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• Patients protected from outdated interventions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.
