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Evidence based practice- concept, definition

When there is a lack of research reported in literature to guide clinical practice, it becomes necessary to design and conduct studies to generate evidence. There are many areas in clinical practice that do not have an established evidence base (e.g. care for dying children, primary care intervention to improve mental health outcomes in high risk individuals) as a result, their is an urgent need to conduct studies so that health care providers can base their treatment decisions on sound evidence from studies. Evidence based practice is an approach that enables clinicians to provide the highest quality of care in meeting the multifaceted needs of their patients and families

When health care providers know find, critically appraise and use the best evidence and patients are confident that their health care providers are using evidence based bare optimal outcomes are achieved for all.

for example, If you are caring for a patient who sustained head injury in a motor vehicle accident, would you want to know and use the most effective, empirically supported treatment established from randomally controlled triad to decrease his/her intracranial pressure.

If you are diagnosed with cancer today and when faced with the decision about which type of chemotherapy to choose, would you want to know the evidence regarding the risks and benefits of each chemotherapeutic agents.

Without current best evidence, practice is rapidly outdated, often to the detriment of patients. e.g. for years paediatric primary care providers adviced parents to place their infants in a prone position while sleeping with the underlying reasoning that this is the best position to prevent aspiration in event of vomiting. With evidence indicating that the prone positioning increases the risk of Sudden infant death Syndrome, the American Academy of Paediatrics released a clinical practice guidelines recommending a supine position for infant sleep (AAP, 2000)

Research utilization emphasizes the transfer of specific research based knowledge into practice.

Research Utilization

The term research utilization and evidence based practice are sometimes used synonymously.

It is the process of transferring research knowledge into practice; thus facilitating an innovative change in practice protocols. Research utilization is the use of findings from a disciplined study or a set of studies in a practical application that is unrelated to the original research.

Research utilization can be defined very broadly as the use of research findings in any and all aspects of one’s work as a registered nurse. While there are specific kinds of research utilization, such as instrumental, conceptual, and persuasive (Estabrooks, 1997), at its simplest it is the use of research.

Evidence-Based Nursing Practice

EBN is, much broader than research utilization, encompassing not only research findings, but other forms of practice knowledge as well. Evidence based practice involves making clinical decision on the basis of the best possible evidence.

It is defined as the use of current best evidence by clinicians when making patient care decisions, it entails finding the best evidence , critically evaluating it, integrating it with clinical expertise and patient preferences and applying the results to the clinical practice.

Evidence Based Practice

Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (Sackett et al., 1996)

Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician literature searching and the application of formal rules of evidence evaluating the clinical literature. (Evidence-Based Working Group, 1992)

 Definition

It is a problem solving approach to clinical practice that integrates-a systematic search for and critical appraisal for the most relevant evidence to answer a burning clinical question

  • One’s own clinical expertise
  • Best External Evidence
  • Patients preference and values

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