Escolar Documentos
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Process to Practice
Bracken Health Sciences Library
(adapted from a presentation of Dr. Norma MacIntyre, School of Rehabilitation Therapy, Queens University)
N. MacIntyre, 2005
a methodological approach to clinical practice where evidence is used to inform decision-making about making a diagnosis (or interpreting a diagnostic test), selecting an intervention, or evaluating prognostic indicators
an approach to health care practice in which the clinician is aware of the evidence that bears on her clinical practice, and the strength of that evidence
an approach to decision making in which the clinician uses the best evidence available, in consultation with patient, to decide upon the option which suits that patient best
Evidence-Based Practice
Involves life-long, self-directed, problem-based learning Involves exploring the relationship between clinical reasoning and research evidence
Involves practice
N. MacIntyre, 2005
Keeping Up?
Do nothing and get out of date Depend solely on courses/conferences Choose the main professional journal(s) and read them cover to cover every month
Learn how to find and appraise the evidence to answer questions that come from clinical practice
N. MacIntyre, 2005
Each nurse possesses, through basic education and continuing learning, knowledge relevant to her/his professional practice
Providing a theoretical and/or evidence-based rationale for all decisions Understanding the knowledge required to meet the needs of complex clients Knowing where/how to access learning resources when necessary
Seeking and reviewing research in nursing, health sciences and related disciplines Using research to inform practice/professional service
Ensuring practice is based in theory and evidence and meets all relevant standards/guidelines Assessing/describing the client situation using a theory, framework or evidence-based tool Managing multiple nursing interventions simultaneously
Evaluating/describing the outcome of specific interventions and modifying the plan/approach Integrating research findings into professional service and practice
Collect the Evidence Critically Appraise the Evidence for Validity and Relevance
N. McKibbon, 1999
Results ~ Self-reflection
N. McKibbon, 1999
PICO
Intervention
PICO
Comparison Intervention
Placebo, etc.
Outcome
PICO
Do nurse led tobacco cessation interventions result in decreased smoking rates after hospital admission for coronary heart disease?
PICO
PATIENT
INTERVENTION
PICO
COMPARISON
No comparison
OUTCOME
PICO
Evidence Pyramid
Evidence Pyramid
once, often by different research teams in different locations. A meta-analysis combines results from different studies, hopefully averaging out any differences caused by random change or local variation and getting at something close to the real truth. In general a meta-analysis, if you can find one, will be a better guide to practice than an individual article.