Evidence Based Practice

The Setting up of an evidence based practice group within our neurology

unit

CONTENT

• What is Evidence Based Practice?

• Stages involved

• Plans for development of group

• First project achieved

• Barriers to E.B.P.

• Discussions/Questions

• 1. What is Evidence Based Practice?

• 2. Is there a need?

Evidence Based Medicine

• “Evidence based medicine is the conscientious, explicit & judicious use of current best evidence in making decisions about the are of the individual patient”

• (Sacket al 1996)

Evidence Based Nursing

• “Evidence based care concerns the incorporation of evidence from research, clinical expertise and patient preferences into decisions about the health care of individual patients.”

• (Sacket 1988)

• Evidence based health care is about applying the best available evidence to a specific clinical question

• Is this a new concept?

• “Nursing should become a research based profession” (Hunt 1981)

• “Nursing performing too many tasks & not within a framework of scientific verification” (Roper 1977)

Barriers to E.B.P.

• Time constraints

• Limited access to literature

• Lack of training & information seeking & critical appraisal skills

• Practice V Intellect

• Work culture

Need for E.B.P.

• Diminished health care resources

• Patients protected from outdated interventions

• Health care professional may be safeguarded from potential litigation

Stages Involved

• 1. Convert needs into answerable questions

• 2. Find best evidence

• 3. Critically appraise evidence

• 4. Apply results to practice

• 5. Evaluate performance

Aims of Group

• To increase awareness & understanding of E.B.P. through teaching sessions

• To promote the use of E.B.P. to inform our clinical practice

Initial Plans for First Meeting

• Aims & plans to develop

• Regular meetings

• Identified facilitator

• Open to all

• Documentation/minutes

• Ground rules

• The Cochrane Centre

• Critically appraisal skills teaching programmes

• Centres for E.B.P.

• RCN Audit services/Good Practice Network

• Research utilisation conferences

• Evidence based journals

Main Areas of Interest

• Peripheral Neuropathic /diabetic ulcer care

• S/C pumps, IV care

• Urinary catheters

• NG tubes

• Gastrostomy tubes

First Project

• Best evidence available in relation to the care of various foot/leg ulcers patients have within our unit

• Identified question

• tracked down best evidence

• Critically appraised evidence as group

• Applied to practice using file with guidelines

File Guidelines

• Assessing, planning, implementing & evaluating care for leg/foot ulcers

• Holistic care

• List of best dressings for which ulcer

• Samples of journals used/evidence

Thoughts for the Future

• Easier Access

• Greater dissemination

• Kirrane C (2000) Evidence-based practice in neurology: a team approach to development. Nursing Standard, 14, 52, 43-45.