Evidence-Based Medicine Working Group. (1992). Evidence-Based medicine: A new approach to teaching the practice of medicine. JAMA, 268 (17), 2420-2425.
Evidence-based medicine is a new paradigm that places emphasis on new skills for physicians that include: performing efficient in performing literature searches and applying formal rules of evidence in examining clinical literature (critical appraisal exercise, which applies when authority is not trusted, the answer unknown, or there are divergent opinions). This is in addition to traditional clinical skills, understanding patients' emotional needs
This represents a shift from old processes used by physicians such as intuition, unsystematic clinical experience, and pathophysiologic rationale. Discusses Kuhn's notions of paradigms and paradigm shifts: paradigms are ways of viewing the world that define the problems addressed and the range of admissible evidence that can be used to solve them. Paradigm shifts occur when the old paradigm does not answer problems and a new paradigm in line with…...
Evidence-Based Medicine
Discuss advantages, disadvantages feasibility clinical practice evidence-based focusing errors administration intravenous medications hospitals role correct procedures and nurse experience.
Advantages, disadvantages and feasibility of evidence-based medicine in clinical practice: Errors in the administration of intravenous medications in hospitals
In 2000, the Institute of Medicine released a report with the shocking statistic that "up to 98,000 patients die in hospitals every year due to medical errors," a statistic supported by another study by the Chicago Tribune which "found that poorly trained or overworked nurses were responsible for the deaths of 1,700 patients and injuries up to 9,548 since 1995" (Your health: Medical errors linked to nurses, 2000, CNN). IV errors are one of the most frequent sources of unnecessary patient harm: "IV medications are associated with 54% of potential adverse drug events (ADEs) (Kaushal, et al. 2001), 56% of medication errors (oss, et al., 2000), and 61% of the [most] serious and…...
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References
Loewy, Erich H. (2012). Ethics and evidence-based medicine: Is there a conflict? Medscape.
Evidence-Based Medicine
The process of evidence-based medicine is similar to any occupation within the healthcare discipline. However, differences emerge as a result of different theoretical models and practice domains used. Thus, the process for evidence-based medicine follows a cycle that stems from clinical decisions required to be made in different stages of the medicine treatment process. It involves identifying clinical questions that reflect the required information to make clinical decisions. They consider the specific group of clients or patient being treated, besides the treatment context.
The role of technology in evidence-based medicine
The success of evidence-based medicine depends upon a solid technology infrastructure. Evidence-based medication is the "upright, unequivocal, and sensible utilization of best confirmation in settling on decisions about the consideration of individual patients."* It is likewise one of the most amazing drives in health care today, determined by the quality development, pay-for-execution activities and the advancement and selection of information…...
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References
Pines, J.M. (2013). Evidence-based emergency care: Diagnostic testing and clinical decision rules. Chichester, West Sussex, UK: Wiley-Blackwell.
Meza, J.P., & Passerman, D.S. (2011). Integrating narrative medicine and evidence-based medicine: The everyday social practice of healing. London: Radcliffe Pub.]
Nordenstro-m, J. (2007). Evidence-based medicine in Sherlock Holmes' footsteps. Malden, MA: Blackwell Pub.
Decker, M., (2001). Interdisciplinarity in technology assessment: Implementation and its chances and limits; mit 10 Tabellen. Berlin [u.a.: Springer.
"The prevalence of obesity (BMI > 30) has been increasing; currently; at least 27% of the adult population is obese" (McTigue 2003: vii). Despite being one of the most pervasive health problems in modernity, there is relatively little information on obesity available in the annals of evidence-based medicine. This may be due to the fact that obesity is such a complex and multifactorial disease, without a clear etiology. Perfectly-controlled studies can be difficult to construct. Many different factors can impact a person's ability to maintain a health BMI, spanning from genetics to culture to lifestyle to social and economic factors.
A 2003 evidence-based review of existing studies of obesity in adults found in MEDLINE from January 1, 1994 to July 31, 2001 only found four meeting the relevant criteria of studying persons suffering from obesity. There were no CT (randomized controlled trials, or the 'gold standard'…...
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References
McTigue, K. (2003 et al.). Screening and interventions for overweight and obesity in adults.
Agency for Healthcare Research and Quality (AHRQ). Systematic Evidence Review, 21.
.. If one of the goals of the healthcare system is to promote health and prevent illness and injury, it may be logical to start with those who work in the system." (Yassi, Ostry, Spiegel, and Walsh, 2002, p.1)
Presently the healthcare environment is characterized by nurse shortages of 25% of the entire nursing force. It is held that the working conditions along with job stress negatively impact the nursing force and its turnover rate. Injuries are also reported by nursing staff. It is likely that the nursing shortage is the number one challenge in today's healthcare provision. The negative work environment negatively impacts the nursing professional and their decision to either leave or to potentially fail altogether to enter the profession.
Naturally when there is a shortage of any type of professional worker some area suffers their absence and when this concept is applied in the field of healthcare provision it…...
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Bibliography
Institute of Medicine. Performance Measurement: Accelerating Improvement. Washington DC: National Academy Press; 2006.
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press; 2001.
Lewis Patricia S. And Latney, Cynthia (2003) Achieve Best Practice With an Evidence-Based Approach. Critical Care Nurse. Vol. 23. No. 6 December 2003. Online available at: http://ccn.aacnjournals.org/cgi/reprint/23/6/67.pdf
Rundall, K. (2002) Evidence-Based Management in Healthcare: Lessons from Clinical Practice. Academy for Health Services Research and Health Policy. Meeting. Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 20. Manchester Centre for Healthcare Management, Manchester Business School University of Manchester, Devonshire House, University Precinct Centre, Oxford Road,, Manchester,
SYSTEMS THEOY vs. DIFFUSION OF INNOVATION THEOY
EVIDENCED-BASED PACTICE
Systems theory and diffusion of innovation theory
Systems theory and healthcare delivery in the U.S.
According to theorist Ludwig von Bertalanffy, it is essential to view organisms -- both living and man-made -- as functional systems in a holistic sense to understand their true nature. This principle is manifested in the human body and also the organizations which provide healthcare. "A complex adaptive system is a collection of individual agents with freedom to act in ways that are not always totally predictable, and whose actions are interconnected so that one agent's actions changes the context for other agents. Examples include the immune system, a colony of termites, the financial market, and just about any collection of humans (for example, a family, a committee, or a primary healthcare team)" (Plsek & Greenhalgh 2001: 625).
Complex systems, such as the healthcare delivery system, have 'fuzzy' boundaries in the…...
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References
Bryant, R. (2010). Extending the reach of nursing knowledge and innovation. Nursing and Health Policy Perspectives. International Nursing Review, 57(4), 406.
Retrieved from CINAL at doi:10.1111/j.1466-7657.2010.00864.x
Fitzgerald, L. (2002 et al.). Interlocking interactions, the diffusion of innovations in health care.
Human Relations 55(12) 1429-1449. Retrieved from Google Scholar:
Essay Topic Examples
1. The Importance of Evidence-Based ractice in Medicine:
This essay would analyze the impact of evidence-based research in clinical settings, showcasing how the integration of clinical expertise and the most current, clinically relevant research improves patient outcomes and healthcare efficiency. It would explore how evidence-based medicine has evolved and become a gold standard for care.
2. Overcoming Challenges in Implementing Evidence-Based ractices:
Focusing on barriers such as resistance from professionals, lack of resources, or difficulty in staying updated with the vast amount of new research, this essay would discuss methods to overcome these hurdles. It might include case studies of successful implementation strategies and the outcomes resulting from these changes.
3. The Role of Evidence-Based Research in ublic olicy:
Here, the essay would examine how evidence-based research influences the formulation, implementation, and evaluation of public policy. The discussion could cover examples of policies that have been significantly shaped by scientific evidence and the…...
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Primary Sources
Centre for Evidence-Based Medicine. \"Evidence-Based Medicine Toolkit.\" CEBM, University of Oxford,
Sackett, David L., et al. \"Evidence-Based Medicine: What It Is and What It Isn\'t.\" BMJ, vol. 312, no. 7023, 1996, pp. 71–72., https://www.bmj.com/content/312/7023/71 .Guyatt, Gordon, et al. \"GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations.\" BMJ, vol. 336, no. 7650, 2008, pp. 924–926., https://www.bmj.com/content/336/7650/924 .Moher, David, et al. \"The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration.\" PLoS Medicine, vol. 6, no. 7, 2009, e1000100., https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000100 .Greenhalgh, Trisha. \"How to Read a Paper: The Basics of Evidence-Based Medicine and Healthcare.\" 6th ed., Wiley-Blackwell, 2019.https://www.cebm.ox.ac.uk/resources/ebm-tools/evidence-based-medicine-toolkit.
Essay Topic Examples
1. Impact of Evidence-Based ractice on atient Outcomes:
This essay will explore the significant impact that evidence-based research has on improving patient outcomes in healthcare settings. It will delve into the ways evidence-based practice informs clinical decision-making, reduce variations in care, and ultimately leads to more efficient, effective, and patient-centered health interventions.
2. Evidence-Based Research in Education: Shaping Modern Teaching Strategies:
This topic will examine how evidence-based research is being applied in educational settings to optimize teaching strategies and enhance student learning outcomes. The essay will discuss successful implementations and the integration of empirical evidence into curriculum design, teaching methodologies, and educational policy.
3. Evidence-Based ractice in ublic olicy: Informing Decision-Making:
The essay will focus on the role of evidence-based research in the development and implementation of public policy. It will highlight how data-driven decision-making leads to more pragmatic and effective policies and may explore the successes…...
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Primary Sources
Sackett, David L., et al. \"Evidence based medicine: what it is and what it isn\'t.\" BMJ 312.7023 (1996): 71-72.
Greenhalgh, Trisha. \"How to read a paper: The basics of evidence-based medicine.\" BMJ Publishing Group, 2014.Guyatt, Gordon, et al. \"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.\" BMJ 336.7650 (2008): 924-926.Moher, David, et al. \"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.\" Annals of Internal Medicine 151.4 (2009): 264-269.Stetler, Cheryl B., et al. \"The role of formative evaluation in implementation research and the QUERI experience.\" Journal of General Internal Medicine 21.S2 (2006): S1-S8.
Evidence-based practice has become popular in several disciplines of healthcare and continues to do so. One of the major characteristic of EP is its reliance on scientific evidence, individual choices and needs of the patient and clinical expertise. It is one of the healthcare approaches, in which the professionals make use of the hard evidence available in order to make healthcare decisions for a patient. It builds, enhances and values clinical knowledge, and expertise of pathophysiology and the mechanisms of disease. Furthermore, it also includes conscientious and complex decision-making, that is based not just on the evidence available but also on the situation, preferences and characteristics of the patient. EP recognizes the individuality in healthcare and accepts that it is constantly changing and involves several probabilities and uncertainties. It is ultimately the formation of a process that has been practiced for years by the best clinicians (McKibbon, 1998 ).
Energy and…...
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Bibliography
Covell, D.G., Uman, G.C., Manning, P.R., (1985) Information needs in office practice: are they being met? Ann Intern Med; 103(4):596-99
Matson, E., (1996). Speed kills (the competition). Fast Company, (3):84-91.
McKibbon, A. (1998 ). Evidence-based practice. Bull Med Libr Assoc, 397-401.
Sackett, D.L., Richardson, W.S., Rosenberg, W., Hayes, R.B., (1997) Evidence-based medicine: how to practice and teach EBM. New York: Churchill Livingston.
In principle, the EBP concept relies on fundamental areas of focus within a total-process approach to delivering the highest quality healthcare services (Hardcastle, Usher, & Holmes, 2006; Williamson, 2009). In clinical medicine, that begins with the formulation of the most relevant clinical questions, and continues with the use of the skill to identify the best current evidence, appraise it systematically, and optimally applied to specific situations. Meanwhile, throughout that process, clinical healthcare practitioners simultaneously incorporate their entire knowledge base and clinical experience with their understanding of the needs, values, and expectations of patients and other stakeholders. Finally, the EBP approach to nursing and healthcare includes the ongoing empirical evaluation of clinical procedures within a continuing process whose most important purpose is to improve the future of healthcare delivery by applying the data describing previous experience (Hamric, Spross, & Hanson, 2009).
eferences
Hamric, A.B., Spross, J.A., and Hanson, C.M. (2009). Advanced Practice Nursing:…...
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References
Hamric, A.B., Spross, J.A., and Hanson, C.M. (2009). Advanced Practice Nursing: An
Integrative Approach. St. Louis, MO: Saunders.
Hardcastle, M., Usher, K., and Holmes, C. "Carspecken's five-stage critical qualitative research method: An application to nursing research." Qualitative Health
Employing Evidence-ase Practice
The influence of evidence-based practice (EP) has found reverberations in the field of medical care giving, academia and scientific endeavors. The need for evidence-based quality arises from the need to afford improved healthcare services that are faster, accurate, and more effective. The nurses have responded to the emerging guidelines set by National expert groups. They have reoriented their practices along the lines of the evidence-based practices that have now accentuated their services and will continue to add value to their industry. The redesigning activities have touched upon the facets of academic background and training as well as field practices. They also took initiative to redesign the methodology to be followed by incorporating the scientifically proven methods and updating their information with the inputs contained from their fraternity elsewhere in the country (Stevens, 2013). "Evidence-based medicine." was a term that first made use of in the 1990"s by a…...
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Bibliography
Bennett, S., & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 171-180.
Bury, T.J. (1998). Evidence-based healthcare explained. In T.J. Bury & J.M.Mead (Eds), Evidence-based healthcare. A practical guide for therapists (pp. 3-25).Oxford: Butterworth Heinemann.
Bennett, K.J., Sackett, D.L., Haynes, R.B., Neufeld, V.R., Tugwell, P., Roberts, R. (1987). A controlled trial of teaching critical appraisal of the clinical literature to medical students. JAMA, 257, 2451-2454.
Egan, M., Dubouloz, C.J., von Zweck, C., Vallerand, J. (1998). The client-centered evidence-based practice of occupational therapy. Canadian Journal of Occupational Therapy, 65, 136-143.
nurses deliver evidence-Based care?
Define main ideas within the title supported from the literature
Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group of…...
The chief concern of the researcher should be the safety of the research participant. This is carried out by carefully considering the risk to benefit ratio, using all available information to make an appropriate assessment and continually monitoring the research as it proceeds.
The scientific researcher must obtain informed consent from each research participant. This should be attained in writing although oral consents are sometimes acceptable after the participant has had the chance to carefully consider the risks and benefits and to ask any pertinent questions. Informed consent ought to be seen as an ongoing process, not a singular event or a mere formality.
The researcher must list how privacy and confidentiality concerns will be approached. esearchers must be receptive to not only how information is protected from unauthorized observation, but also if and how participants are to be notified of any unexpected findings from the research that they may or may…...
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References
American Academy of Pediatrics and American Academy of Family Physicians. (2004). Clinical
Practice Guideline: Diagnosis and Management of Acute Otitis Media. Retrieved March
Third, lack of attention to evidence-based practice can lead to inconsistent delivery of care services.
Evidence-based practice relates to almost every aspect of health care at every stage of a client's relationship with the institution. For example, evidence-based practice informs the types of questions asked during the diagnostic procedures and might even impact the diagnosis itself (Bennett & Bennett, 2000). Evidence-based practice impacts the methods by which infections are prevented (Cantrell, 2009). Evidence-based practices impact the extent to which nurses are empowered to make sound, safe, and effective decisions (Scott & Pollock 2008). Evidence-based practice has the potential to transform the structure of a health care organization like MMH. This is because evidence-based practice changes the hierarchical structure in the organization due to the increased responsibility of nurses for conducting their own research. Alternatively, evidence-based practice can be an extension of organizational change. Health care organizations reducing the hierarchical nature…...
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References
Artinian, B.M., West, K.S., & Conger, M.M. (2011). The Artinian Intersystem Model. New York: Springer.
Bennett, S. & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal (2000), 47, 171-180.
Burns, N. & Grove, S.K. (2009). The Practice of Nursing Research. St. Louis, MO: Saunders.
Cantrell, S. (2009). Performing under pressure: Caring for decubitus ulcers. Healthcare Purchasing News. Aug 2009.
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