. The selection criteria included papers from May 1993 discussing treatment protocols used in LLL after treatment for gynecological cancer. The search was performed until October 2014 in MEDLINE, SciVerse, and PEDro using "rehabilitation," "treatment outcome," "therapeutics," "clinical protocol," "gynecologic surgery," "lower extremity," "lower limb," and "lymphedema" as keywords, focused on women with a previous diagnosis of gynecological cancer who received radiation and/or chemotherapy and/or surgery and/or lymphadenectomy as part of their treatment. From 110 studies found, 3 articles that used the complex decongestive therapy (CDT) as a treatment protocol were selected. There were no randomized clinical trials associated with the conservative treatment of LLL post-treatment of gynecological cancer. The three selected articles are retrospective, and had the same outcome - decreased volume of the affected limb lymphedema. Although LLL is more or as frequent and detrimental as upper limb lymphedema post-cancer treatment, there are only a few studies about this subject. Publications are even scarcer when considering studies with interventional approach. Randomized controlled trials are necessary to support rehabilitation resources on lymphedema post-gynecological cancer treatment.
Shelton, Rachel C; Cooper, Brittany Rhoades; Stirman, Shannon Wiltsey
There is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented. This review critically examines and discusses conceptual and methodological issues in studying sustainability, summarizes the multilevel factors that have been found to influence the sustainability of interventions in a range of public health and health care settings, and highlights key areas for future research. Expected final online publication date for the Annual Review of Public Health Volume 39 is April 1, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Smith, Susan C; Penumetcha, Meera
Given the foundational importance of literature searching skills to later stages of research and, ultimately, evidence-based practice, the authors wanted to assess a unique strategy for teaching such skills. This pilot study describes the results of an undergraduate nutrition research course in which a librarian lead several class sessions. The goal of this study was to assess students' perceptions, attitudes and use of research literature and resources before and after a course partially taught by a librarian. Twenty-seven students enrolled in an undergraduate Introduction to Research course at Georgia State University were given pre- and post-test questionnaires at the beginning and end of a course that included three librarian-led class sessions. Most of the results indicate that the repeated involvement of a librarian enriched this particular undergraduate research course. By the end of the course, students were more comfortable in libraries and with using library resources; they used the campus library more frequently; they were more confident in their ability to find high-quality information on nutrition-related topics and identify strengths and weaknesses of different information sources; and they felt they gained skills that will help them achieve their educational and career goals.
Vogel, Kimberly A
Students in allied health educational programs learn evidence-based practice (EBP) skills, yet often do not consistently utilize these skills as practitioners. Barriers to implementing EBP include time pressures and lack of skill. This descriptive study explains how librarians can teach information literacy skills and strengthen knowledge of EBP in graduate occupational therapy (OT) students. The goal of the study was to evaluate students' perception of the effectiveness of learning activities about EBP, and librarians' perception of the value of teaching in an OT curriculum. Sixty-three students at the University of Texas Health Science Center at San Antonio read articles and learned didactic information from OT faculty and librarians about EBP. Students researched intervention questions and electronically sent searches to librarians for feedback. Students applied skills by researching an intervention of their choice. Evaluative data were collected from students in 2009 and 2010 and from librarians in 2009. Both groups rated the learning experiences highly. Students felt the learning experiences improved their effectiveness in carrying out EBP. Librarians valued the experience of teaching information literacy to OT students. These results support other studies showing librarians' effectiveness in developing EBP skills in students. Recommendations are given about using journal clubs and secondary literature to ensure the use of EBP at the workplace.
Rieckmann, Traci R.; Kovas, Anne E.; Cassidy, Elaine F.; McCarty, Dennis
State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical…
Lovelace, Kay A; Aronson, Robert E; Rulison, Kelly L; Labban, Jeffrey D; Shah, Gulzar H; Smith, Mark
We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs' use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important.
Beinortas, Tumas; Bauza, Karolis; Howick, Jeremy; Nunan, David; Mahtani, Kamal Ram
In post-Soviet countries, where medical practice largely relies on experience alone, the incorporation of the best research evidence in clinical practice is limited. In order to promote the awareness and utilization of evidence-based medicine (EBM) among Lithuanian doctors, we organized EBM conferences in each of the two Lithuanian medical schools. More than 500 medical professionals and students attended the conferences in Vilnius (2013) and Kaunas (2014) demonstrating that there is a high demand for formal EBM teaching. Building on the success of these seminal conferences, and to start addressing the lack of EBM practice in the country, the first Lithuanian Centre for Evidence-Based Medicine was established at Vilnius University Medical Faculty in 2014. The Centre will focus on the implementation of EBM teaching in medical school curriculum, formulating management guidelines, writing systematic reviews and supporting Lithuanian authors in doing so. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.
Thomas, Aliki; Han, Lu; Osler, Brittony P; Turnbull, Emily A; Douglas, Erin
Most health professions, including occupational therapy, have made the application of evidence-based practice a desired competency and professional responsibility. Despite the increasing emphasis on evidence-based practice for improving patient outcomes, there are numerous research-practice gaps in the health professions. In addition to efforts aimed at promoting evidence-based practice with clinicians, there is a strong impetus for university programs to design curricula that will support the development of the knowledge, attitudes, skills and behaviours associated with evidence-based practice. Though occupational therapy curricula in North America are becoming increasingly focused on evidence-based practice, research on students' attitudes towards evidence-based practice, their perceptions regarding the integration and impact of this content within the curricula, and the impact of the curriculum on their readiness for evidence-based practice is scarce. The present study examined occupational therapy students' perceptions towards the teaching and assessment of evidence-based practice within a professional master's curriculum and their self-efficacy for evidence-based practice. The study used a mixed methods explanatory sequential design. The quantitative phase included a cross-sectional questionnaire exploring attitudes towards evidence-based practice, perceptions of the teaching and assessment of evidence-based practice and evidence-based practice self-efficacy for four cohorts of students enrolled in the program and a cohort of new graduates. The questionnaire was followed by a focus group of senior students aimed at further exploring the quantitative findings. All student cohorts held favourable attitudes towards evidence-based practice; there was no difference across cohorts. There were significant differences with regards to perceptions of the teaching and assessment of evidence-based practice within the curriculum; junior cohorts and students with previous
Häuser, Winfried; Ablin, Jacob; Perrot, Serge; Fitzcharles, Mary-Ann
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus‑based guidelines from Canada, Germany, Israel, and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic workup of patients with chronic widespread (generalized) pain (CWP) and to assist patients and physicians in shared decision making on treatment options. Every patient with CWP requires, at the first medical evaluation, a complete history, medical examination, and some laboratory tests (complete blood count, measurement of C‑reactive protein, serum calcium, creatine phosphokinase, thyroid‑stimulating hormone, and 25‑hydroxyvitamin D levels) to screen for metabolic or inflammatory causes of CWP. Any additional laboratory or radiographic testing should depend on red flags suggesting some other medical condition. The diagnosis is based on the history of a typical cluster of symptoms (CWP, nonrestorative sleep, physical and/or mental fatigue) that cannot be sufficiently explained by another medical condition. Optimal management should begin with education of patients regarding the current knowledge of FM (including written materials). Management should be a graduated approach with the aim of improving health‑related quality of life. The initial focus should ensure active participation of patients in applying healthy lifestyle practices. Aerobic and strengthening exercises should be the foundation of nonpharmacologic management. Cognitive behavioral therapies should be considered for those with mood disorder or inadequate coping strategies. Pharmacologic therapies may be considered for those with severe pain (duloxetine, pregabalin, tramadol) or sleep disturbance (amitriptyline, cyclobenzaprine, pregabalin). Multimodal programs should be considered for those with severe disability.
Full Text Available Abstract Background Validated instruments are needed to evaluate the programmatic impact of Evidence Based Practice (EBP training and to document the competence of individual trainees. This study aimed to translate the Fresno test into Spanish and subsequently validate it, in order to ensure the equivalence of the Spanish version against the original English version. Methods Before and after study performed between October 2007 and June 2008. Three groups of participants: (a Mentors of family medicine residents (expert group (n = 56; (b Family medicine physicians (intermediate experience group (n = 17; (c Family medicine residents (novice group (n = 202; Medical residents attended an EBP course, and two sets of the test were administered before and after the course. The Fresno test is a performance based measure for use in medical education that assesses EBP skills. The outcome measures were: inter-rater and intra-rater reliability, internal consistency, item analyses, construct validity, feasibility of administration, and responsiveness. Results Inter-rater correlations were 0.95 and 0.85 in the pre-test and the post-test respectively. The overall intra-rater reliability was 0.71 and 0.81 in the pre-test and post-test questionnaire, respectively. Cronbach's alpha was 0.88 and 0.77, respectively. 152 residents (75.2% returned both sets of the questionnaire. The observed effect size for the residents was 1.77 (CI 95%: 1.57-1.95, the standardised response mean was 1.65 (CI 95%:1.47-1.82. Conclusions The Spanish version of the Fresno test is a useful tool in assessing the knowledge and skills of EBP in Spanish-speaking residents of Family Medicine.
O'Regan, Kevin; Marsden, Paul; Sayers, Gerardine; Morrissey, Mary; Hegarty, Heather; Allen, Michael; O'Connor, Owen J; Malone, Dermot; Maher, Michael M
The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site. Twenty-one participants (second-year radiology residents) at 8 centers in a radiology training program were included. The course in PBL was delivered over 16 weekly 1-hour sessions. There were 8 local education site coordinators (staff radiologists), who had completed an intensive 1-day course at the principal teaching site. The host site was linked to the participant sites using videoconferencing technology. Course evaluation included 1) a 5-point Likert-type scale and an open-ended evaluation questionnaire midway through the course (week 8) and a summation questionnaire after its completion (week 16) and 2) a consultation forum held during the penultimate session. The data responses to the questionnaires were entered in a spreadsheet, and the data were analyzed. Qualitative data were manually coded and analyzed for common themes. Descriptive statistical analyses were performed. Eighty-five percent of evaluation questionnaires and 53% of summation questionnaires were returned. The overall satisfaction of the participants with course content was high, with median rating of 4 on the 5-point scale. All participants agreed that videoconferencing as a medium did not hinder adequate discussion among centers and worked well as an interactive teaching method (median, 4). Local coordinators were satisfied with local technical support and training (median, 4), and overall, the module was rated highly, with ratings of 4 from both residents and local coordinators. Seventy-one percent of residents and 86% of local coordinators reported that they would have been unable to participate in the course without videoconferencing. All participants completed the course requirements satisfactorily. The
Full Text Available Abstract Background Non-attendance rates in psychiatric outpatient clinics have been a topic of considerable interest. It is measured as an indicator of quality of service provision. Failed attendances add to the cost of care as well as having an adverse impact on patients leading to missing medications, delay in identifying relapses and increasing waiting list time. Recent trials have demonstrated that prompting letters sent to patients led to a decrease in non-attendance rates. We applied this evidence based practice in our community mental health setting to evaluate its impact. Methods Using a before and after study design, we sent prompting letters to all patients due to attend outpatient clinic appointments for a period of six months in 2007. Non-attendance rates were compared with the corresponding period in 2006. We also looked at trends of non-attendance prior to this intervention and compared results with other parts of our service where this intervention had not been applied. Results 1433 prompting letters were sent out to all out-patient appointments made from June to November 2007. This resulted in an average non-attendance rate of 17% which was significantly less compared to 27% between June and November 2006 (RR 0.65, 95% CI 0.56 to 0.76, NNT 11. No downward trend in non-attendance rate was identified either prior to the intervention or when compared with similar teams across the city. Conclusion Prompt letters have been shown to reduce non-attendance rates in previous RCTs and systematic reviews. Our findings demonstrate a reduction in non-attendance rates with prompting letters even under non-trial conditions. Majority of the patients were constant during the two periods compared although there were some changes in medical personnel. This makes it difficult to attribute all the change, solely to the intervention alone. Perhaps our work shows that the results of pragmatic randomised trials are easily applicable and produce similar
Reviewed by Yasin OZARSLAN
Full Text Available EFFECTIVE BLENDED LEARNING PRACTICES:Evidence-based Perspectives in ICT-facilitated EducationEdited by Elizabeth Stacey and Philippa Gerbic, Information ScienceReference; 1 edition (March 30, 2009, ISBN-10: 1605662968, 358 pp.Reviewed by Yasin OZARSLANFaculty of Education,Eskisehir Osmangazi University,Eskisehir-TURKEYBlended learning refers to the integration of faceto-face and online learning activities with the goal of maximizing the value of students' experiences in both settings. This book collects new international research into many aspects of blended learningfrom the perspectives of learners, teachers, designers, and professional and academic developers in various disciplines, learningcommunities and universities from around the world. This book addresses the relative newness of online learning within blended environments. The book's broader audience is anyone who isinterested in areas such as blended learning, communities of learning, virtual education, professional learning and community development, instructional technology, flexible learning, distance education and collaborative learning.Blended approaches in teacher education, blending collaborative online learning,blended learning and teaching philosophies, campus-based student learning environments, ICT-enhanced blended learning, learning communities for K-12 teachers, professional development for blended learning, reciprocal mentoring,redesigning initial teacher education, responses to blended environments, strategiesfor blended teaching and learning, virtual learning and real communities are the topics covered in this book.It reviews literature about blended learning in relation to the three sections of the book and discusses strategies for teaching and learning and establishing communities in its different contexts. The chapters of this book provide research perspectives on a range of blended learning issues and contexts and discuss implications for teaching and learning. The
Gerstenmaier, Jan F
The diagnosis of a pancreatic mass lesion in the presence of chronic pancreatitis can be extremely challenging. At the same time, a high level of certainty about the diagnosis is necessary for appropriate management planning. The aim of this study was to establish current best evidence about which imaging methods reliably differentiate a benign from a malignant lesion, and show how that evidence is best applied. A diagnostic algorithm based on Bayesian analysis is proposed.
Ashktorab, Tahereh; Pashaeypoor, Shahzad; Rassouli, Maryam; Alavi-Majd, Hamid
Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students' competencies in EBP. This study aimed to investigate the nursing students' knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran. In this cross-sectional study, 170 undergraduate nursing students were selected from two faculties of nursing and midwifery in Tehran, Iran. A census sampling method was applied and they were all before graduation in 2013. The Rubin and Parrish questionnaire was used to assess the students' knowledge, attitude and intention to implement EBP as well as factors affecting the implementation of EBP. Students completed the instrument through self-report. Descriptive statistics, Independent sample t-test and Pearson correlation coefficient were used to analyze the data. The students mean scores of knowledge, attitude and intention to implement EBP was 31.08 ± 5.77, 50.40 ± 9.58, 36.01 ± 4.64, respectively. The students' age was inversely correlated with their scores of knowledge, attitude and intention to use EBP (P research methods (P research methods nor familiarity with EBP could significantly affect the students' intention to implement EBP. The present study showed that nursing students have not a high mean score in the three subscales of knowledge, attitude and intention to implement EBP. It is essential for faculties and nurse managers not only to focus on education of EBP, but also to support nurses and nursing students to implement it in the process patient care.
Full Text Available Abstract Background Mental health policymaking to support the implementation of evidence-based practices (EBPs largely has been directed toward clinicians. However, implementation is known to be dependent upon a broader ecology of service delivery. Hence, focusing exclusively on individual clinicians as targets of implementation is unlikely to result in sustainable and widespread implementation of EBPs. Discussion Policymaking that is informed by the implementation literature requires that policymakers deploy strategies across multiple levels of the ecology of implementation. At the organizational level, policies are needed to resource the added marginal costs of EBPs, and to assist organizational learning by re-engineering continuing education units. At the payor and regulatory levels, policies are needed to creatively utilize contractual mechanisms, develop disease management programs and similar comprehensive care management approaches, carefully utilize provider and organizational profiling, and develop outcomes assessment. At the political level, legislation is required to promote mental health parity, reduce discrimination, and support loan forgiveness programs. Regulations are also needed to enhance consumer and family engagement in an EBP agenda. And at the social level, approaches to combat stigma are needed to ensure that individuals with mental health need access services. Summary The implementation literature suggests that a single policy decision, such as mandating a specific EBP, is unlikely to result in sustainable implementation. Policymaking that addresses in an integrated way the ecology of implementation at the levels of provider organizations, governmental regulatory agencies, and their surrounding political and societal milieu is required to successfully and sustainably implement EBPs over the long term.
Rotheram-Fuller, Erin J; Swendeman, Dallas; Becker, Kimberly D; Daleiden, Eric; Chorpita, Bruce; Harris, Danielle M; Mercer, Neil T; Rotheram-Borus, Mary Jane
Introduction Strategies are needed to improve the efficacy of paraprofessional home visitors for pregnant women in the United States. This study evaluates the maternal and child outcomes when evidence-based practices (EBP) are replicated with flexibility, rather than fidelity to a manualized intervention. Methods Pregnant mothers (N = 203) in five clinics were recruited in the waiting rooms and randomized to standard clinic care as the control condition (n = 104) or standard care plus home visiting (n = 99). Home visitors (n = 9) were selected, trained in foundational skills common to EBP and four problem domains (weight control, breastfeeding, daily habits, and depression). Independent interviewers assessed targeted outcomes at birth (82%) and 6 months later (83%). Home visitors, called Mentor Mothers [MM], made an average of 14.9 home visits or telephone contacts (SD = 9; total contacts = 1491) addressing maternal daily habits, breastfeeding, and depression. Intervention and control mothers were similar in weight, Body Mass Index (BMI), depression and social support at baseline and 6 months later. The percentage of low birth weight babies was similar; intervention infants' growth (weight/height Z score) tended to be significantly better compared to the control condition. There are many explanations for the failure to find significant benefits: insufficient statistical power; the benefits of repeated assessments by warm, supportive peers to improve outcomes; or the failure of EBP and the need to maintain replication with fidelity. All study mothers had better outcomes than documented among comparable published samples of low-income, Latina and Korean-American mothers in Los Angeles, CA. ClinicalTrials.gov registration NCT01687634.
This article concerns the introduction of evidence-based practice (EBP) in foundation research. Five suggestions are discussed: (a) EBP relative to other epistemologies, (b) EBP in the context of the history of science, (c) research designs and levels of EBP, (d) EBP and measurement, and (e) systematic reviews as a review topic of the content of…
N. van Dijk; B. Spek; M Wieringa-de Waard; C. Lucas
BACKGROUND: The importance and value of the principles of evidence-based practice (EBP) in the decision-making process is recognized by speech-language therapists (SLTs) worldwide and as a result curricula for speech-language therapy students incorporated EBP principles. However, the willingness
Spek, B.; Wieringa-de Waard, M.; Lucas, C.; van Dijk, N.
The importance and value of the principles of evidence-based practice (EBP) in the decision-making process is recognized by speech-language therapists (SLTs) worldwide and as a result curricula for speech-language therapy students incorporated EBP principles. However, the willingness actually to use
Garbacz, S. Andrew; Watkins, Natasha D.; Diaz, Yamalis; Barnabas, Ernesto R., Jr.; Schwartz, Billie; Eiraldi, Ricardo
The purpose of this paper is to demonstrate how Conjoint Behavioral Consultation (CBC) can be used by school behavioral health programs within the Interactive Systems Framework (ISF) as a tool for developing and supporting intervention plans that integrate mental health evidence-based practices (EBPs). External behavioral health consultants…
Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.
Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…
Jagger, Susan L.; Yore, Larry D.
"Science literacy for all" is the central goal of science education reforms, and there is a growing importance of the language arts in science. Furthermore, there are strong calls for teacher professionalism and self-directed professional learning that involve evidence-based best practices. This raises questions about whether science teaching…
Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N.; Horvath, Andrea R.; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Oude Rengerink, Katrien; Gee, Harry; Mol, Ben W. J.; Khan, Khalid S.
ABSTRACT: BACKGROUND: Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However,