EBP
Integrating individual clinical expertise and the best external evidence from systematic research
It is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients
What 3 sources does EBP combine info from?
1) clinical expertise
2) research evidence
3) patient values
Purpose of EBP?
- improve quality, effectiveness, appropriateness of clinical practice
- reduce variation in practice patterns which can be a result of geographical differences or gaps between current knowledge and its application to care
- share decision making with patients
- provide framework, self-directed learning crucial for continued provision of quality care
2 most common barriers to implementation of EBP in allied health
1) practical = time and resource restrictions, ability to access, analyse and interpret relevant evidence. As well as institutional support to implement evidence into practice
2) knowledge = practitioners understanding of research concepts which allow them to be proficient consumers of research
What is the importance of patient values?
Treating the patient as an individual and respecting their perspective
- cultural
- personal
The term evidence based practice was coined by?
Gordon guyatt
David sackett
What is the EBP process? (5 A’s)
- ACCESS the patient/situation
- ASK an answerable clinical question (PICO)
- ACQUIRE the evidence
- APPRAISE the evidence
- APPLY the evidence
What are the key elements of quality health care?
- Safe
- Effective
- Patient centred
- Timely
- Efficient
- Equitable
Define quantitative research:
- Used when something needs to be measured
- formal, objective and systematic process in which numerical data are utilised to obtain information about the world
- ## numbers, proportions and statistics
Define qualitative research:
- When something needs to be explored and described
- descriptions through interviews, observation focus groups
- not necessarily generalisable
Difference between purpose of quantitative and qualitative research?
Quan = to determine cause and effect
Qual = to describe a phenomena
Describe how the hypothesis fits in with both quan and qual research
Quan = stated before start of research process
..DEDUCTIVE …to test a theory
Qual = developed during research process
..INDUCTIVE …to generate a theory
Use of variables in quan and qual research?
Quan = all variables are controlled
Qual = there are no variables, purely interested in the naturally occur in phenomenon
What does PICO stand for?
P = patient/problem I = intervention C = comparison intervention O = outcomes
Describe descriptive studies:
- Quantitative
- Often start of research process after someone notices something unusual
- surveys, case reportings
- CANNOT establish casual relationships
Describe observational studies:
- cross sectional, cohort, case-control
- data collected about participants NO active intervention
- describe size of disease problem
- investigation of relationship between characteristics of participants and their health status
What is a cross-sectional study?
- Relationship between 2 areas, eg. Alcohol and falls
- associations can be studied
- determine prevalence
- cannot be used if number of occurances (eg. Number of falls) is very low, then case control must be used
What is a case control study?
- involves cases and controls eg.
CASE = People who report having falls
CONTROL = people who report not having falls
PREDICTOR = self-reported regular alco consumption - determines strength of association between predictor variable(alcohol) and presence or absence of disease(falls)
What is a cohort study?
- follow up, longitudinal study
- directly measure INCIDENCE of a disease
- cohort = group of people who share a characteristic within a defined period
- sample of cohort of people exposed to risk factor is identified along with sample of unexposed controls
What distinguishes observational studies from experimental?
Ability to control for confounding factors
What is the stepped wedge design in RCT?
One cluster/individual receive the intervention in each time period, so that all participants get the intervention eventually just at different time intervals
- data collected at each time period
