Evaluating the Properties of the Evidence-Based Practice Attitude Scale (EBPAS) in Health Care

ERIC Educational Resources Information Center

Melas, Christos D.; Zampetakis, Leonidas A.; Dimopoulou, Anastasia; Moustakis, Vassilis

2012-01-01

The Evidence-Based Practice Attitude Scale (EBPAS; Aarons, 2004) is a relatively new construct for the study of attitudes toward the adoption of innovation and evidence-based practices (EBPs) in mental health service settings. Despite widespread interest in measuring the attitudes of health care providers in conjunction with the adoption of EBPs,…

Beyond evidence-based nursing: tools for practice.

PubMed

Jutel, Annemarie

2008-05-01

This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions. As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach. This article summarizes nursing's simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making. I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale. Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more. This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions.

The experience of Australian project leaders in encouraging practitioners to adopt research evidence in their clinical practice.

PubMed

Henderson, Amanda J; Davies, Jan; Willet, Michaela R

2006-11-01

This paper describes a qualitative program evaluation which sought to identify factors that either assist or impede the adoption of clinical evidence in everyday practice. Thirteen Australian projects were funded in a competitive grant program to adopt innovative strategies to improve the uptake of research evidence in everyday clinical practice. Project leaders' reports were analysed to collate common themes related to 1) critical elements in successful application of research knowledge, 2) barriers to implementing evidence, and 3) lessons for other organisations that might implement a similar project. Despite the diversity of the methods used to establish projects and the range of topics and clinical settings, many similarities were identified in the perceived critical success elements, barriers, and lessons for adopting clinical evidence. Eighteen themes emerged across the data including: leadership support; key stakeholder involvement; practice changes; communication; resources; education of staff; evaluation of outcomes; consumers; knowledge gaps; adoption/implementing staff; access to knowledge; risk assessment; collaboration; effectiveness of clinical research evidence; structure/organisation; cultural barriers; previous experiences; and information technology. Leaders of projects to adopt evidence in clinical practice identified barriers, critical success elements and lessons that impacted on their projects. A range of influences on the adoption of evidence were identified, and this knowledge can be used to assist others undertaking similar projects.

State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems.

PubMed

Stewart, Rebecca E; Marcus, Steven C; Hadley, Trevor R; Hepburn, Brian M; Mandell, David S

2018-06-01

Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States. The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness. Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives. Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.

Network Structural Influences on the Adoption of Evidence-Based Prevention in Communities

ERIC Educational Resources Information Center

Fujimoto, Kayo; Valente, Thomas W.; Pentz, Mary Ann

2009-01-01

This study examined the impact of key variables in coalition communication networks, centralization and density, on the adoption of evidence-based substance abuse prevention. Data were drawn from a network survey and a corresponding community leader survey that measured leader attitudes and practices toward substance abuse prevention programs. Two…

Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

PubMed

Asokan, G V

2012-11-01

Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. © 2012 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

The Influence of Social Capital on Nurse-Perceived Evidence-Based Practice Implementation in South Korea.

PubMed

Shin, Ji In; Lee, Eunjoo

2017-05-01

To examine the relationship between evidence-based practice (EBP) adoption and social capital in nurses and to determine how social capital affected EBP adoption in South Korea. A cross-sectional, correlational design was used. In total, 432 registered nurses from two university-affiliated teaching hospitals in South Korea completed the questionnaire, which included demographic items, the Developing Evidence-Based Practice Questionnaire, and the Social Capital Outcomes for Nurses scale. Data were analyzed using hierarchical regression to identify the predictors of EBP adoption. Nurses with higher social capital scores reported fewer perceived barriers to finding and reviewing evidence, and changing practice. Higher social capital scores were associated with higher levels of perceived facilitators of EBP adoption and skills appraisal in finding and reviewing evidence. Social capital was a significant predictor of EBP adoption. Nurses with greater opportunities to exchange and communicate their ideas freely are more likely to accept new evidence through diverse channels and trust-based relationships between nurses, which allows healthcare organizations to promote innovations such as EBP adoption. Therefore, social capital in nurses could serve as a driving force for EBP adoption and should provide a healthy foundation for changes in patient care practices. Nurses with higher social capital are tending to adopt EBP willingly. High trust enables nurses to facilitate and support change in practice. Therefore, to improve EBP adoption in patient care, it needs to be monitored that relationships between nurses are carefully structured and that they foster mutual interaction. © 2017 Sigma Theta Tau International.

Attitudes Toward Adoption of Evidence-Based Practice Among Physical Therapists and Social Workers: A Lesson for Interprofessional Continuing Education.

PubMed

Gudjonsdottir, Bjorg; Arnadottir, Hervor A; Gudmundsson, Halldor S; Juliusdottir, Sigrun; Arnadottir, Solveig A

2017-01-01

Professionals who embrace evidence-based practice (EBP) continually search for research evidence, appraise, and apply it, while interacting with each client in his/her situation. This dynamic learning process takes a substantial commitment from professionals and requires a positive attitude toward EBP. The main objective of this research was to explore the following: 1) distinct dimensions of attitudes toward adoption of EBP among physical therapists and social workers and 2) the relationship between these dimensions of attitudes and selected background characteristics of the compared professions. Cross-sectional web-based surveys were conducted in 2012 and 2013 on a population-based sample from the Icelandic Physical Therapy Association and the Icelandic Association of Social Workers. The participants were 214 physical therapists (76.3% women) and 163 social workers (92.2% women). The Evidence-Based Practice Attitude Scale (EBPAS) and its four subscales were used to survey dimensions of attitudes toward EBP. Scores on the total EBPAS range from zero to five, with a higher score indicating a more positive attitude toward EBPs. Linear regression was used to explore the relationship between the EBPAS scales and selected background variables. The overall response rate was 39%. Both professions generally held positive attitudes toward adoption of EBP, with an average EBPAS total score of 3.06 (SD = 0.46). The professionals' background characteristics were independently related to at least one dimension of attitudes toward EBP. More positive attitudes were associated with being a physical therapist, a woman, in a younger age group, having a graduate degree, working with individual clients, and having at least five same-profession coworkers. The results may be useful to design continuing education focusing on EBP. Such inventions should be targeted to professional attitudes, background, and other contextual factors.

Evidence-based practice: how nurse leaders can facilitate innovation.

PubMed

Shirey, Maria R

2006-01-01

Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.

Evidence-based Management: From Theory to Practice in Health Care

PubMed Central

Walshe, Kieran; Rundall, Thomas G.

2001-01-01

The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence-based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision-making processes of clinicians and managers, the ideas of evidence-based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision-making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence-based managerial practice. PMID:11565163

How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments

PubMed Central

Drinkwater, Michael J.; Matthews, Kelly E.; Seiler, Jacob

2017-01-01

While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. PMID:28232589

Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

PubMed

Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

2015-12-01

In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

Clinical librarians as facilitators of nurses' evidence-based practice.

PubMed

Määttä, Sylvia; Wallmyr, Gudrun

2010-12-01

The aim of this study was to explore nurses' and ward-based clinical librarians' reflections on ward-based clinical librarians as facilitators for nurses' use of evidences-based practice. Nurses' use of evidence-based practice is reported to be weak. Studies have suggested that clinical librarians may promote evidence-based practice. To date, little is known about clinical librarians participating nurses in the wards. A descriptive, qualitative design was adopted for the study. In 2007, 16 nurses who had been attended by a clinical librarian in the wards were interviewed in focus groups. Two clinical librarians were interviewed by individual interviews. In the analysis, a content analysis was used. Three themes were generated from the interviews with nurses: 'The grip of everyday work', 'To articulate clinical nursing issues' and 'The clinical librarians at a catalyst'. The nurses experienced the grip of everyday work as a hindrance and had difficulties to articulate and formulate relevant nursing issues. In such a state, the nurses found the clinical librarian presence in the ward as enhancing the awareness of and the use of evidence-based practice. Three themes emerged from the analysis with the librarians. They felt as outsiders, had new knowledge and acquired a new role as ward-based clinical librarians. Facilitation is needed if nurses' evidence-based practice is going to increase. The combined use of nurses and clinical librarians' knowledge and skills can be optimised. To achieve this, nurses' skills in consuming and implementing evidence ought to be strengthened. The fusion of the information and knowledge management skill of the ward-based clinical librarian and the clinical expertise of the nurses can be of value. With such a collaborative model, nurse and ward-based clinical librarian might join forces to increase the use of evidence-based practice. © 2010 Blackwell Publishing Ltd.

Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

PubMed

Williams, Nathaniel J

2016-05-05

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs. The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed. Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p < .05), self-reported EBT adoption at a 12-month follow-up (R (2) = .17, p < .001), and self-reported use of EBTs with clients at a 12-month follow-up (R (2) = .25, p < .001). Discriminant validity evidence was provided by small associations with clinicians' concurrently measured psychological work climate perceptions of functionality (R (2) = .06, p < .05), engagement (R (2) = .06, p < .05), and stress (R (2) = .00, ns). The EBTI is a practical and theoretically grounded measure of mental health clinicians' EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians' intentions to adopt EBTs. Discussion focuses on research and practice applications.

Evidence-Based Practice in Psychology

ERIC Educational Resources Information Center

American Psychologist, 2006

2006-01-01

The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes…

Community coalitions as a system: effects of network change on adoption of evidence-based substance abuse prevention.

PubMed

Valente, Thomas W; Chou, Chich Ping; Pentz, Mary Ann

2007-05-01

We examined the effect of community coalition network structure on the effectiveness of an intervention designed to accelerate the adoption of evidence-based substance abuse prevention programs. At baseline, 24 cities were matched and randomly assigned to 3 conditions (control, satellite TV training, and training plus technical assistance). We surveyed 415 community leaders at baseline and 406 at 18-month follow-up about their attitudes and practices toward substance abuse prevention programs. Network structure was measured by asking leaders whom in their coalition they turned to for advice about prevention programs. The outcome was a scale with 4 subscales: coalition function, planning, achievement of benchmarks, and progress in prevention activities. We used multiple linear regression and path analysis to test hypotheses. Intervention had a significant effect on decreasing the density of coalition networks. The change in density subsequently increased adoption of evidence-based practices. Optimal community network structures for the adoption of public health programs are unknown, but it should not be assumed that increasing network density or centralization are appropriate goals. Lower-density networks may be more efficient for organizing evidence-based prevention programs in communities.

Implementation of Evidence-Based Practice From a Learning Perspective.

PubMed

Nilsen, Per; Neher, Margit; Ellström, Per-Erik; Gardner, Benjamin

2017-06-01

For many nurses and other health care practitioners, implementing evidence-based practice (EBP) presents two interlinked challenges: acquisition of EBP skills and adoption of evidence-based interventions and abandonment of ingrained non-evidence-based practices. The purpose of this study to describe two modes of learning and use these as lenses for analyzing the challenges of implementing EBP in health care. The article is theoretical, drawing on learning and habit theory. Adaptive learning involves a gradual shift from slower, deliberate behaviors to faster, smoother, and more efficient behaviors. Developmental learning is conceptualized as a process in the "opposite" direction, whereby more or less automatically enacted behaviors become deliberate and conscious. Achieving a more EBP depends on both adaptive and developmental learning, which involves both forming EBP-conducive habits and breaking clinical practice habits that do not contribute to realizing the goals of EBP. From a learning perspective, EBP will be best supported by means of adaptive learning that yields a habitual practice of EBP such that it becomes natural and instinctive to instigate EBP in appropriate contexts by means of seeking out, critiquing, and integrating research into everyday clinical practice as well as learning new interventions best supported by empirical evidence. However, the context must also support developmental learning that facilitates disruption of existing habits to ascertain that the execution of the EBP process or the use of evidence-based interventions in routine practice is carefully and consciously considered to arrive at the most appropriate response. © 2017 Sigma Theta Tau International.

Psychometric Properties and U.S. National Norms of the Evidence-Based Practice Attitude Scale (EBPAS)

ERIC Educational Resources Information Center

Aarons, Gregory A.; Glisson, Charles; Hoagwood, Kimberly; Kelleher, Kelly; Landsverk, John; Cafri, Guy

2010-01-01

The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure…

Research awareness: An important factor for evidence-based practice?

PubMed

McSherry, Robert; Artley, Angela; Holloran, Jan

2006-01-01

Despite the growing body of literature, the reality of getting evidence into practice remains problematic. The purpose of this study was to establish levels of research awareness amongst registered health care professionals (RHCPs) and the influence of research awareness on evidence-based practice activities. This was a descriptive quantitative study. A convenience sample of 2,126 registered RHCPs working in a large acute hospital in Northeast England, the United Kingdom was used. A self-completion Research Awareness Questionnaire (RAQ) was directed towards measuring RHCP: attitudes towards research, understanding of research and the research process, and associations with practising using an evidence base. Data were entered into a Statistical Package for Social Science (SPSS) database and descriptive and inferential statistics were used. A total of 843 questionnaires were returned. Seven hundred and thirty-three (91%) RHCPs overwhelmingly agreed with the principle that evidence-based practice has a large part to play in improving patient care. This point was reinforced by 86% (n = 701) of respondents strongly agreeing or agreeing with the idea that evidence-based practice is the way forward to change clinical practice. Significant associations were noted between levels of confidence to undertake a piece of research and whether the individual had received adequate information about the research process, had basic knowledge and understanding of the research process, or had research awareness education or training. The study shows that RHCPs, regardless of position or grade, have a positive attitude towards research but face many obstacles. The key obstacles are lack of time, support, knowledge, and confidence. To address these obstacles, it is imperative that the organisation adopts a structured and coordinated approach to enable and empower individuals to practice using an evidence base.

Supporting influenza vaccination intent among nurses: effects of leadership and attitudes toward adoption of evidence-based practice.

PubMed

Paparone, Pamela

2015-03-01

The leadership styles of healthcare organizations and the attitudes of nurses toward the adoption of evidence-based practice (EBP) were examined to provide a predictor of influenza vaccination intent (VI) and improve the current inadequate vaccination rate among nurses. Influenza is a costly and potentially serious disease. The United States has set a benchmark of a 90% influenza vaccination rate among healthcare personnel by 2020. A sample of 354 registered nurses completed a survey assessing demographic data, the leadership styles of their organization, their attitudes toward EBP, and their VI. A significant positive correlation was found between transformational leadership and VI, but not between transactional leadership and VI. Attitudes toward EBP correlated weakly, but insignificantly, with VI. Transformational leadership can predict and positively influence vaccination rates among nurses, thus decreasing vaccine preventable illness and improving patient outcomes.

EditorialEvidence based library and information practice.

PubMed

Grant, Maria J

2011-06-01

Whilst many of us engage in supporting clinicians in identifying, appraising and using evidence, how many of us adopt the same approach to our own work? A recent survey by the UK LIS Research Coalition indicated that 60% of respondents use research reports as a source of information whilst a similar proportion of health library respondents use professional events such as conferences as a source of information. This summer sees the 6(th) International Evidence Based Library and Information Practice (EBLIP6) being held at the University of Salford, UK between 27(th) -30(th) June which will go some way to satisfying this latter information need whilst the Health Information and Libraries Journal can help satisfy the need for research reports. Whatever you're doing this summer, let's make it evidence based. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Evidence based practice readiness: A concept analysis.

PubMed

Schaefer, Jessica D; Welton, John M

2018-01-15

To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

The Good, the Bad, and the Ugly of Evidence-Based Practice

ERIC Educational Resources Information Center

Bouffard, Marcel; Reid, Greg

2012-01-01

The evidence-based practice (EBP) movement has been extremely influential over the last 20 years. Fields like medicine, physiotherapy, occupational therapy, nursing, psychology, and education have adopted the idea that policy makers and practitioners should use interventions that have demonstrated efficiency and effectiveness. This apparently…

Clinician adoption patterns and patient outcome results in use of evidence-based nursing plans of care.

PubMed

Kim, Tae Youn; Lang, Norma M; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

2007-10-11

Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study's aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses' adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice.

Implementing Evidence-Based Social Work Practice

ERIC Educational Resources Information Center

Mullen, Edward J.; Bledsoe, Sarah E.; Bellamy, Jennifer L.

2008-01-01

Recently, social work has been influenced by new forms of practice that hold promise for bringing practice and research together to strengthen the scientific knowledge base supporting social work intervention. The most recent new practice framework is evidence-based practice. However, although evidence-based practice has many qualities that might…

What Is Evidence-Based Practice? Research-to-Results Brief. Publication #2007-14

ERIC Educational Resources Information Center

Metz, Allison J. R.; Espiritu, Rachele; Moore, Kristin A.

2007-01-01

This brief represents part 1 in a series on fostering the adoption of evidence-based practices in out-of-school time programs. The lag between discovering effective practices and using them "on the ground" can be unnecessarily long, sometimes taking 15 to 20 years! The purpose of this brief is to provide practitioners with a better understanding…

Getting to uptake: do communities of practice support the implementation of evidence-based practice?

PubMed

Barwick, Melanie A; Peters, Julia; Boydell, Katherine

2009-02-01

Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments.

PubMed

Drinkwater, Michael J; Matthews, Kelly E; Seiler, Jacob

2017-01-01

While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. © 2017 M. J. Drinkwater et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Barriers to implementing evidence-based clinical guidelines: A survey of early adopters

PubMed Central

Spallek, Heiko; Song, Mei; Polk, Deborah E; Bekhuis, Tanja; Frantsve-Hawley, Julie; Aravamudhan, Krishna

2010-01-01

Objective The purpose of this study is to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines. Method This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges. Results The most common barriers to implementation are difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems have to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature. Conclusions Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists’ fears need to be addressed. PMID:21093800

Evidence based practice in long term care settings.

PubMed

Specht, Janet K

2013-04-01

The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

Evidence-based practice of periodontics.

PubMed

Cobb, Charles M; MacNeill, Simon R; Satheesh, Keerthana

2010-01-01

Evidence-based practice involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations, and preferences. It recognizes that care is individualized and ever-changing and involves uncertainties and probabilities. The specialty of periodontics has abundant high-level evidence upon which treatment decisions can be determined. This paper offers a brief commentary and overview of the available evidence commonly used in the private practice of periodontics.

Clinician Adoption Patterns and Patient Outcome Results in Use of Evidence-Based Nursing Plans of Care

PubMed Central

Kim, Tae Youn; Lang, Norma M.; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

2007-01-01

Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing [1]. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study’s aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses’ adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice. PMID:18693871

Sicily statement on evidence-based practice

PubMed Central

Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

2005-01-01

Background A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC"). Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'. PMID:15634359

Evidence-based policy as reflexive practice. What can we learn from evidence-based medicine?

PubMed

Bal, Roland

2017-04-01

The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively. In the conclusion, I discuss the prospects of such a practice for evidence-based policy.

Brokering the Evidence-Practice Gap: A Strategy for Moving Evidence Into Clinical Practice.

PubMed

Segre, Lisa S; Trusty, Stephanie; Gullickson, Renee; Chuffo Davila, Rebecca; O'Hara, Michael W

2018-05-08

Moving novel, evidence-based interventions into broad community use is challenging. This column describes how a midlevel public health administrator acted in the role of broker to link university-based researchers with maternal health clinical staff to successfully implement an innovative, evidence-based maternal depression treatment. Program evaluation assessed adoption, implementation, reach, and effectiveness. In reflecting on this partnership, the broker provided critical elements of access, credibility, and accountability. A partnership between service providers and research teams provides one strategy to disseminate evidence-based practices among those served by public-health programs.

The status of states' policies to support evidence-based practices in children's mental health.

PubMed

Cooper, Janice L; Aratani, Yumiko

2009-12-01

This study examined the efforts of states' mental health authorities to promote the use of evidence-based practices through policy. Data were drawn from three components of a national study, including a survey of state children's mental health directors (N=53), which was developed using a three-step process that involved stakeholders. Data from the directors' survey revealed that over 90% of states are implementing strategies to support the use of evidence-based practices. The scope of these efforts varies, with 36% reporting statewide reach. Further, states' strategies for implementing evidence-based practices are often not accompanied by comparable efforts to enhance information systems, even though enhancing such systems can bolster opportunities for successful implementation. Variability in the adoption of evidence-based practices, poor attention to information systems, and inconsistent fiscal policies threaten states' efforts to improve the quality of children's mental health services.

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.

2013-01-01

Objective Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Methods Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader member exchange with innovation climate and attitudes toward adoption and use of EBP. Results Transformational leadership predicted higher innovation climate during implementation while leader member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Conclusions Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. PMID:22449648

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Sawitzky, Angelina C.

2006-01-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice. PMID:17183411

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice.

PubMed

Aarons, Gregory A; Sawitzky, Angelina C

2006-02-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice.

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings

ERIC Educational Resources Information Center

Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.

2015-01-01

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…

Getting to Uptake: Do Communities of Practice Support the Implementation of Evidence-Based Practice?

PubMed Central

Barwick, Melanie A.; Peters, Julia; Boydell, Katherine

2009-01-01

Introduction Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario’s children’s mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Method Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Results Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. Conclusion CoPs present a promising model for translating EBP knowledge and promoting practice change in children’s mental health that requires further study. PMID:19270845

The Process of Adoption of Evidence-based Tobacco Use Prevention Programs in California Schools

PubMed Central

Little, Melissa A.; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

2014-01-01

Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community- and organizational variables on the adoption of prevention programs via school administrators’ beliefs and the organization’s receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts’ use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools. PMID:24398826

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

Envisaging the use of evidence-based practice (EBP): how nurse academics facilitate EBP use in theory and practice across Australian undergraduate programmes.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2017-09-01

culture for nurses and students to apply evidence-based practice principles, and collaboration between academia and practice will make facilitation by academics practical and meaningful for students. Findings from this study point to a number of initiatives for clinical leadership to provide infrastructure and support for academics, practising nurses and undergraduate students to adopt evidence-based practice in practice settings, thereby influencing practice outcomes. © 2016 John Wiley & Sons Ltd.

Evidence-Based Special Education in the Context of Scarce Evidence-Based Practices

ERIC Educational Resources Information Center

TEACHING Exceptional Children, 2014

2014-01-01

Evidence-based practices (EBPs) are supported as generally effective for populations of learners by bodies of high-quality and experimental research and, when aligned with stakeholder values and practical needs, should be prioritized for implementation. However, evidence-based practices are not currently available for all learner types in all…

Adaptive Practice: Next Generation Evidence-Based Practice in Digital Environments.

PubMed

Kennedy, Margaret Ann

2016-01-01

Evidence-based practice in nursing is considered foundational to safe, competent care. To date, rigid traditional perceptions of what constitutes 'evidence' have constrained the recognition and use of practice-based evidence and the exploitation of novel forms of evidence from data rich environments. Advancements such as the conceptualization of clinical intelligence, the prevalence of increasingly sophisticated digital health information systems, and the advancement of the Big Data phenomenon have converged to generate a new contemporary context. In today's dynamic data-rich environments, clinicians have new sources of valid evidence, and need a new paradigm supporting clinical practice that is adaptive to information generated by diverse electronic sources. This opinion paper presents adaptive practice as the next generation of evidence-based practice in contemporary evidence-rich environments and provides recommendations for the next phase of evolution.

Academic-practice partnerships to promote evidence-based practice in long-term care: oral hygiene care practices as an exemplar.

PubMed

McConnell, Eleanor Schildwachter; Lekan, Deborah; Hebert, Catherine; Leatherwood, Lisa

2007-01-01

Learning in practice disciplines suffers when gaps exist between classroom instruction and students' observations of routine clinical practices.(1) Academic institutions, therefore, have a strong interest in fostering the rapid and effective translation of evidence-based care techniques into routine practice. Long-term care (LTC) practice sites are particularly vulnerable to gaps between classroom teaching and how daily care is implemented, owing to the recent rapid advances in the scientific bases of care for frail older adults, the relative isolation of most LTC sites from academic settings,(2) and the relatively small number of registered nurses (RNs) available in LTC settings who can facilitate translation of research-based practices into care.(3) The aim of this project was to demonstrate the feasibility and value of an academic practice partnership to implement evidence-based approaches to solving resident care problems in LTC, as many scientifically proven practices hold promise for improving resident outcomes yet adoption is often slow.(4) We developed and implemented a clinical practice improvement process, based on diffusion of innovations theory and research,(5-8) to serve as a new model of academic-practice collaboration between a university school of nursing, LTC facility management and direct-care staff, as a means of developing high quality clinical sites for student rotations. The goal was to implement a sustainable evidence-based oral care program as an exemplar of how scientific evidence can be translated into LTC practice. This project focused on oral hygiene because the staff was dissatisfied with their existing resident oral care program, and an evidence-base for oral care in LTC existed that had not yet been incorporated into care routines. This article describes a systematic, replicable process for linking advanced practice registered nurse expertise with staff insights about care systems to reduce the gap between teaching and practice in

Evidence-based practice.

PubMed Central

McKibbon, K A

1998-01-01

Evidence-based practice (EBP) is spreading in popularity in many health care disciplines. One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. Librarians play an important role in the spread of EBP because of the importance of identifying and retrieving appropriate literature from various sources for use in making health care decisions. This article gives an overview of how to search for therapy, diagnosis, etiology, and prognosis both for original studies and secondary publications such as systematic reviews, meta-analyses, and clinical practice guidelines. Understanding how this research is done, how it is indexed, and how to retrieve the clinical evidence are an important set of skills that librarians can provide for clinicians interested in EBP. PMID:9681176

Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation.

PubMed

Aarons, Gregory A; Sommerfeld, David H

2012-04-01

Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader-member exchange with innovation climate and attitudes toward adoption and use of EBP. Transformational leadership predicted higher innovation climate during implementation, whereas leader-member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Supporting Implementation of Evidence-Based Practices through Practice-Based Coaching

ERIC Educational Resources Information Center

Snyder, Patricia A; Hemmeter, Mary Louise; Fox, Lise

2015-01-01

In active implementation science frameworks, coaching has been described as an important competency "driver" to ensure evidence-based practices are implemented as intended. Empirical evidence also has identified coaching as a promising job-embedded professional development strategy to support implementation of quality teaching practices.…

Evidence-based Practice for Mere Mortals

PubMed Central

Sim, Ida; Sanders, Gillian D; McDonald, Kathryn M

2002-01-01

The poor translation of evidence into practice is a well-known problem. Hopes are high that information technology can help make evidence-based practice feasible for mere mortal physicians. In this paper, we draw upon the methods and perspectives of clinical practice, medical informatics, and health services research to analyze the gap between evidence and action, and to argue that computing systems for bridging this gap should incorporate both informatics and health services research expertise. We discuss 2 illustrative systems—trial banks and a web-based system to develop and disseminate evidence-based guidelines (alchemist)— and conclude with a research and training agenda. PMID:11972727

Evidence-Based Practice Guidelines and School Nursing

ERIC Educational Resources Information Center

Adams, Susan; McCarthy, Ann Marie

2007-01-01

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

Evidence-based clinical practice guidelines for chronic pancreatitis 2015.

PubMed

Ito, Tetsuhide; Ishiguro, Hiroshi; Ohara, Hirotaka; Kamisawa, Terumi; Sakagami, Junichi; Sata, Naohiro; Takeyama, Yoshifumi; Hirota, Morihisa; Miyakawa, Hiroyuki; Igarashi, Hisato; Lee, Lingaku; Fujiyama, Takashi; Hijioka, Masayuki; Ueda, Keijiro; Tachibana, Yuichi; Sogame, Yoshio; Yasuda, Hiroaki; Kato, Ryusuke; Kataoka, Keisho; Shiratori, Keiko; Sugiyama, Masanori; Okazaki, Kazuichi; Kawa, Shigeyuki; Tando, Yusuke; Kinoshita, Yoshikazu; Watanabe, Mamoru; Shimosegawa, Tooru

2016-02-01

Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

The History of Evidence-Based Practice in Nursing Education and Practice.

PubMed

Mackey, April; Bassendowski, Sandra

Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

Developing an evidence-based practice protocol: implications for midwifery practice.

PubMed

Carr, K C

2000-01-01

Evidence-based practice is defined and its importance to midwifery practice is presented. Guidelines are provided for the development of an evidence-based practice protocol. These include: identifying the clinical question, obtaining the evidence, evaluating the validity and importance of the evidence, synthesizing the evidence and applying it to the development of a protocol or clinical algorithm, and, finally, developing an evaluation plan or measurement strategy to see if the new protocol is effective.

Toward More Evidence-Based Practice

PubMed Central

Hotelling, Barbara A.

2005-01-01

Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided. PMID:17273422

Evidence-Based Practice: Separating Science From Pseudoscience

PubMed Central

Lee, Catherine M; Hunsley, John

2015-01-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821

Evidence-Based Practice: Separating Science From Pseudoscience.

PubMed

Lee, Catherine M; Hunsley, John

2015-12-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills.

Evidence-based dentistry: a clinician's perspective.

PubMed

Bauer, Janet; Spackman, Sue; Chiappelli, Francesco; Prolo, Paolo; Stevenson, Richard

2006-07-01

Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

Managing caries: the need to close the gap between the evidence base and current practice.

PubMed

Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

2015-11-13

Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice.

PubMed

Duncombe, Daphne C

2018-03-01

To examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas. It is evident from previous studies that a number of factors exist which either obstruct or promote the utilisation of research evidence in nursing practice. Identifying these factors is vital to the successful uptake of evidence-based practice in nursing. Descriptive, comparative study. Data were collected using self-administered questionnaires. A stratified random sample (n = 100) of registered nurses participated; 5-point Likert-like scales were used to examine nurses' perceptions of barriers and facilitators of evidence-based practice. Descriptive statistics were used to describe demographic characteristics and to compare responses of nurses. Participants were predominantly female (98.4%), in the 25 to <35 years age group (45.9%). Of nurses surveyed, 72.1% had never tried to implement evidence-based practice previously. The greatest barriers identified were as follows: "Inadequate resources for implementing research findings" (85.2%; n = 52) and "Inadequate training in research methods" (83.6%; n = 51). The top facilitators identified were as follows: "Training in research methods" (88.5%; n = 54) and "Organisational policies and protocols that are evidence-based" (86.9%; n = 53). Nurses generally expressed that they required additional training in research and evidence-based practice concepts. Although some nurses had a desire to implement evidence-based practice to provide quality care and improve patient outcomes, many expressed that they lacked the required resources. The study draws attention to the need for prioritisation of evidence-based practice both at institutional and governmental levels. Successful adoption of evidence-based practice implies combined efforts of nurses, healthcare providers and policymakers. Further research is needed to determine the best

Using a Critical Appraisal Assignment to Infuse Evidence-Based Practice into a Therapeutic Modality Course

ERIC Educational Resources Information Center

Zwart, Mary Beth; Olson, Bernadette

2014-01-01

Context: It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding…

Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program.

PubMed

Cabell, A; Casteel, C; Chronister, T; Nocera, M; Vladutiu, C J; Peek-Asa, C

2013-12-01

Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.

Evidence-Based Nonpharmacological Practices to Address Behavioral and Psychological Symptoms of Dementia.

PubMed

Scales, Kezia; Zimmerman, Sheryl; Miller, Stephanie J

2018-01-18

To draw from systematic and other literature reviews to identify, describe, and critique nonpharmacological practices to address behavioral and psychological symptoms of dementia (BPSDs) and provide evidence-based recommendations for dementia care especially useful for potential adopters. A search of systematic and other literature reviews published from January 2010 through January 2017. Nonpharmacological practices were summarized to describe the overall conceptual basis related to effectiveness, the practice itself, and the size and main conclusions of the evidence base. Each practice was also critically reviewed to determine acceptability, harmful effects, elements of effectiveness, and level of investment required, based on time needed for training/implementation, specialized care provider requirements, and equipment/capital requirements. Nonpharmacological practices to address BPSDs include sensory practices (aromatherapy, massage, multi-sensory stimulation, bright light therapy), psychosocial practices (validation therapy, reminiscence therapy, music therapy, pet therapy, meaningful activities), and structured care protocols (bathing, mouth care). Most practices are acceptable, have no harmful effects, and require minimal to moderate investment. Nonpharmacological practices are person-centered, and their selection can be informed by considering the cause and meaning of the individual's behavioral and psychological symptoms. Family caregivers and paid care providers can implement evidence-based practices in home or residential care settings, although some practices require the development of more specific protocols if they are to become widely used in an efficacious manner. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Desired attributes of evidence assessments for evidence-based practices.

PubMed

Leff, H Stephen; Conley, Jeremy A

2006-11-01

In this paper we describe three approaches to assessing evidence for stakeholders interested in evidence-based practices: narrative reviews, systematic reviews (including meta-analyses), and registries. We then compare the approaches in terms of the degree to which they posses desired attributes of evidence assessments. Our review suggests that hybrid approaches that combined the best features of all three should be pursued to further the use of evidence-based practices, and that such hybrids are possible given the capacity of the World Wide Web. We conclude by stressing the need for empirical research on evidence assessments.

Evidence-Based Dentistry in Everyday Practice.

PubMed

Gudray, Kiran; Walmsley, Anthony Damien

2016-12-01

This article informs readers of a method of implementing evidence-based dentistry in practice. Following these steps, practitioners should be able to use this skill in an efficient manner. The importance of evidence-based dentistry and its relevance to situations encountered in everyday practice is also highlighted. Clinical relevance: This article highlights a series of steps to be followed by practitioners to ensure that treatment provided is supported by the most recent, good quality evidence.

The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study

PubMed Central

2012-01-01

Background Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States. Methods In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics. Results We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice. Conclusions The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes. PMID:22726759

Perspectives of dental students and faculty about evidence-based dental practice.

PubMed

Abdelkarim, Ahmad; Sullivan, Donna

2014-12-01

The study aimed at evaluating attitudes and perceptions of dental students and faculty toward evidence-based practice, integration of technology and social media, general practitioners' and specialists' scope of practice, and dental practice rewards and disadvantages. A survey instrument was designed with 10 statements rated on a five-point Likert scale (strongly agree to strongly disagree) and an optional comment section. The survey instrument was delivered through SurveyMonkey, whereby 401 students and 182 faculty members from ten U.S. dental schools participated (16% estimated response rate). Null hypotheses regarding the equality between the responses of the two groups were statistically tested using Mann-Whitney U test. Statistical significance was set at .05. Evidence-based practice is positively perceived by both groups, but with significantly higher support by faculty than students (P = 0.002). Both groups agreed that technological advancements are advantageous (P = 0.95), but do not constitute good dentistry and cannot mask poor clinical skills. Students showed higher support for social media than faculty (P = 0.000). Both groups perceived group practices positively. Faculty members showed higher agreement than students toward limitation of dental specialists' practices to their specialties (P = 0.000). Both groups are aware of practice disadvantages, such as increased litigation, health risks, and detriment to the dentist's posture. However, they both perceive dental practice positively despite all these challenges. Students and faculty share generally comparable perspectives toward dental practice. They are both in agreement with evidence-based practice and adoption of technology. They both acknowledge practice limitations. Copyright © 2014 Elsevier Inc. All rights reserved.

Barriers and Enablers to Evidence-Based Practices

ERIC Educational Resources Information Center

Foster, Robyn

2014-01-01

The importance of educational practices based on evidence is well-supported in the literature, however barriers to their implementation in classrooms still exist. This paper examines the phenomenon of evidence-based practice in education highlighting enablers and barriers to their implementation with particular reference to RTLB practice.

Evidence - based medicine/practice in sports physical therapy.

PubMed

Manske, Robert C; Lehecka, B J

2012-10-01

A push for the use of evidence-based medicine and evidence-based practice patterns has permeated most health care disciplines. The use of evidence-based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision-making. In this era of health care utilization sports physical therapists are expected to integrate clinical experience with conscientious, explicit, and judicious use of research evidence in order to make clearly informed decisions in order to help maximize and optimize patient well-being. One of the more common reasons for not using evidence in clinical practice is the perceived lack of skills and knowledge when searching for or appraising research. This clinical commentary was developed to educate the readership on what constitutes evidence-based practice, and strategies used to seek evidence in the daily clinical practice of sports physical therapy.

Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care-associated infection rates in a cohort of acute care general hospitals.

PubMed

Halpin, Helen Ann; McMenamin, Sara B; Simon, Lisa Payne; Jacobsen, Diane; Vanneman, Megan; Shortell, Stephen; Milstein, Arnold

2013-04-01

In 2008, hospitals were selected to participate in the California Healthcare-Associated Infection Prevention Initiative (CHAIPI). This research evaluates the impact of CHAIPI on hospital adoption and implementation of evidence-based patient safety practices and reduction of health care-associated infection (HAI) rates. Statewide computer-assisted telephone surveys of California's general acute care hospitals were conducted in 2008 and 2010 (response rates, 80% and 76%, respectively). Difference-in-difference analyses were used to compare changes in process and HAI rate outcomes in CHAIPI hospitals (n = 34) and non-CHAIPI hospitals (n = 149) that responded to both waves of the survey. Compared with non-CHAIPI hospitals, CHAIPI hospitals demonstrated greater improvements between 2008 and 2010 in adoption (P = .021) and implementation (P = .012) of written evidence-based practices for overall patient safety and prevention of HAIs and in assessing their compliance (P = .033) with these practices. However, there were no significant differences in the changes in HAI rates between CHAIPI and non-CHAIPI hospitals over this time period. Participation in the CHAIPI collaborative was associated with significant improvements in evidence-based patient safety practices in hospitals. However, determining how evidence-based practices translate into changes in HAI rates may take more time. Our results suggest that all hospitals be offered the opportunity to participate in an active learning collaborative to improve patient safety. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

The adoption and implementation of an evidence based practice in child and family mental health services organizations: a pilot study of functional family therapy in New York State.

PubMed

Zazzali, James L; Sherbourne, Cathy; Hoagwood, Kimberly Eaton; Greene, Deborah; Bigley, Michael F; Sexton, Thomas L

2008-03-01

Numerous challenges persist in providing evidence-based treatments to children and families in community-based settings. Functional Family Therapy (FFT), one such evidence-based treatment, is a family prevention and intervention program for adolescents with conduct disorder or oppositional defiant disorder. This paper presents pilot data in support of a conceptual framework explaining the adoption and implementation of FFT in a small sample of family and child mental health services organizations in New York State. The conceptual framework is grounded in the diffusion of innovations and the organizational behavior literatures, as well as previously published accounts of the adoption and implementation of evidence-based treatments in mental health. Pilot study data demonstrated that factors associated with the adoption of FFT included: The program fitting with the mission of the organization, as well as the organization having a strong interest in evidence-based treatments. Once a decision to adopt FFT was made, the degree to which it fit with organizational characteristics (e.g., available resource sets, organizational structure, and culture) influenced the ease with which it was implemented. Implications for the adoption and implementation of other evidence-based treatments are discussed.

Evidence-Based Practices Are Not Reformulated Best Practices: A Response to Martindale's "Children with Significant Hearing Loss: Learning to Listen, Talk, and Read--Evidence-Based Best Practices"

ERIC Educational Resources Information Center

Schirmer, Barbara R.; Williams, Cheri

2008-01-01

"Communication Disorders Quarterly's" special series on evidence-based practices and, specifically, Martindale's article on evidence-based practices in learning to listen, talk, and read among children with significant hearing loss appear to confuse best practices with evidence-based practices and, perhaps more serious, offer little evidence for…

The influence of experiential learning on medical equipment adoption in general practices.

PubMed

Bourke, Jane; Roper, Stephen

2014-10-01

The benefits of the availability and use of medical equipment for medical outcomes are understood by physicians and policymakers alike. However, there is limited understanding of the decision-making processes involved in adopting and using new technologies in health care organisations. Our study focuses on the adoption of medical equipment in Irish general practices which are marked by considerable autonomy in terms of commercial practice and the range of medical services they provide. We examine the adoption of six items of medical equipment taking into account commercial, informational and experiential stimuli. Our analysis is based on primary survey data collected from a sample of 601 general practices in Ireland on practice characteristics and medical equipment use. We use a multivariate Probit to identify commonalities in the determinants of the adoption. Many factors, such as GP and practice characteristics, influence medical equipment adoption. In addition, we find significant and consistent evidence of the influence of learning-by-using effects on the adoption of medical equipment in a general practice setting. Knowledge generated by experiential or applied learning can have commercial, organisational and health care provision benefits in small health care organisations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

E-Learning and Evidence Based Practice in Schools

ERIC Educational Resources Information Center

Quong, Terrence

2016-01-01

JCTIC has used open source software to develop a unique school online environment that has made evidence based practice viable in their school. In this paper the proposition is made that eLearning enables evidence based practice which in turn leads to improved student outcomes. Much has been written about evidence based practice in schools, but…

Factors influencing evidence-based practice in prosthetics and orthotics.

PubMed

Andrysek, Jan; Christensen, James; Dupuis, Annie

2011-03-01

The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources. The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Cross sectional survey. An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada. A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice. Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice. This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.

Evidence-based Medicine in Pediatric Orthopaedics: Evidence-based Practice Committee Summary of Levels of Evidence, Clinical Practice Guidelines, Appropriate Use Criteria, and Best Practice Guidelines.

PubMed

Gandhi, Jigar S; Shea, Kevin G; Sponseller, Paul D; Brighton, Brian K; Ganley, Theodore J

2018-04-30

The concept of evidence-based medicine has evolved over the past 2 decades, and has become a cornerstone to clinical decision-making in virtually every aspect of medicine. With a commitment to providing its members with high-quality evidence-based guidelines, the American Academy of Orthopaedic Surgeons has instituted concerted efforts since 2006 to develop clinical practice guidelines (CPGs) and appropriate use criteria (AUCs) for certain orthopaedic conditions. Many of these CPGs and AUCs detail the management of pediatric orthopaedic conditions. By the same token, members of the Pediatric Orthopaedic Society of North America (POSNA) Evidence Based Practice Committee have been publishing succinct evaluations of randomized controlled trials in pediatric orthopaedic surgery to create an evidence-based repository for quick reference to available high-level evidence as well as resource to identify gaps in the current research and identify opportunities for future investigation. In instances where higher-level evidence needed to develop CPGs is not available to address a critically important clinical question, consensus recommendations from experts in the field have been obtained to develop best practice guidelines (BPGs). The purpose of this review is to provide readers with a deeper understanding of the key principles of evidence-based medicine and methodologies used for the development of CPGs, AUCs, and BPGs.

Information literacy for evidence-based practice in perianesthesia nurses: readiness for evidence-based practice.

PubMed

Ross, Jacqueline

2010-04-01

Information literacy, the recognition of information required, and the development of skills for locating, evaluating, and effectively using relevant evidence is needed for evidence-based practice (EBP). The purpose of this study was to examine perianesthesia nurses' perception of searching skills and access to evidence sources. The design was a descriptive, exploratory survey. The sample consisted of ASPAN members (n = 64) and nonmembers (n = 64). The Information Literacy for Evidence-Based Nursing Practice instrument was used. Findings were that ASPAN members read more journal articles, were more proficient with computers, and used Cumulative Index to Nursing and Allied Health Literature (CINAHL) more frequently than nonmembers. The three top barriers to use of research were: lack of understanding of organization or structure of electronic databases, lack of skills to critique and/or synthesize the literature, and difficulty in accessing research materials. In conclusion, education is needed for critiquing literature and understanding electronic databases and research articles to promote EBP in perianesthesia areas. Copyright 2010. Published by Elsevier Inc.

Practice-based evidence study design for comparative effectiveness research.

PubMed

Horn, Susan D; Gassaway, Julie

2007-10-01

To describe a new, rigorous, comprehensive practice-based evidence for clinical practice improvement (PBE-CPI) study methodology, and compare its features, advantages, and disadvantages to those of randomized controlled trials and sophisticated statistical methods for comparative effectiveness research. PBE-CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It uses the knowledge of front-line caregivers, who develop study questions and define variables as part of a transdisciplinary team. Its comprehensive measurement framework provides a basis for analyses of significant bivariate and multivariate associations between treatments and outcomes, controlling for patient differences, such as severity of illness. PBE-CPI studies can uncover better practices more quickly than randomized controlled trials or sophisticated statistical methods, while achieving many of the same advantages. We present examples of actionable findings from PBE-CPI studies in postacute care settings related to comparative effectiveness of medications, nutritional support approaches, incontinence products, physical therapy activities, and other services. Outcomes improved when practices associated with better outcomes in PBE-CPI analyses were adopted in practice.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare

From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice.

PubMed

Ellis, Isabelle; Howard, Peter; Larson, Ann; Robertson, Jeanette

2005-01-01

This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery. Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP). A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants. The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.

Evidence-Based Practice for Outpatient Clinical Teams

ERIC Educational Resources Information Center

Hamilton, John D.

2006-01-01

This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

Advances in evidence-based cancer adoptive cell therapy.

PubMed

Ge, Chunlei; Li, Ruilei; Song, Xin; Qin, Shukui

2017-04-01

Adoptive cell therapy (ACT) has been developed in cancer treatment by transferring/infusing immune cells into cancer patients, which are able to recognize, target, and destroy tumor cells. Recently, sipuleucel-T and genetically-modified T cells expressing chimeric antigen receptors (CAR) show a great potential to control metastatic castration-resistant prostate cancer and hematologic malignancies in clinic. This review summarized some of the major evidence-based ACT and the challenges to improve cell quality and reduce the side effects in the field. This review also provided future research directions to make sure ACT widely available in clinic.

Lessons to be Learned from Evidence-based Medicine: Practice and Promise of Evidence-based Medicine and Evidence-based Education.

ERIC Educational Resources Information Center

Wolf, Fredric M.

2000-01-01

Presents statistics of deaths caused by medical errors and argues the effects of misconceptions in diagnosis and treatment. Suggests evidence-based medicine to enhance the quality of practice and minimize error rates. Presents 10 evidence-based lessons and discusses the possible benefits of evidence-based medicine to evidence-based education and…

Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

PubMed

Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

2012-06-01

BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government

Practice to Evidence: Using Evaluability Assessment to Generate Practice-Based Evidence in Rural South Georgia

ERIC Educational Resources Information Center

Honeycutt, Sally; Hermstad, April; Carvalho, Michelle L.; Arriola, Kimberly R. Jacob; Ballard, Denise; Escoffery, Cam; Kegler, Michelle C.

2017-01-01

Evidence from formal evaluation of real-world practice can address gaps in the public health knowledge base and provide information about feasible, relevant strategies for varied settings. Interest in evaluability assessment (EA) as an approach for generating practice-based evidence has grown. EA has been central to several structured assessment…

Practice-Based Evidence: Delivering What Works

ERIC Educational Resources Information Center

Brendtro, Larry K.; Mitchell, Martin L.

2012-01-01

Many methods claim to be Evidence-Based Practices. Yet success comes not from a particular practice, but principles that underlie all effective helping. This article uses the principle of consilience to tap knowledge from science, values, and practical experience.

Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines.

PubMed

Sweeney, Jane K; Heriza, Carolyn B; Blanchard, Yvette; Dusing, Stacey C

2010-01-01

(1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations. Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified. Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.

Evidence and Evidence-Based Practices: Are We There Yet?

ERIC Educational Resources Information Center

Schalock, Robert L.; Gomez, Laura E.; Verdugo, Miguel A.; Claes, Claudia

2017-01-01

The purpose of this article is to move the field of intellectual and closely related developmental disabilities (IDD) towards a better understanding of evidence and evidence-based practices. To that end, we discuss (a) different perspectives on and levels of evidence, (b) commonly used evidence-gathering strategies, (c) standards to evaluate…

Towards an Understanding of Evidence-Based Practice

ERIC Educational Resources Information Center

Digennaro Reed, Florence D.; Reed, Derek D.

2008-01-01

The past two decades have seen a rise in the use of the term "evidence-based practice" and a simultaneous increase in the variations in its definition and evaluation. Subsequently, this rise in interest for evidence-based practices has become a double-edged sword for practitioners--that is, while there are a number of interpretations on the…

Evidence-Based and Values-Based Practices for People with Severe Disabilities

ERIC Educational Resources Information Center

Singer, George H. S.; Agran, Martin; Spooner, Fred

2017-01-01

This article discusses the relationship between evidence-based practices (EBPs) and values in research and practice pertaining to people with severe disabilities. The importance of basing educational and habilitation practices on substantial scientific evidence for practical, moral, and legal reasons is acknowledged given the prevalence of…

Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

PubMed

Choma, Kim; McKeever, Amy E

2015-02-01

The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

Benchmarking: measuring the outcomes of evidence-based practice.

PubMed

DeLise, D C; Leasure, A R

2001-01-01

Measurement of the outcomes associated with implementation of evidence-based practice changes is becoming increasingly emphasized by multiple health care disciplines. A final step to the process of implementing and sustaining evidence-supported practice changes is that of outcomes evaluation and monitoring. The comparison of outcomes to internal and external measures is known as benchmarking. This article discusses evidence-based practice, provides an overview of outcomes evaluation, and describes the process of benchmarking to improve practice. A case study is used to illustrate this concept.

Evidence-Based Practice: Management of Vertigo

PubMed Central

Nguyen-Huynh, Anh T.

2012-01-01

Synopsis The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented. PMID:22980676

Personalizing Research: Special Educators' Awareness of Evidence-Based Practice

ERIC Educational Resources Information Center

Guckert, Mary; Mastropieri, Margo A.; Scruggs, Thomas E.

2016-01-01

Although evidence-based practices are considered critical to student success, a research-to-practice gap exists. This qualitative study examined practicing special education teachers' perceptions of their use of evidence-based practices. Special education teachers were interviewed and their classroom practices examined. Major themes emerged and…

Teaching Evidence-Based Practice

ERIC Educational Resources Information Center

Mullen, Edward J.; Bellamy, Jennifer L.; Bledsoe, Sarah E.; Francois, Julia Jean

2007-01-01

A complete and mindfully developed blueprint for implementing evidence-based practice (EBP) in social work should include a full complement of coordinated goals and strategies for all stakeholders, including future social workers. To this end, schools of social work should teach students to be lifelong learners; teach students what is currently…

Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

PubMed

Gambrill, E

1999-03-01

Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

Effectiveness of an education intervention to strengthen nurses' readiness for evidence-based practice: A single-blind randomized controlled study.

PubMed

Saunders, Hannele; Vehviläinen-Julkunen, Katri; Stevens, Kathleen R

2016-08-01

Nurses' lack of readiness for evidence-based practice slows down the uptake, adoption, and implementation of evidence-based practice which is of international concern as it impedes attainment of the highest quality of care and best patient outcomes. There is limited evidence about the most effective approaches to strengthen nurses' readiness for evidence-based practice. To evaluate the effectiveness of an Advanced Practice Nurse-delivered education program to strengthen nurses' readiness for evidence-based practice at a university hospital. A single-blind randomized controlled trial with repeated measures design, with measures completed during spring and fall 2015, before the education program (T0), within 1week after (T1), 8weeks after (T2), and 4months after completion of education interventions (T3). One large university hospital system in Finland, consisting of 15 acute care hospitals. The required sample size, calculated by a priori power analysis and including a 20% estimated attrition rate, called for 85 nurse participants to be recruited. Nurses working in different professional nursing roles and care settings were randomly allocated into two groups: intervention (evidence-based practice education, N=43) and control (research utilization education, N=34). The nurse participants received live 4-h education sessions on the basic principles of evidence-based practice (intervention group) and on the principles of research utilization (control group). The intervention group also received a web-based interactive evidence-based practice education module with a booster mentoring intervention. Readiness for evidence-based practice data, previous experience with evidence-based practice, and participant demographics were collected using the Stevens' EBP Readiness Inventory. Nurses' confidence in employing evidence-based practice and actual evidence-based practice knowledge were lower at T0, compared with the post-education scores, specifically at T1. The improvement

Developing a Policy Flight Simulator to Facilitate the Adoption of an Evidence-Based Intervention

PubMed Central

Yu, Zhongyuan; Hirschman, Karen B.; Pepe, Kara; Pauly, Mark V.; Naylor, Mary D.; Rouse, William B.

2018-01-01

While the use of evidence-based interventions (EBIs) has been advocated by the medical research community for quite some time, uptake of these interventions by healthcare providers has been slow. One possible explanation is that it is challenging for providers to estimate impacts of a specific EBI on their particular organization. To address that concern, we developed and evaluated a type of simulation called a policy flight simulator to determine if it could improve the adoption decision about a specific EBI, the transitional care model (TCM). The TCM uses an advanced practice nurse-led model of care to transition older adults with multiple chronic conditions from a hospitalization to home. An evaluation by a National Advisory Committee, made up of senior representatives from various stakeholders in the U.S. healthcare system, found the policy flight simulator to be a useful tool that has the potential to better inform adoption decisions. This paper describes the simulation development effort and documents lessons learned that may be useful to the healthcare modeling community and those interested in using simulation to support decisions based on EBIs. PMID:29805921

The use of collaboration to implement evidence-based safe practices.

PubMed

Clarke, John R

2013-12-01

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year. Significance for public healthSince the Institute of Medicine's To Err is Human identified medical errors as a major cause of death, the public has been interested in the recommendations for reporting of medical errors and implementing safe systems for the delivery of healthcare. The Commonwealth of Pennsylvania has followed those recommendations and found that an essential intermediate step between analysing reports and implementing safe systems is collaborative learning among healthcare institutions. The experience in Pennsylvania should be useful to other public organizations wishing to improve safety.

Health decision making: lynchpin of evidence-based practice.

PubMed

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

Health Decision Making: Lynchpin of Evidence-Based Practice

PubMed Central

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. Implications for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers’ intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed. PMID:19015288

Implementing Evidence-Based Practices for People With Schizophrenia

PubMed Central

Drake, Robert E.; Bond, Gary R.; Essock, Susan M.

2009-01-01

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions. PMID:19491315

Evidence-Based Practices and Autism

ERIC Educational Resources Information Center

Mesibov, Gary B.; Shea, Victoria

2011-01-01

Interventions for autism are increasing being held to standards such as "evidence-based practice" in psychology and "scientifically-based research" in education. When these concepts emerged in the context of adult psychotherapy and regular education, they caused considerable controversy. Application of the concepts to autism treatments and special…

Identifying Educational Practices Supported by Rigorous Evidence: A Guide to the Selection of Evidence-Based Practices

ERIC Educational Resources Information Center

Regional Resource Center Program, 2014

2014-01-01

One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…

De-adoption of an evidence-based trauma intervention in schools: A retrospective report from an urban school district

PubMed Central

Nadeem, Erum; Ringle, Vanesa

2017-01-01

The de-adoption of evidence-based practices (EBPs) is a largely understudied topic. The present study examined factors related to the de-adoption of an EBP for students exposed to traumatic events in a large urban school district. Qualitative interviews conducted with school clinicians and district administrators two years after the district embarked on a large-scale roll-out of the EBP distinguished between factors that impacted partial de-adoption after one year (phase 1) and complete de-adoption by the district after two years (phase 2). Phase 1 factors included organizational consistency, workforce stability, prior success, positive student outcomes, school- and district- level supports, innovation-setting fit, and innovation-related issues. Phase 2 factors included district-level leadership changes, financial and workforce instability, and shifting priorities. Study results suggest that sustainment-enhancing strategies should be included in the early stages of program implementation to most effectively adapt to school- and system- level changes. PMID:28775793

Contemporary occupational therapy practice: the challenges of being evidence based and philosophically congruent.

PubMed

Gustafsson, Louise; Molineux, Matthew; Bennett, Sally

2014-04-01

Several authors have written of the need to embrace occupation and use it to energise our practice, research and education for the benefit of the profession, individual occupational therapists and ultimately, and most significantly, our clients. However, Wilcock (1999) best summarises the issues and the work that must be done, calling for the profession to adopt a consistent professional philosophy. This approach is entirely congruent with the paradigm approach proposed by Kielhofner (2009). Reinforcing the ideas of Doris Sym, Wilcock (p. 192) states that ‘the first essential for each individual in any profession is the acceptance of a philosophy that is the profession’s keystone.’ Wilcock is clear that such a philosophy should not be adopted and enacted in a rigid way, but it should be dynamic so as to enable the profession to respond to research and theories, and changes in the world. In essence, a professional philosophy should guide research, education and practice and be a touchstone when considering potential changes to practice. It is our suggestion that occupational therapists, individually and collectively, need to use our occupational philosophy, currently best operationalised by the Contemporary Paradigm, to inform EBP. In conclusion, we again find ourselves at a cross road for the profession with the occupational philosophy of the Contemporary Paradigm at times challenged by the adoption of research evidence into practice. We would encourage all occupational therapists to engage in EBP but do so ever mindful of its complexity. We would suggest that evidence-based decision making is viewed through the lens of the occupational therapy philosophy, with occupational therapists critically questioning whether or not the ‘procedure’ for which there is evidence is consistent with the Contemporary Paradigm. This is a complex matter, with many remaining issues to be explored. We would encourage all occupational therapists to interrogate the ways in

Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

PubMed

Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

2018-04-01

The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

Evidence Based Medicine in Pediatric Practice: Brief Review

PubMed Central

Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin

2010-01-01

Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

PubMed Central

2014-01-01

Background Having a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses. The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation. Method We carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used. Results In total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r = 0.59, p = 0.001). There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r = 0.38, p < .0001). Participants who had learned about evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups. Conclusion This study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between

'That doesn't translate': the role of evidence-based practice in disempowering speech pathologists in acute aphasia management.

PubMed

Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn

2015-07-01

An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech pathologists practising in this setting have articulated a sense of dissonance regarding their limited service provision to this population. A clearer understanding of why this evidence-practice gap exists is essential in order to support and promote evidence-based approaches to the care of people with aphasia in acute care settings. To provide an understanding of speech pathologists' conceptualization of evidence-based practice for acute post-stroke aphasia, and its implementation. This study adopted a phenomenological approach, underpinned by a social constructivist paradigm. In-depth interviews were conducted with 14 Australian speech pathologists, recruited using a purposive sampling technique. An inductive thematic analysis of the data was undertaken. A single, overarching theme emerged from the data. Speech pathologists demonstrated a sense of disempowerment as a result of their relationship with evidence-based practice for acute aphasia management. Three subthemes contributed to this theme. The first described a restricted conceptualization of evidence-based practice. The second revealed speech pathologists' strained relationships with the research literature. The third elucidated a sense of professional unease over their perceived inability to enact evidence-based clinical recommendations, despite their desire to do so. Speech pathologists identified a current knowledge-practice gap in their management of aphasia in acute hospital settings. Speech pathologists place significant emphasis on the research evidence; however, their engagement with the research is limited, in part because it is perceived to lack clinical utility. A sense

Evidence-Based Practice in Education. Conducting Educational Research

ERIC Educational Resources Information Center

Pring, Richard; Thomas, Gary

2004-01-01

The book begins with an explication of evidence-based practice. Some of the ideas of its proponents are discussed, including the Campbell Collaboration, and the application to education of Cochrane-style reviews and meta-analyses. The thinking behind evidence-based practice has been the subject of much criticism, particularly in education, and…

Evidence based practice in clinical physiotherapy education: a qualitative interpretive description.

PubMed

Olsen, Nina R; Bradley, Peter; Lomborg, Kirsten; Nortvedt, Monica W

2013-04-11

Health care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students' use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers. In total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process. Four integrative themes emerged from the analysis: "attempt to apply evidence-based practice", "novices in clinical practice", "prioritize practice experience over evidence-based practice" and "lack role models in evidence-based practice". Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice. Clinical instructors are in a position to influence students during clinical education, and thus, important potential role models in

EVIDENCE – BASED MEDICINE/PRACTICE IN SPORTS PHYSICAL THERAPY

PubMed Central

Lehecka, B.J.

2012-01-01

A push for the use of evidence‐based medicine and evidence‐based practice patterns has permeated most health care disciplines. The use of evidence‐based practice in sports physical therapy may improve health care quality, reduce medical errors, help balance known benefits and risks, challenge views based on beliefs rather than evidence, and help to integrate patient preferences into decision‐making. In this era of health care utilization sports physical therapists are expected to integrate clinical experience with conscientious, explicit, and judicious use of research evidence in order to make clearly informed decisions in order to help maximize and optimize patient well‐being. One of the more common reasons for not using evidence in clinical practice is the perceived lack of skills and knowledge when searching for or appraising research. This clinical commentary was developed to educate the readership on what constitutes evidence‐based practice, and strategies used to seek evidence in the daily clinical practice of sports physical therapy. PMID:23091778

Factors Influencing the Intention of Perinatal Nurses to Adopt the Baby-Friendly Hospital Initiative in Southeastern Quebec, Canada: Implications for Practice

PubMed Central

2014-01-01

Nurses play a major role in promoting the baby-friendly hospital initiative (BFHI), yet the adoption of this initiative by nurses remains a challenge in many countries, despite evidences of its positive impacts on breastfeeding outcomes. The aim of this study was to identify the factors influencing perinatal nurses to adopt the BFHI in their practice. Methods. A sample of 159 perinatal nurses from six hospital-based maternity centers completed a survey based on the theory of planned behavior. Hierarchical multiple linear regression analyses were performed to assess the relationship between key independent variables and nurses' intention to adopt the BFHI in their practice. A discriminant analysis of nurses' beliefs helped identify the targets of actions to foster the adoption the BFHI among nurses. Results. The participants are mainly influenced by factors pertaining to their perceived capacity to overcome the strict criteria of the BFHI, the mothers' approval of a nursing practice based on the BFHI, and the antenatal preparation of the mothers. Conclusions. This study provides theory-based evidence for the development of effective interventions aimed at promoting the adoption of the BFHI in nurses' practice. PMID:25101173

Factors influencing the intention of perinatal nurses to adopt the baby-friendly hospital initiative in southeastern quebec, Canada: implications for practice.

PubMed

Chabot, Guylaine; Lacombe, Marie

2014-01-01

Nurses play a major role in promoting the baby-friendly hospital initiative (BFHI), yet the adoption of this initiative by nurses remains a challenge in many countries, despite evidences of its positive impacts on breastfeeding outcomes. The aim of this study was to identify the factors influencing perinatal nurses to adopt the BFHI in their practice. Methods. A sample of 159 perinatal nurses from six hospital-based maternity centers completed a survey based on the theory of planned behavior. Hierarchical multiple linear regression analyses were performed to assess the relationship between key independent variables and nurses' intention to adopt the BFHI in their practice. A discriminant analysis of nurses' beliefs helped identify the targets of actions to foster the adoption the BFHI among nurses. Results. The participants are mainly influenced by factors pertaining to their perceived capacity to overcome the strict criteria of the BFHI, the mothers' approval of a nursing practice based on the BFHI, and the antenatal preparation of the mothers. Conclusions. This study provides theory-based evidence for the development of effective interventions aimed at promoting the adoption of the BFHI in nurses' practice.

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality

Evidence based general practice: a retrospective study of interventions in one training practice.

PubMed Central

Gill, P.; Dowell, A. C.; Neal, R. D.; Smith, N.; Heywood, P.; Wilson, A. E.

1996-01-01

OBJECTIVES--To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. DESIGN--Retrospective review of case notes. SETTING--One suburban training general practice. SUBJECTS--122 consecutive doctor-patient consultations over two days. MAIN OUTCOME MEASURES--Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. RESULTS--21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. CONCLUSIONS--Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting. PMID:8608291

The Four Cornerstones of Evidence-Based Practice in Social Work

ERIC Educational Resources Information Center

Gilgun, Jane F.

2005-01-01

The purpose of this article is to place evidence-based practice within its wider scholarly contexts and draw lessons from the experiences of other professions that are engaged in implementing it. The analysis is based primarily on evidence-based medicine, the parent discipline of evidence-based practice, but the author also draws on evidence-based…

Attitudes of mental health occupational therapists toward evidence-based practice.

PubMed

Hitch, Danielle P

2016-02-01

Evidence-based practice is an important driver in modern health care and has become a priority in mental health occupational therapy in recent years. The aim of this study was to measure the attitudes of a cohort of mental health occupational therapists toward evidence-based practice. Forty-one mental health occupational therapists were surveyed using the Evidence-Based Practice Attitude Scale (EBPAS). Mann-Whitney U tests and Spearman's rho were used to analyze the data. The occupational therapy respondents had generally positive attitudes toward evidence-based practices comparable to established norms. Respondents with further qualifications beyond their professional degree were significantly more likely to try new interventions (p = .31). Significant negative correlations were found also for the subscales of Appeal and Openness in relation to years of occupational therapy practice (rho = -.354, p = .023; rho = -.344, p = 0.28) and mental health experience (rho = -.390, p = 0.12; rho = -.386, p = .013). Therapist factors can significantly impact attitudes toward evidence-based practice. © CAOT 2015.

Evidence-Based Practice in Psychology among College Counseling Center Clinicians

ERIC Educational Resources Information Center

Cooper, Stewart E.; Benton, Sherry A.; Benton, Stephen L.; Phillips, Julia C.

2008-01-01

This empirically based study sought to discover factors underlying diverse sources of information used to inform therapy practice, perceived salience of sources of evidence for clinical practice, importance of common factors to therapy efficiency, and beliefs about evidence-based practice, particularly in the form of evidence-supported treatments…

School-based pediatric physical therapists' perspectives on evidence-based practice.

PubMed

Schreiber, Joe; Stern, Perri; Marchetti, Gregory; Provident, Ingrid; Turocy, Paula Sammarone

2008-01-01

This study described the current knowledge, beliefs, attitudes, and practices of a group of school-based pediatric physical therapists regarding evidence-based practice (EBP). Five practitioners participated in this project. Each was interviewed individually and in a group and completed a quantitative survey. All of the participants had a positive attitude toward EBP and believed that it should be an important element of clinical practice. Knowledge and practice were more variable, with several individuals reporting a lack of confidence in this area and an inability to routinely implement EBP. These participants were more likely to rely on colleagues, interaction with their supervisor, and professional experience to aid in decision making than research evidence. Pediatric physical therapists face numerous challenges accessing, analyzing, and applying research evidence. It is critical for the profession to identify optimal ways to support practitioners in this aspect of clinical practice.

Using pedagogical approaches to influence evidence-based practice integration - processes and recommendations: findings from a grounded theory study.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2017-04-01

The study aimed to explore the processes undertaken by nurse academics when integrating evidence-based practice (EBP) into their teaching and learning practices. This article focuses on pedagogical approaches employed by academics to influence evidence-based practice integration into undergraduate programs across Australian universities. Nursing academics are challenged to incorporate a variety of teaching and learning strategies to teach evidence-based practice and determine their effectiveness. However, literature suggests that there are limited studies available focusing on pedagogical approaches in evidence-based practice education. A constructivist grounded theory methodology, informed by Charmaz was used for this study. Data were collected during 2014 from 23 nurse academics across Australian universities through semi-structured interviews. Additionally, nine were observed during teaching of undergraduate students. Twenty subject outlines were also analysed following Charmaz's approach of data analysis. 'Influencing EBP integration' describes the pedagogical approaches employed by academics to incorporate EBP knowledge and skills into undergraduate curricula. With the use of various teaching and learning strategies, academics attempted to contextualize EBP by engaging students with activities aiming to link evidence to practice and with the EBP process. Although, some strategies appeared to be engaging, others were traditional and seemed to be disengaging for students due to the challenges experienced by participants that impeded the use of the most effective teaching methods. Study findings offer valuable insights into the teaching practices and identify some key challenges that require the adoption of appropriate strategies to ensure future nurses are well prepared in the paradigm of evidence-based practice. © 2016 John Wiley & Sons Ltd.

Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey.

PubMed

Saunders, Hannele; Stevens, Kathleen R; Vehviläinen-Julkunen, Katri

2016-08-01

The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. A cross-sectional descriptive survey design. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. © 2016 John Wiley

A marketing perspective on disseminating evidence-based approaches to disease prevention and health promotion.

PubMed

Maibach, Edward W; Van Duyn, Mary Ann S; Bloodgood, Bonny

2006-07-01

Evidence-based disease prevention practice guidelines can provide a rationale for health programming decisions, which should, in turn, lead to improved public health outcomes. This logic has stimulated the creation of a growing number of evidence-based prevention practice guidelines, including the Guide to Community Preventive Services. Few systematic efforts have been made to document the degree of adoption and implementation of these approaches, although the evidence on translation of research into practice in other health fields indicates that the adoption and implementation rate is low. Drawing on the marketing literature, we suggest three approaches to enhance the adoption and implementation of evidence-based approaches: 1) conducting consumer research with prospective adopters to identify their perspectives on how evidence-based prevention programs can advance their organization's mission, 2) building sustainable distribution channels to promote and deliver evidence-based programs to prospective adopters, and 3) improving access to easily implemented programs that are consistent with evidence-based guidelines. Newly emerging paradigms of prevention research (e.g., RE-AIM) that are more attuned to the needs of the marketplace will likely yield a new generation of evidence-based preventive approaches that can be more effectively disseminated. We suggest that the public health community prioritize the dissemination of evidence-based prevention approaches, because doing so is a potent environmental change strategy for enhancing health.

Evidence-Based Practice: Integrating Classroom Curriculum and Field Education

ERIC Educational Resources Information Center

Tuchman, Ellen; Lalane, Monique

2011-01-01

This article describes the use of problem-based learning to teach the scope and consequences of evidence-based practices in mental health through an innovative assignment that integrates classroom and field learning. The authors illustrate the planning and implementation of the Evidence-Based Practice: Integrating Classroom Curriculum and Field…

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

ERIC Educational Resources Information Center

Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to…

An innovative clinical practicum to teach evidence-based practice.

PubMed

Brancato, Vera C

2006-01-01

A clinical practicum was successfully implemented for RN to BSN students to apply evidence-based practice to actual clinical problems affecting nursing practice. The author describes how this practicum was implemented and the requisite resources and support systems. This senior-level capstone course enabled students to understand and value a lifelong learning approach to evidence-based practice.

Analytic Validation of Immunohistochemical Assays: A Comparison of Laboratory Practices Before and After Introduction of an Evidence-Based Guideline.

PubMed

Fitzgibbons, Patrick L; Goldsmith, Jeffrey D; Souers, Rhona J; Fatheree, Lisa A; Volmar, Keith E; Stuart, Lauren N; Nowak, Jan A; Astles, J Rex; Nakhleh, Raouf E

2017-09-01

- Laboratories must demonstrate analytic validity before any test can be used clinically, but studies have shown inconsistent practices in immunohistochemical assay validation. - To assess changes in immunohistochemistry analytic validation practices after publication of an evidence-based laboratory practice guideline. - A survey on current immunohistochemistry assay validation practices and on the awareness and adoption of a recently published guideline was sent to subscribers enrolled in one of 3 relevant College of American Pathologists proficiency testing programs and to additional nonsubscribing laboratories that perform immunohistochemical testing. The results were compared with an earlier survey of validation practices. - Analysis was based on responses from 1085 laboratories that perform immunohistochemical staining. Of 1057 responses, 65.4% (691) were aware of the guideline recommendations before this survey was sent and 79.9% (550 of 688) of those have already adopted some or all of the recommendations. Compared with the 2010 survey, a significant number of laboratories now have written validation procedures for both predictive and nonpredictive marker assays and specifications for the minimum numbers of cases needed for validation. There was also significant improvement in compliance with validation requirements, with 99% (100 of 102) having validated their most recently introduced predictive marker assay, compared with 74.9% (326 of 435) in 2010. The difficulty in finding validation cases for rare antigens and resource limitations were cited as the biggest challenges in implementing the guideline. - Dissemination of the 2014 evidence-based guideline validation practices had a positive impact on laboratory performance; some or all of the recommendations have been adopted by nearly 80% of respondents.

A Rasch Model Analysis of Evidence-Based Treatment Practices Used in the Criminal Justice System

PubMed Central

Henderson, Craig E.; Taxman, Faye S.; Young, Douglas W.

2008-01-01

This study used item response theory (IRT) to examine the extent to which criminal justice facilities and community-based agencies are using evidence-based substance abuse treatment practices (EBPs), which EBPs are most commonly used, and how EBPs cluster together. The study used data collected from wardens, justice administrators, and treatment directors as part of the National Criminal Justice Treatment Practices survey (NCJTP; Taxman et al., 2007a), and includes both adult criminal and juvenile justice samples. Results of Rasch modeling demonstrated that a reliable measure can be formed to gauge the extent to which juvenile and adult correctional facilities, and community treatment agencies serving offenders, have adopted various treatment practices supported by research. We also demonstrated the concurrent validity of the measure by showing that features of the facilities’ organizational contexts were associated with the extent to which facilities were using EBPs, and which EBPs they were using. Researchers, clinicians, and program administrators may find these results interesting not only because they show the program factors most strongly related to EBP use, but the results also suggest that certain treatment practices are generally clustered together, which may help stakeholders plan and prioritize the adoption of new EBPs in their facilities. The study has implications for future research focused on understanding the adoption and implementation of EBPs in correctional environments. PMID:18029116

Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists.

PubMed

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; Muñoz-Rodríguez, Diana Isabel; Ramírez, Lorena; González-Ruíz, Katherine; Domínguez-Sánchez, María Andrea; Durán-Palomino, Diana; Girabent-Farrés, Montserrat; Flórez-López, María Eugenia; Bagur-Calafat, M Caridad

2015-01-01

The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.

Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists

PubMed Central

Correa-Bautista, Jorge Enrique; Muñoz-Rodríguez, Diana Isabel; Ramírez, Lorena; González-Ruíz, Katherine; Domínguez-Sánchez, María Andrea; Durán-Palomino, Diana; Girabent-Farrés, Montserrat; Flórez-López, María Eugenia; Bagur-Calafat, M Caridad

2015-01-01

Objective: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. Methods: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. Results: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. Conclusion: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice. PMID:26019383

Evidence based practice in clinical physiotherapy education: a qualitative interpretive description

PubMed Central

2013-01-01

Background Health care undergraduate students are expected to practice evidence-based after they graduate. Previous research indicates that students face several problems with transferring evidence-based practice to real patient situations. Few studies have explored reasons for this. The aim of this study was to explore beliefs, experiences and attitudes related to third year students’ use of evidence-based practice in clinical physiotherapy education among students, clinical instructors and visiting teachers. Methods In total, six focus group interviews were conducted: three with 16 students, two with nine clinical instructors and one with four visiting teachers. In addition, one individual interview and one interview in a pair were conducted with clinical instructors. Interviewing three different participant-categories ensured comparative analysis and enabled us to exploit differences in perspectives and interactions. Interpretive description guided this process. Results Four integrative themes emerged from the analysis: “attempt to apply evidence-based practice”, “novices in clinical practice”, “prioritize practice experience over evidence-based practice” and “lack role models in evidence-based practice”. Students tried to search for research evidence and to apply this knowledge during clinical placements; a behaviour that indicated a positive attitude towards evidence-based practice. At the same time, students were novices and required basic background information more than research information. As novices they tended to lean on their clinical instructors, and were more eager to gain practical experience than practicing evidence-based; a behaviour that clinical instructors and visiting teachers often supported. Students noticed a lack of an EBP culture. Both students and clinical instructors perceived a need for role models in evidence-based practice. Conclusions Clinical instructors are in a position to influence students during clinical

Starting Strong: Evidence-­Based Early Literacy Practices

ERIC Educational Resources Information Center

Blamey, Katrin; Beauchat, Katherine

2016-01-01

Four evidence-based instructional approaches create an essential resource for any early literacy teacher or coach. Improve your teaching practices in all areas of early literacy. Use four proven instructional approaches--standards based, evidenced based, assessment based, and student based--to improve their teaching practice in all areas of early…

Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals.

PubMed

Heiwe, Susanne; Kajermo, Kerstin Nilsson; Tyni-Lenné, Raija; Guidetti, Susanne; Samuelsson, Monika; Andersson, Inga-Lena; Wengström, Yvonne

2011-04-01

To explore dieticians', occupational therapists' and physical therapists' attitudes, beliefs, knowledge and behaviour concerning evidence-based practice within a university hospital setting. Cross-sectional survey. University hospital. All dieticians, occupational therapists and physical therapists employed at a Swedish university hospital (n = 306) of whom 227 (74%) responded. Attitudes towards, perceived benefits and limitations of evidence-based practice, use and understanding of clinical practice guidelines, availability of resources to access information and skills in using these resources. Findings showed positive attitudes towards evidence-based practice and the use of evidence to support clinical decision-making. It was seen as necessary. Literature and research findings were perceived as useful in clinical practice. The majority indicated having the necessary skills to be able to interpret and understand the evidence, and that clinical practice guidelines were available and used. Evidence-based practice was not perceived as taking into account the patient preferences. Lack of time was perceived as the major barrier to evidence-based practice. The prerequisites for evidence-based practice were assessed as good, but ways to make evidence-based practice time efficient, easy to access and relevant to clinical practice need to be continuously supported at the management level, so that research evidence becomes linked to work-flow in a way that does not adversely affect productivity and the flow of patients.

Market factors and electronic medical record adoption in medical practices.

PubMed

Menachemi, Nir; Mazurenko, Olena; Kazley, Abby Swanson; Diana, Mark L; Ford, Eric W

2012-01-01

Previous studies identified individual or practice factors that influence practice-based physicians' electronic medical record (EMR) adoption. Less is known about the market factors that influence physicians' EMR adoption. The aim of this study was to explore the relationship between environmental market characteristics and physicians' EMR adoption. The Health Tracking Physician Survey 2008 and Area Resource File (2008) were combined and analyzed. Binary logistic regression was used to examine the relationship between three dimensions of the market environment (munificence, dynamism, and complexity) and EMR adoption controlling for several physician and practice characteristics. In a nationally representative sample of 4,720 physicians, measures of market dynamism including increases in unemployment, odds ratio (OR) = 0.95, 95% confidence interval (CI) [0.91, 0.99], or poverty rates, OR = 0.93, 95% CI [0.89, 0.96], were negatively associated with EMR adoption. Health maintenance organization penetration, OR = 3.01, 95% CI [1.49, 6.05], another measure of dynamism, was positively associated with EMR adoption. Physicians practicing in areas with a malpractice crisis, OR = 0.82, 95% CI [0.71, 0.94], representing environmental complexity, had lower EMR adoption rates. Understanding how market factors relate to practice-based physicians' EMR adoption can assist policymakers to better target limited resources as they work to realize the national goal of universal EMR adoption and meaningful use.

Crafting practice guidelines in the world of evidence-based medicine.

PubMed

Chung, Kevin C; Shauver, Melissa J

2009-10-01

In the era of exponential increase in the medical literature, physicians and health policy-makers are relying on well-constructed, evidence-based practice guidelines to help ensure that the care given to patients is based on valid, scientific data. The construction of practice guidelines, however, may not always adhere to accepted research protocol. In this article, the authors detail the steps required to produce effective, evidence-based practice guidelines. The seven essential steps in crafting a practice guideline are presented: (1) defining a topic, (2) selecting a work group, (3) performing a literature review, (4) writing the guideline, (5) peer review, (6) making plans for review and revision, and (7) dissemination. Given the importance of practice guidelines in supporting everyday practice, this article strives to provide a practical guide in the development of this key component of evidence-based medicine.

The dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention.

PubMed

McKay, Virginia R; Margaret Dolcini, M; Hoffer, Lee D

2017-12-01

Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de-adoption. The current mixed-method study examines EBI de-adoption and the subsequent impact on a community-based organization (CBO) dedicated to HIV prevention. We conducted a case study with a CBO implementing RESPECT, an HIV prevention EBI, over 5 years (2010-2014), but then de-adopted the intervention. We collected archival data documenting RESPECT implementation and conducted two semi-structured interviews with RESPECT staff (N = 5). Using Fixsen and colleagues' implementation framework, we developed a narrative of RESPECT implementation, delivery, and de-adoption and a thematic analysis to understand additional consequences of RESPECT de-adoption. Discontinuation of RESPECT activities unfolded in a process over time, requiring effort by RESPECT staff. RESPECT de-adoption had wide-reaching influences on individual staff, interactions between the staff and the community, the agency overall, and for implementation of future EBIs. We propose a revision of the implementation framework, incorporating EBI de-adoption as a phase of the implementation cycle. Furthermore, EBI de-adoption may have important, unintended consequences and can inform future HIV prevention strategies and guide research focusing on EBI de-adoption.

Dissemination of evidence-based practices for anxiety disorders in Wyoming: a survey of practicing psychotherapists.

PubMed

Hipol, Leilani J; Deacon, Brett J

2013-03-01

Despite the well-established effectiveness of exposure-based cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, therapists have been slow to adopt CBT into their clinical practice. The present study was conducted to examine the utilization of psychotherapy techniques for anxiety disorders among community practitioners in a rural setting in order to determine the current status of the dissemination of CBT. A sample of 51 licensed psychotherapists from various mental health professions was recruited from online practice listings in the state of Wyoming. Participants completed a survey assessing their use of various psychotherapy techniques in the past 12 months for clients with obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and social phobia. Nearly all psychotherapists reported providing CBT, and techniques such as cognitive restructuring, arousal-reduction strategies, and mindfulness were used by the vast majority of respondents. Therapist-assisted exposure was rarely utilized, and providers who delivered exposure therapy often did so alongside other techniques of questionable compatibility with this approach. Non-evidence-based techniques were frequently used, particularly by self-proclaimed anxiety specialists. Our findings highlight the successes and failures of efforts to disseminate exposure-based CBT to community practitioners. Implications for clinical training and practice are discussed.

Evaluation of nurse engagement in evidence-based practice.

PubMed

Davidson, Judy E; Brown, Caroline

2014-01-01

The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

Queer challenges to evidence-based practice.

PubMed

Zeeman, Laetitia; Aranda, Kay; Grant, Alec

2014-06-01

This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley

Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in healthcare. study protocol.

PubMed

Kyratsis, Yiannis; Ahmad, Raheelah; Holmes, Alison

2012-03-21

We know that patient care can be improved by implementing evidence-based innovations and applying research findings linked to good practice. Successfully implementing innovations in complex organisations, such as the UK's National Health Service (NHS), is often challenging as multiple contextual dynamics mediate the process. Research studies have explored the challenges of introducing innovations into healthcare settings and have contributed to a better understanding of why potentially useful innovations are not always implemented in practice, even if backed by strong evidence. Mediating factors include health policy and health system influences, organisational factors, and individual and professional attitudes, including decision makers' perceptions of innovation evidence. There has been limited research on how different forms of evidence are accessed and utilised by organisational decision makers during innovation adoption. We also know little about how diverse healthcare professionals (clinicians, administrators) make sense of evidence and how this collective sensemaking mediates the uptake of innovations. The study will involve nine comparative case study sites of acute care organisations grouped into three regional clusters across England. Each of the purposefully selected sites represents a variety of trust types and organisational contexts. We will use qualitative methods, in-depth interviews, observation of key meetings, and systematic analysis of relevant secondary data to understand the rationale and challenges involved in sourcing and utilising innovation evidence in the empirical setting of infection prevention and control. We will use theories of innovation adoption and sensemaking in organisations to interpret the data. The research will provide lessons for the uptake and continuous use of innovations in the English and international health systems. Unlike most innovation studies, which involve single-level analysis, our study will explore the

Motivational Interviewing: An Evidence-Based Practice for Improving Student Practice Skills

ERIC Educational Resources Information Center

Hohman, Melinda; Pierce, Paloma; Barnett, Elizabeth

2015-01-01

Motivational interviewing (MI) is an evidence-based communication method to assist clients in resolving their ambivalence regarding change. With a school emphasis on evidence-based practice and learning outcomes, a social work department implemented a semester-long course on MI. The purpose of this study was to determine baseline skills and…

Practice-Based Evidence: Intelligent Action Inquiry for Complex Problems

ERIC Educational Resources Information Center

Eppley, Karen; Shannon, Patrick

2017-01-01

We have two goals for this article: to question the efficacy of evidence-based practice as the foundation of reading education policy and to propose practice-based evidence as a viable, more socially just alternative. In order to reach these goals, we describe the limits of reading policies of the last half century and argue for the possibilities…

Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.

PubMed

Lang, Jason M; Connell, Christian M

2017-01-01

Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.

Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development and psychometric validation.

PubMed

Fernández-Domínguez, Juan Carlos; de Pedro-Gómez, Joan Ernest; Morales-Asencio, José Miguel; Bennasar-Veny, Miquel; Sastre-Fullana, Pedro; Sesé-Abad, Albert

2017-01-01

Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals. A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach's alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19). Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity. Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual

The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of "Evidence-Based" in a Policy Context.

PubMed

Walker, Sarah Cusworth; Lyon, Aaron R; Aos, Steve; Trupin, Eric W

2017-01-01

As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge. In this paper we review the development of the Washington State Inventory of Evidence-Based, Research-Based and Promising Practices as a case study for the process of defining evidence-based practice in a policy context. As part of this study we also present a comparison of other well-known evidence-based practice inventories and examine consistencies and differences in the process of identifying and developing program ratings.

Translating research into practice: speeding the adoption of innovative health care programs.

PubMed

Bradley, Elizabeth H; Webster, Tashonna R; Baker, Dorothy; Schlesinger, Mark; Inouye, Sharon K; Barth, Michael C; Lapane, Kate L; Lipson, Debra; Stone, Robyn; Koren, Mary Jane

2004-07-01

For this study, the authors conducted case studies of four varied clinical programs to learn key factors influencing the diffusion and adoption of evidence-based innovations in health care. They found that the success and speed of the adoption/diffusion process depend on: the roles of senior management and clinical leadership; the generation of credible supportive data; an infrastructure dedicated to translating the innovation from research into practice; the extent to which changes in organizational culture are required; and the amount of coordination needed across departments or disciplines. The translation process also depends on the characteristics and resources of the adopting organization, and on the degree to which people believe that the innovation responds to immediate and significant pressures in their environment.

Developing the skills required for evidence-based practice.

PubMed

French, B

1998-01-01

The current health care environment requires practitioners with the skills to find and apply the best currently available evidence for effective health care, to contribute to the development of evidence-based practice protocols, and to evaluate the impact of utilizing validated research findings in practice. Current approaches to teaching research are based mainly on gaining skills by participation in the research process. Emphasis on the requirement for rigour in the process of creating new knowledge is assumed to lead to skill in the process of using research information created by others. This article reflects upon the requirements for evidence-based practice, and the degree to which current approaches to teaching research prepare practitioners who are able to find, evaluate and best use currently available research information. The potential for using the principles of systematic review as a teaching and learning strategy for research is explored, and some of the possible strengths and weakness of this approach are highlighted.

Using Gemba Boards to Facilitate Evidence-Based Practice in Critical Care.

PubMed

Bourgault, Annette M; Upvall, Michele J; Graham, Alison

2018-06-01

Tradition-based practices lack supporting research evidence and may be harmful or ineffective. Engagement of key stakeholders is a critical step toward facilitating evidence-based practice change. Gemba , derived from Japanese, refers to the real place where work is done. Gemba boards (visual management tools) appear to be an innovative method to engage stakeholders and facilitate evidence-based practice. To explore the use of gemba boards and gemba huddles to facilitate practice change. Twenty-two critical care nurses participated in interviews in this qualitative, descriptive study. Thematic analysis was used to code and categorize interview data. Two researchers reached consensus on coding and derived themes. Data were managed with qualitative analysis software. The code gemba occurred most frequently; a secondary analysis was performed to explore its impact on practice change. Four themes were derived from the gemba code: (1) facilitation of staff, leadership, and interdisciplinary communication, (2) transparency of outcome data, (3) solicitation of staff ideas and feedback, and (4) dissemination of practice changes. Gemba boards and gemba huddles became part of the organizational culture for promoting and disseminating evidence-based practices. Unit-based, publicly located gemba boards and huddles have become key components of evidence-based practice culture. Gemba is both a tool and a process to engage team members and the public to generate clinical questions and to plan, implement, and evaluate practice changes. Future research on the effectiveness of gemba boards to facilitate evidence-based practice is warranted. ©2018 American Association of Critical-Care Nurses.

Clarification and Elaboration on Evidence-Based Practice in Psychology

ERIC Educational Resources Information Center

Wampold, Bruce E.; Goodheart, Carol D.; Levant, Ronald F.

2007-01-01

Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in…

Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study

PubMed Central

2012-01-01

services conducting daily fundamental movement skill sessions, and such services having a physical activity policy supporting physical activity training for staff were also evident. Conclusion The intervention was effective in improving a number of centre based childcare service policies and practices associated with promoting child physical activity. Adoption of a broader range of practices may require more intensive and prolonged intervention support. PMID:22929434

Pressure damage prevention: basing practice on evidence.

PubMed

Parker, K; Morgan, L; Clayton, J; Gerrish, K; Nolan, M

As part of an initiative to develop evidence-based practice at the Northern General Hospital, Sheffield, a three-part project was undertaken. The aims were to identify barriers to using research in nursing, establish a baseline of nurses' knowledge and its influence on their practice in one essential area of nursing care--pressure damage prevention--and develop a strategy for change which took account of the findings from the first two parts of the project. In this article, the authors describe the second part of the project which examined nursing knowledge and practice with reference to the management of pressure damage prevention. The findings are discussed and the authors recommend that nurses integrate into their practice evidence from sources such as systematic reviews.

[Evidence-based Chinese medicine：theory and practice].

PubMed

Zhang, Jun-Hua; Li, You-Ping; Zhang, Bo-Li

2018-01-01

The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine. The basic concept of evidence-based Chinese medicine: EBCM is an applied discipline, following the theory and methodology of evidence-based medicine, to collect, evaluate, produce, transform the evidence of effectiveness, safety and economy of TCM, to reveal the feature and regular pattern of TCM taking effect, and to guide the development of clinical guidelines, clinical pathways and health decisions. The effects and achievements of EBCM development: secondary studies mainly based on systematic review/Meta-analysis were extensively carried out; clinical efficacy studies mainly relying on randomized controlled trials grew rapidly; clinical safety evaluations based on real world study have been conducted; methodological researches mainly focused on study quality control deepened gradually; internationalization researches mainly on report specifications have got some breakthroughs; standardization researches based on treatment specification were strengthened gradually; the research team and talents with the characteristics of inter-disciplinary have been steadily increased. A number of high-quality research findings have been published at international well-known journals; the clinical efficacy and safety evidence of TCM has been increased; the level of clinical rational use of TCM has been improved; a large number of Chinese patent medicines with big market have been cultured. The

An information technology infrastructure to enable evidence-based nursing practice.

PubMed

Pochciol, Joan M; Warren, Joan I

2009-01-01

The movement toward evidence-based practice (EBP) poses new organizational challenges to provide the necessary infrastructure to promote effective nursing interventions based on the best available evidence. The purpose of this article is to describe a collaborative effort between nursing and library services to provide readily accessible information at the bedside to support nurses using the best available evidence. In collaboration with nursing, the Health Services Librarian created an information resource titled "Research-based Nursing Practice: Finding the Evidence," which enables nursing staff to access the resources at the bedside without having to perform lengthy searches. Every known resource that will educate nurses in defining EBP to providing them with the links to Web sites, published articles, and all the information resources is included in the tool. Much has been written about building the organizational infrastructure to promote EBP and finding the filtered, synthesized research evidence, but to our knowledge, little has been published on building the information technology infrastructure, which will give nurses real-time access at the point-of-care to the research evidence. The research-based nursing practice system is helping bridge the gap between evidence-based resources and practice by compiling the literature in one place and making it easily and readily accessible.

A Quantitative Analysis of Evidence-Based Testing Practices in Nursing Education

ERIC Educational Resources Information Center

Moore, Wendy

2017-01-01

The focus of this dissertation is evidence-based testing practices in nursing education. Specifically, this research study explored the implementation of evidence-based testing practices between nursing faculty of various experience levels. While the significance of evidence-based testing in nursing education is well documented, little is known…

Unraveling Evidence-Based Practices in Special Education

ERIC Educational Resources Information Center

Cook, Bryan G.; Cook, Sara Cothren

2013-01-01

Evidence-based practices (EBPs) are instructional techniques that meet prescribed criteria related to the research design, quality, quantity, and effect size of supporting research, which have the potential to help bridge the research-to-practice gap and improve student outcomes. In this article, the authors (a) discuss the importance of clear…

A policy-into-practice intervention to increase the uptake of evidence-based management of low back pain in primary care: a prospective cohort study.

PubMed

Slater, Helen; Davies, Stephanie Joy; Parsons, Richard; Quintner, John Louis; Schug, Stephan Alexander

2012-01-01

Persistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs). To encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1  =  nil and 5  =  excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale). Ninety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change  =  -5.6±8.2, p<0.0001; 95% confidence interval: -7.6 to -3.6) and significant positive shifts on all measures of clinical knowledge and skills (p<0.0001 for all questions). Self management strategies were recommended more frequently post-intervention. The majority of responders who were guideline-inconsistent for work and bed rest recommendations (82% and 62% respectively) at pre-intervention, gave guideline-consistent responses at post-intervention. An interprofessional pain education program set within a framework that aligns health policy and practice, encourages PCPs to adopt more self

Criteria for evidence-based practice in Iranian traditional medicine.

PubMed

Soltani Arabshahi, SeyyedKamran; Mohammadi Kenari, Hoorieh; Kordafshari, Gholamreza; Shams-Ardakani, MohammadReza; Bigdeli, Shoaleh

2015-07-01

The major difference between Iranian traditional medicine and allopathic medicine is in the application  of  evidence  and  documents.  In  this  study,  criteria  for  evidence-based  practice  in  Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.

Making the Case for Evidence-Based Practice

ERIC Educational Resources Information Center

Bates, Joanne; McClure, Janelle; Spinks, Andy

2010-01-01

Evidence-based practice is the collection, interpretation, and use of data, such as collection statistics or assessment results, that measure the effectiveness of a library media program. In this article, the authors will present various forms of evidence and show that any library media specialist can use data to make informed decisions that…

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the adopting parent or adopted child, we will ask for the following evidence: (a) A copy of the birth...

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the adopting parent or adopted child, we will ask for the following evidence: (a) A copy of the birth...

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2014 CFR

2014-04-01

... FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the adopting parent or adopted child, we will ask for the following evidence: (a) A copy of the birth...

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the adopting parent or adopted child, we will ask for the following evidence: (a) A copy of the birth...

A Comprehensive Approach in Dissemination of Evidence-Based Care for PTSD

DTIC Science & Technology

2011-09-01

facilitate practice evaluation and identification of potential gaps in care. APIRE staff have met with key clinical staff from select behavioral health...provide evidence-based care and identify potential gaps in care. Finally, strategies to implement the PCL-C, PHQ-9, and AUDIT-C for routine screening and...systems-level, facilitate detection of potential gaps in evidence-based care, and speed the adoption of evidence-based care into clinical practice

[Evidence based medicine. A new paradigm for medical practice].

PubMed

Carneiro, A V

1998-01-01

Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.

The state of readiness for evidence-based practice among nurses: An integrative review.

PubMed

Saunders, Hannele; Vehviläinen-Julkunen, Katri

2016-04-01

To review factors related to nurses' individual readiness for evidence-based practice and to determine the current state of nurses' evidence-based practice competencies. An integrative review study. Thirty-seven (37) primary research studies on nurses' readiness for evidence-based practice, of which 30 were descriptive cross-sectional surveys, 5 were pretest-posttest studies, and one study each was an experimental pilot study and a descriptive qualitative study. Included studies were published from the beginning of 2004 through end of January 2015. The integrative review study used thematic synthesis, in which the quantitative studies were analyzed deductively and the qualitative studies inductively. Outcomes related to nurses' readiness for evidence-based practice were grouped according to the four main themes that emerged from the thematic synthesis: (1) nurses' familiarity with evidence-based practice (EBP); (2) nurses' attitudes toward and beliefs about evidence-based practice; (3) nurses' evidence-based practice knowledge and skills; and (4) nurses' use of research in practice. Methodological quality of the included studies was evaluated with Joanna Briggs Institute critical appraisal tools. Although nurses were familiar with, had positive attitudes toward, and believed in the value of EBP in improving care quality and patient outcomes, they perceived their own evidence-based practice knowledge and skills insufficient for employing evidence-based practice, and did not use best evidence in practice. The vast majority (81%) of included studies were descriptive cross-sectional surveys, 84% used a non-probability sampling method, sample sizes were small, and response rates low. Most included studies were of modest quality. More robust, theoretically-based and psychometrically sound nursing research studies are needed to test and evaluate the effectiveness of interventions designed to advance nurses' evidence-based practice competencies, especially teaching them

The role of organizational research in implementing evidence-based practice: QUERI Series

PubMed Central

Yano, Elizabeth M

2008-01-01

Background Health care organizations exert significant influence on the manner in which clinicians practice and the processes and outcomes of care that patients experience. A greater understanding of the organizational milieu into which innovations will be introduced, as well as the organizational factors that are likely to foster or hinder the adoption and use of new technologies, care arrangements and quality improvement (QI) strategies are central to the effective implementation of research into practice. Unfortunately, much implementation research seems to not recognize or adequately address the influence and importance of organizations. Using examples from the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI), we describe the role of organizational research in advancing the implementation of evidence-based practice into routine care settings. Methods Using the six-step QUERI process as a foundation, we present an organizational research framework designed to improve and accelerate the implementation of evidence-based practice into routine care. Specific QUERI-related organizational research applications are reviewed, with discussion of the measures and methods used to apply them. We describe these applications in the context of a continuum of organizational research activities to be conducted before, during and after implementation. Results Since QUERI's inception, various approaches to organizational research have been employed to foster progress through QUERI's six-step process. We report on how explicit integration of the evaluation of organizational factors into QUERI planning has informed the design of more effective care delivery system interventions and enabled their improved "fit" to individual VA facilities or practices. We examine the value and challenges in conducting organizational research, and briefly describe the contributions of organizational theory and environmental context to the research framework

Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital-Physician Integration Complementary or Substitutive Strategies?

PubMed

Everson, Jordan; Lee, Shoou-Yih Daniel; Adler-Milstein, Julia

2016-12-01

In response to evolving policies and conditions, hospitals have increased health information technology (HIT) adoption and strived to improve hospital-physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and hospital-physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement. © The Author(s) 2016.

Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

PubMed

Brooke, Joanne Mary; Mallion, Jaimee

2016-08-01

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses. © 2016 John Wiley & Sons Australia, Ltd.

Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development and psychometric validation

PubMed Central

Fernández-Domínguez, Juan Carlos; de Pedro-Gómez, Joan Ernest; Morales-Asencio, José Miguel; Sastre-Fullana, Pedro; Sesé-Abad, Albert

2017-01-01

Introduction Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals. Methods A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach’s alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19). Results Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity. Conclusions Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The

Evidence-Based Practice and School Nurse Practice: A Review of Literature

ERIC Educational Resources Information Center

Yonkaitis, Catherine F.

2018-01-01

School nurses report that evidence-based practice (EBP) is not a part of their daily practice, and most have had no formal education regarding EBP or its implementation. The purpose of this review is to identify what strategies might be effective to educate school nurses about EBP as a first step toward establishing EBP in school nurse practice.…

Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

PubMed

André, Beate; Aune, Anne G; Brænd, Jorunn A

2016-05-01

Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students.

PubMed

Singleton, Joanne K

2017-10-01

Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p < .001, and EBPI, t = 8.4 (52), p < .001. A large effect size of .75 standard deviation (SD) gain above the mean for EBPB, and a very large effect size of 1 SD gain above the mean for EBPI were observed. Repeated measures ANOVA showed that all cohorts made gains across the curriculum. Effect sizes for EBPB ranged from .25 to 1 SD above the mean, and .75 to 1.5 for EBPI. DNP students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.

Attitudes and barriers to evidence-based practice in optometry educators.

PubMed

Suttle, Catherine M; Challinor, Kirsten L; Thompson, Rachel E; Pesudovs, Konrad; Togher, Leanne; Chiavaroli, Neville; Lee, Adrian; Junghans, Barbara; Stapleton, Fiona; Watt, Kathleen; Jalbert, Isabelle

2015-04-01

Evidence-based practice (EBP) is an essential component of good quality, patient-centered health care. This requires practitioners to acquire EBP skills and knowledge during undergraduate and continuing education. Evidence-based practice education exists in a range of health care disciplines, including optometry. Evidence-based practice education, however, depends on relevant skills and knowledge in educators. Courses and workshops exist for the development of EBP teaching skills in some areas of health care but not in optometry. Here, we describe a pilot workshop designed to enhance the teaching of EBP and to investigate the perspectives of optometric educators on EBP including their attitudes and perceived barriers to EBP and its teaching. Twenty-seven optometric educators including 8 facilitators participated. Of these, 14 were academics (including the 8 facilitators) and 13 were practitioners. Evidence-based practice attitudes were assessed using the Evidence-Based Practice Attitude Scale-50 with appropriate modifications for optometry. Workshop design incorporated strategies to trigger discussion among participants. A nominal group technique was used to identify, prioritize, and reach consensus on barriers to EBP. Although some participants expressed reservations about EBP, a common understanding of the contemporary definition of EBP emerged in educators. Thirty-five barriers to EBP were identified; "time" was selected in the top five barriers by most participants and attracted the highest total score, well above any other barrier (negative attitude to EBP, volume of evidence, integration with clinical practice, and lack of lifelong learning mind-set). Attitudes toward EBP were generally positive and negatively correlated with age and time since graduation, respectively. A group of optometrists and academics new to implementing education in EBP displayed positive attitudes to EBP but considered that its application and teaching could be significantly hindered

Evidence-Based Practice: A Framework for Making Effective Decisions

ERIC Educational Resources Information Center

Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.

2012-01-01

The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…

How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

PubMed

OʼRourke, Hannah M; Fraser, Kimberly D

2016-01-01

Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in healthcare. study protocol

PubMed Central

2012-01-01

Background We know that patient care can be improved by implementing evidence-based innovations and applying research findings linked to good practice. Successfully implementing innovations in complex organisations, such as the UK's National Health Service (NHS), is often challenging as multiple contextual dynamics mediate the process. Research studies have explored the challenges of introducing innovations into healthcare settings and have contributed to a better understanding of why potentially useful innovations are not always implemented in practice, even if backed by strong evidence. Mediating factors include health policy and health system influences, organisational factors, and individual and professional attitudes, including decision makers' perceptions of innovation evidence. There has been limited research on how different forms of evidence are accessed and utilised by organisational decision makers during innovation adoption. We also know little about how diverse healthcare professionals (clinicians, administrators) make sense of evidence and how this collective sensemaking mediates the uptake of innovations. Methods The study will involve nine comparative case study sites of acute care organisations grouped into three regional clusters across England. Each of the purposefully selected sites represents a variety of trust types and organisational contexts. We will use qualitative methods, in-depth interviews, observation of key meetings, and systematic analysis of relevant secondary data to understand the rationale and challenges involved in sourcing and utilising innovation evidence in the empirical setting of infection prevention and control. We will use theories of innovation adoption and sensemaking in organisations to interpret the data. The research will provide lessons for the uptake and continuous use of innovations in the English and international health systems. Discussion Unlike most innovation studies, which involve single-level analysis, our

[A Study of the Evidence-Based Nursing Practice Competence of Nurses and Its Clinical Applications].

PubMed

Hsu, Li-Ling; Hsieh, Suh-Ing; Huang, Ya-Hsuan

2015-10-01

Nurses must develop competence in evidence-based nursing in order to provide the best practice medical care to patients. Evidence-based nursing uses issue identification, data mining, and information consolidation from the related medical literature to help nurses find the best evidence. Therefore, for medical institutions to provide quality clinical care, it is necessary for nurses to develop competence in evidence-based nursing. This study aims to explore the effect of a fundamental evidence-based nursing course, as a form of educational intervention, on the development of evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, and outcome expectations of evidence-based practice in nurse participants. Further the competence of these nurses in overcoming obstacles in evidence-based nursing practice. This quasi-experimental study used a pre-post test design with a single group of participants. A convenience sample of 34 nurses from a municipal hospital in northern Taiwan received 8 hours of a fundamental evidence-based nursing course over a two-week period. Participants were asked to complete four questionnaires before and after the intervention. The questionnaires measured the participants' basic demographics, experience in mining the medical literature, evidence-based nursing knowledge, self-efficacy in evidence-based practice activities, outcome expectations of evidence-based practice, competence in overcoming obstacles in evidence-based nursing practice, and learning satisfaction. Collected data was analyzed using paired t, Wilcoxon Signed Rank, and McNemar tests to measure the differences among participants' evidence-based nursing knowledge and practice activities before and after the workshop. The nurses demonstrated significantly higher scores from pre-test to post-test in evidence-based nursing knowledge II, self-efficacy in evidence-based nursing practice activities, and outcome expectations of evidence-based practice

Practice-Based Evidence in Community Guide Systematic Reviews.

PubMed

Vaidya, Namita; Thota, Anilkrishna B; Proia, Krista K; Jamieson, Sara; Mercer, Shawna L; Elder, Randy W; Yoon, Paula; Kaufmann, Rachel; Zaza, Stephanie

2017-03-01

To assess the relative contributions and quality of practice-based evidence (PBE) and research-based evidence (RBE) in The Guide to Community Preventive Services (The Community Guide). We developed operational definitions for PBE and RBE in which the main distinguishing feature was whether allocation of participants to intervention and comparison conditions was under the control of researchers (RBE) or not (PBE). We conceptualized a continuum between RBE and PBE. We then categorized 3656 studies in 202 reviews completed since The Community Guide began in 1996. Fifty-four percent of studies were PBE and 46% RBE. Community-based and policy reviews had more PBE. Health care system and programmatic reviews had more RBE. The majority of both PBE and RBE studies were of high quality according to Community Guide scoring methods. The inclusion of substantial PBE in Community Guide reviews suggests that evidence of adequate rigor to inform practice is being produced. This should increase stakeholders' confidence that The Community Guide provides recommendations with real-world relevance. Limitations in some PBE studies suggest a need for strengthening practice-relevant designs and external validity reporting standards.

Council for Exceptional Children: Standards for Evidence-Based Practices in Special Education

ERIC Educational Resources Information Center

TEACHING Exceptional Children, 2014

2014-01-01

In this article, the "Council for Exceptional Children (CEC)" presents Standards for Evidence-Based Practices in Special Education. The statement presents an approach for categorizing the evidence base of practices in special education. The quality indicators and the criteria for categorizing the evidence base of special education…

Evidence-Based Teaching Practice in Nursing Education: Faculty Perspectives and Practices.

PubMed

Kalb, Kathleen A; O'Conner-Von, Susan K; Brockway, Christine; Rierson, Cindy L; Sendelbach, Sue

2015-01-01

This national online study was conducted to describe nursing faculty perspectives and practices about evidence-based teaching practice (EBTP). Professional standards for nurse educator practice stress the importance of EBTP; however, the use of evidence by faculty in curriculum design, evaluation and educational measurement, and program development has not been reported. Nurse administrators of accredited nursing programs in the United States (N = 1,586) were emailed information about the study, including the research consent form and anonymous survey link, and invited to forward information to nursing faculty. Respondents (551 faculty and nurse administrators) described the importance of EBTP in nursing education, used multiple sources of evidence in their faculty responsibilities, and identified factors that influence their ability to use EBTP. EBTP in nursing education requires sustained institutional, administrative, and collegial support to promote faculty effectiveness and student learning.

The Effects of Practice-Based Training on Graduate Teaching Assistants’ Classroom Practices

PubMed Central

Becker, Erin A.; Easlon, Erin J.; Potter, Sarah C.; Guzman-Alvarez, Alberto; Spear, Jensen M.; Facciotti, Marc T.; Igo, Michele M.; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K–12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. PMID:29146664

Leadership, Organizational Climate, and Perceived Burden of Evidence-Based Practice in Mental Health Services.

PubMed

Brimhall, Kim C; Fenwick, Karissa; Farahnak, Lauren R; Hurlburt, Michael S; Roesch, Scott C; Aarons, Gregory A

2016-09-01

The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care.

Leadership, Organizational Climate, and Perceived Burden of Evidence-Based Practice in Mental Health Services

PubMed Central

Brimhall, Kim C.; Fenwick, Karissa; Farahnak, Lauren R.; Hurlburt, Michael S.; Roesch, Scott C.

2015-01-01

The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care. PMID:26152770

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

PubMed Central

Slater, Helen; Davies, Stephanie Joy; Parsons, Richard; Quintner, John Louis; Schug, Stephan Alexander

2012-01-01

Background Persistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs). Methods To encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1 =  nil and 5 =  excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale). Results Ninety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change  = −5.6±8.2, p<0.0001; 95% confidence interval: −7.6 to −3.6) and significant positive shifts on all measures of clinical knowledge and skills (p<0.0001 for all questions). Self management strategies were recommended more frequently post-intervention. The majority of responders who were guideline-inconsistent for work and bed rest recommendations (82% and 62% respectively) at pre-intervention, gave guideline-consistent responses at post-intervention. Conclusion An interprofessional pain education program set within a framework that aligns health policy and practice

Evidence-Based Practice Empowers Early Childhood Professionals and Families. FPG Snapshot #33

ERIC Educational Resources Information Center

FPG Child Development Institute, 2006

2006-01-01

Evidence-based practice emerged as a result of the gap often seen between research and practice and gained momentum with the standards and accountability movement. Yet it originates in medicine. Healthcare professionals using evidence-based medicine determine a patient's treatment based on an assessment of evidence from the literature and current…

A practical approach to evidence-based dentistry: How to search for evidence to inform clinical decisions.

PubMed

Brignardello-Petersen, Romina; Carrasco-Labra, Alonso; Booth, H Austin; Glick, Michael; Guyatt, Gordon H; Azarpazhooh, Amir; Agoritsas, Thomas

2014-12-01

Knowing how to search for evidence that can inform clinical decisions is a fundamental skill for the practice of evidence-based dentistry. There are many available types of evidence-based resources, characterized by their degrees of coverage of preappraised or summarized evidence at varying levels of processing, from primary studies to systematic reviews and clinical guidelines. The practice of evidence-based dentistry requires familiarity with these resources. In this article, the authors describe the process of searching for evidence: defining the question, identifying the question's nature and main components, and selecting the study design that best addresses the question.

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

PubMed

Canada, Amanda N

2016-04-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based

Evidence-Based Practice in Kinesiology: The Theory to Practice Gap Revisited

ERIC Educational Resources Information Center

Knudson, Duane

2005-01-01

As evidence-based practice sweeps the applied health professions, it is a good time to evaluate the generation of knowledge in Kinesiology and its transmission to professionals and the public. Knowledge transmission has been debated in the past from the perspectives of the theory-to-practice gap and the discipline versus profession emphasis.…

Feedback informed treatment: evidence-based practice meets social construction.

PubMed

Tilsen, Julie; McNamee, Sheila

2015-03-01

This article explores the challenges presented by the mandate for evidence-based practice for family therapists who identify with the philosophical stance of social construction. The history of psychotherapy outcome research is reviewed, as are current findings that provide empirical evidence for an engaged, dialogic practice. The authors suggest that the binary between empiricism and social construction may be unhinged by understanding empiricism as a particular discursive frame (i.e., a particular way of talking, acting, and being in the world), one of many available as a way of understanding and talking about our work. Through a case vignette, the authors introduce the evidence-based practice of Feedback Informed Treatment as an elaboration of social construction, and as an example of bridging the gap between the discursive frames of empiricism and social construction. © 2014 Family Process Institute.

High School Teachers’ Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate

PubMed Central

Pas, Elise T.; Loh, Deanna; Debnam, Katrina J.; Bradshaw, Catherine P.

2016-01-01

Although evidence-based practices for students’ social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers’ openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers’ openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers’ openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers’ openness to new program adoption are discussed. PMID:28533823

High School Teachers' Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate.

PubMed

Johnson, Stacy R; Pas, Elise T; Loh, Deanna; Debnam, Katrina J; Bradshaw, Catherine P

2017-03-01

Although evidence-based practices for students' social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers' openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers' openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers' openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers' openness to new program adoption are discussed.

Innovation characteristics and intention to adopt sustainable facilities management practices.

PubMed

Lee, So Young; Kang, Mihyun

2013-01-01

Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.

Evidence-based practice: the importance of education and leadership.

PubMed

Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro

2010-01-01

To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

Promoting Evidence-Based Practice: Models and Mechanisms from Cross-Sector Review

ERIC Educational Resources Information Center

Nutley, Sandra; Walter, Isabel; Davies, Huw T. O.

2009-01-01

This article draws on both a cross-sector literature review of mechanisms to promote evidence-based practice and a specific review of ways of improving research use in social care. At the heart of the article is a discussion of three models of evidence-based practice: the research-based practitioner model, the embedded research model, and the…

Evidence-based dentistry: a model for clinical practice.

PubMed

Faggion, Clóvis M; Tu, Yu-Kang

2007-06-01

Making decisions in dentistry should be based on the best evidence available. The objective of this study was to demonstrate a practical procedure and model that clinicians can use to apply the results of well-conducted studies to patient care by critically appraising the evidence with checklists and letter grade scales. To demonstrate application of this model for critically appraising the quality of research evidence, a hypothetical case involving an adult male with chronic periodontitis is used as an example. To determine the best clinical approach for this patient, a four-step, evidence-based model is demonstrated, consisting of the following: definition of a research question using the PICO format, search and selection of relevant literature, critical appraisal of identified research reports using checklists, and the application of evidence. In this model, the quality of research evidence was assessed quantitatively based on different levels of quality that are assigned letter grades of A, B, and C by evaluating the studies against the QUOROM (Quality of Reporting Meta-Analyses) and CONSORT (Consolidated Standards of Reporting Trials) checklists in a tabular format. For this hypothetical periodontics case, application of the model identified the best available evidence for clinical decision making, i.e., one randomized controlled trial and one systematic review of randomized controlled trials. Both studies showed similar answers for the research question. The use of a letter grade scale allowed an objective analysis of the quality of evidence. A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists' decision making skill.

The Evidence. Supported Education: A Promising Practice. Evidence-Based Practices KIT (Knowledge Informing Transformation)

ERIC Educational Resources Information Center

Unger, Karen V.

2011-01-01

Supported Employment is an evidence-based practice that helps people with mental illness find and keep meaningful jobs in the community. Given these outcomes the challenge for Supported Employment programs is to rethink the emphasis on immediate work for everyone and help consumers utilize appropriate education and training opportunities available…

Factors influencing the development of evidence-based practice among nurses: a self-report survey

PubMed Central

2012-01-01

Background Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP). The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice. PMID:23092366

Relationships between duration of practice, educational level, and perception of barriers to implement evidence-based practice among critical care nurses.

PubMed

Phillips, Carswella

2015-12-01

Globally, a greater emphasis has been placed on the delivery of safe, patient-centered, evidence-based nursing care. As point-of-care providers, critical care nurses play a key role in ensuring that patients receive the safest, most effective treatment available. In order to deliver scientific-based care, critical care nurses must stay abreast of the current trends, as well as engage in the evidence-based practice process. This study aimed to describe research activities, to identify barriers to implement evidence-based practice and to explore professional factors related to the use of evidence-based practice among critical care nurses at three teaching hospitals in south-eastern United States. A survey design and convenience sampling method was used. A sample of 30 critical care staff nurses participated in the study. A 61-item online questionnaire composed of a demographic survey - BARRIERS scale - and Evidence-Based Practice Questionnaire was used. Simple descriptive statistics, Pearson's product moment correlations, and independent-sample t test procedures were used to analyze the data. Critical care nurses' reported positive attitudes, but viewed knowledge and use of evidence-based practice less favorably. These results may indicate that having a positive attitude towards evidence-based practice does not necessarily translate to knowledge and use of the evidence-based practice process in clinical practice. An unwillingness to change and time constraints were identified as the top barriers to use evidence-based practice in this study. Perceptions of barriers to use evidence-based practice were higher in those critical care nurses who had less practical experience and educational preparation. The results suggest that critical care nurses possess the foundation to engage in the evidence-based practice process; however, their knowledge, practice, and attitudes just need to be cultivated and strengthened. Understanding the nurses' professional factors, current use

Toward a Transdisciplinary Model of Evidence-Based Practice

PubMed Central

Satterfield, Jason M; Spring, Bonnie; Brownson, Ross C; Mullen, Edward J; Newhouse, Robin P; Walker, Barbara B; Whitlock, Evelyn P

2009-01-01

Context This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed. PMID:19523122

[Online information service: the library support for evidence-based practice].

PubMed

Markulin, Helena; Petrak, Jelka

2014-01-01

It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice.

Evidence-Based Practice and School Libraries: Interconnections of Evidence, Advocacy, and Actions

ERIC Educational Resources Information Center

Todd, Ross J.

2015-01-01

This author states that a professional focus on evidence based practice (EBP) for school libraries emerged from the International Association of School Librarianship conference when he presented the concept. He challenged the school library profession to actively engage in professional and reflective practices that chart, measure, document, and…

Sustainability of Evidence-Based Acute Pain Management Practices for Hospitalized Older Adults.

PubMed

Shuman, Clayton J; Xie, Xian-Jin; Herr, Keela A; Titler, Marita G

2017-11-01

Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.

Using Principles of Evidence-Based Practice to Improve Prescriptive Recommendations

ERIC Educational Resources Information Center

Schraw, Gregory; Patall, Erika A.

2013-01-01

We draw on the evidence-based practice (EBP) literature to consider the relationship between empirical results reported in primary research journals and prescriptive recommendations for practice based on those results. We argue that the relationship between individual empirical findings and practice should be mediated by two additional steps in…

Field Supervisor Perspectives on Evidence-Based Practice: Familiarity, Feasibility, and Implementation

ERIC Educational Resources Information Center

Heffernan, Kristin; Dauenhauer, Jason

2017-01-01

The Council on Social Work Education has designated field education as social work's signature pedagogy, putting field supervisors in a key role of preparing students as competent social workers. This study examined field supervisors' Evidence Based Practice (EBP) behaviors using a modified version of the Evidence-Based Practice Process Assessment…

The current status of evidence-based practice in juvenile justice.

PubMed

McKee, Esther Chao; Rapp, Lisa

2014-01-01

The advent of evidence-based practice (EBP) has significantly changed the juvenile justice system while producing intense controversy. The intent of this article is to provide an update on the current status of EBP in the juvenile justice system. Specifically, this article will describe the evolution of juvenile justice philosophy as it has informed current juvenile justice policies and programs, discuss the scope of current juvenile justice research regarding EBP, identify barriers to implementing EBP, expound on the development of EBP in juvenile justice, discern the characteristics of evidence-based interventions in the juvenile justice system, and finally describe how to select and assess evidence-based practices and interventions.

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence you are the legally adopting parent or legally adopted child. 404.733 Section 404.733 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the...

Evidence-based integrated environmental solutions for secondary lead smelters: pollution prevention and waste minimization technologies and practices.

PubMed

Genaidy, A M; Sequeira, R; Tolaymat, T; Kohler, J; Rinder, M

2009-05-01

An evidence-based methodology was adopted in this research to establish strategies to increase lead recovery and recycling via a systematic review and critical appraisal of the published literature. In particular, the research examines pollution prevention and waste minimization practices and technologies that meet the following criteria: (a) reduce/recover/recycle the largest quantities of lead currently being disposed of as waste, (b) technically and economically viable, that is, ready to be diffused and easily transferable, and (c) strong industry interest (i.e., industry would consider implementing projects with higher payback periods). The following specific aims are designed to achieve the study objectives: Aim 1 - To describe the recycling process of recovering refined lead from scrap; Aim 2 - To document pollution prevention and waste management technologies and practices adopted by US stakeholders along the trajectory of LAB and lead product life cycle; Aim 3 - To explore improved practices and technologies which are employed by other organizations with an emphasis on the aforementioned criteria; Aim 4 - To demonstrate the economic and environmental costs and benefits of applying improved technologies and practices to existing US smelting operations; and Aim 5 - To evaluate improved environmental technologies and practices using an algorithm that integrates quantitative and qualitative criteria. The process of identifying relevant articles and reports was documented. The description of evidence was presented for current practices and technologies used by US smelters as well as improved practices and technologies. Options for integrated environmental solutions for secondary smelters were introduced and rank ordered on the basis of costs (i.e., capital investment) and benefits (i.e., production increases, energy and flux savings, and reduction of SO(2) and slag). An example was provided to demonstrate the utility of the algorithm by detailing the costs and

[A survey on knowledge, attitude and practice related to evidence-based dentistry among dental students].

PubMed

Chang, Zhong-Fu; Zhu, Ce; Tao, Dan-Ying; Feng, Xi-Ping; Lu, Hai-Xia

2017-04-01

To investigate the knowledge, attitude and practice related to evidence-based dentistry among dental students, and to provide a reference for targeted evidence-based dentistry teaching and practice evidence-based dentistry in dental students. Dental students who attended the internship in Shanghai Ninth People's Hospital and Pudong People's Hospital were invited to attend this survey. Information on knowledge, attitude and practices related evidence-based dentistry was collected through questionnaires. SPSS 21.0 software package was used for data analysis. A total of 62 dental students attended this survey. Evidence-based dentistry related knowledge and attitude scores were 5.5±1.9 and 5.1±1.0, respectively. Over three quarters of students took courses on evidence-based medicine, while around half of students (56.5%) self-reported that they knew little about evidence-based medicine. 70.5% students practiced evidence-based dentistry less than once in the process of clinical decision making per week. The majority of students (80.3%) used MEDLINE or other databases to search for practice-related literature less than once per week. 63.9% students used practice guideline. The top three barriers to practice evidence-based dentistry were lack of information resources, insufficient time and lack of search skills. Evidence-based dentistry related knowledge and practice among dental students is deficient, whereas they hold positive attitude on practice. The top three barriers to practice evidence-based dentistry are lack of information resources, insufficient time and lack of search skills.

The attitude of Belgian social insurance physicians towards evidence-based practice and clinical practice guidelines.

PubMed

Heselmans, Annemie; Donceel, Peter; Aertgeerts, Bert; Van de Velde, Stijn; Ramaekers, Dirk

2009-09-09

Evidence-based medicine has broadened its scope and is starting to reach insurance medicine. Although still in its initial stages, physicians in the area of insurance medicine should keep up-to-date with the evidence on various diseases in order to correctly assess disability and to give appropriate advice about health care reimbursement. In order to explore future opportunities of evidence-based medicine to improve daily insurance medicine, there is a need for qualitative studies to better understand insurance physicians' perceptions of EBM. The present study was designed to identify the attitude of insurance physicians towards evidence-based medicine and clinical practice guidelines, and to determine their ability to access, retrieve and appraise the health evidence and the barriers for applying evidence to practice. A cross-sectional survey study was carried out among all Dutch-speaking insurance physicians employed at one of the six Belgian social insurance sickness funds and at the National Institute of Disability and Health care Insurance (n = 224). Chi-square tests were used to compare nominal and ordinal variables. Student's t-tests, ANOVA, Mann-Whitney and Kruskal-Wallis were used to compare means of continuous variables for different groups. The response rate was 48.7%. The majority of respondents were positive towards evidence-based medicine and clinical practice guidelines. Their knowledge of EBM was rather poor. Perceived barriers for applying evidence to practice were mainly time and lack of EBM skills. Although the majority of physicians were positive towards EBM and welcomed more guidelines, the use of evidence and clinical practice guidelines in insurance medicine is low at present. It is in the first place important to eradicate the perceived inertia which limits the use of EBM and to further investigate the EBM principles in the context of insurance medicine. Available high-quality evidence-based resources (at the moment mainly originating from

The attitude of Belgian social insurance physicians towards evidence-based practice and clinical practice guidelines

PubMed Central

Heselmans, Annemie; Donceel, Peter; Aertgeerts, Bert; Van de Velde, Stijn; Ramaekers, Dirk

2009-01-01

Background Evidence-based medicine has broadened its scope and is starting to reach insurance medicine. Although still in its initial stages, physicians in the area of insurance medicine should keep up-to-date with the evidence on various diseases in order to correctly assess disability and to give appropriate advice about health care reimbursement. In order to explore future opportunities of evidence-based medicine to improve daily insurance medicine, there is a need for qualitative studies to better understand insurance physicians' perceptions of EBM. The present study was designed to identify the attitude of insurance physicians towards evidence-based medicine and clinical practice guidelines, and to determine their ability to access, retrieve and appraise the health evidence and the barriers for applying evidence to practice. Methods A cross-sectional survey study was carried out among all Dutch-speaking insurance physicians employed at one of the six Belgian social insurance sickness funds and at the National Institute of Disability and Health care Insurance (n = 224). Chi-square tests were used to compare nominal and ordinal variables. Student's t-tests, ANOVA, Mann-Whitney and Kruskal-Wallis were used to compare means of continuous variables for different groups. Results The response rate was 48.7%. The majority of respondents were positive towards evidence-based medicine and clinical practice guidelines. Their knowledge of EBM was rather poor. Perceived barriers for applying evidence to practice were mainly time and lack of EBM skills. Conclusion Although the majority of physicians were positive towards EBM and welcomed more guidelines, the use of evidence and clinical practice guidelines in insurance medicine is low at present. It is in the first place important to eradicate the perceived inertia which limits the use of EBM and to further investigate the EBM principles in the context of insurance medicine. Available high-quality evidence-based resources

School Psychology: A Public Health Framework: I. From Evidence-Based Practices to Evidence-Based Policies.

ERIC Educational Resources Information Center

Hoagwood, Kimberly; Johnson, Jacqueline

2003-01-01

Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…

An online community of practice to support evidence-based physiotherapy practice in manual therapy.

PubMed

Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

2014-01-01

The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

An exploration of the roles of nurse managers in evidence-based practice implementation.

PubMed

Wilkinson, Joyce E; Nutley, Sandra M; Davies, Huw T O

2011-12-01

Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. METHODOLOGY AND METHODS: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n= 51), documentary analysis and observational data. Data analysis reveals that the role of NMs in facilitating evidence-based practice is under-articulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffective without action to address the problems identified. Copyright ©2011 Sigma Theta Tau International.

Evidence-Based Practice in Mental Health Care to Ethnic Minority Communities: Has Its Practice Fallen Short of Its Evidence?

ERIC Educational Resources Information Center

Aisenberg, Eugene

2008-01-01

Evidence-based practice (EBP) has contributed substantially to the advancement of knowledge in the treatment and prevention of adult mental health disorders. A fundamental assumption, based on documented evidence of effectiveness with certain populations, is that EBP is equally effective and applicable to all populations. However, small sample…

Towards Evidence-Based Practice in Language Intervention for Bilingual Children

ERIC Educational Resources Information Center

Thordardottir, Elin

2010-01-01

Evidence-based practice requires that clinical decisions be based on evidence from rigorously controlled research studies. At this time, very few studies have directly examined the efficacy of clinical intervention methods for bilingual children. Clinical decisions for this population cannot, therefore, be based on the strongest forms of research…

Evidence-based practice among primary care physicians in Kuwait.

PubMed

Ahmad, Abeer S H; Al-Mutar, Nouf B E; Al-Hulabi, Fahad A S; Al-Rashidee, Eman S L; Doi, Suhail A R; Thalib, Lukman

2009-12-01

The level of evidence-based practice (EBP) and awareness has not been previously assessed among primary care physicians in Kuwait. The objectives of this study were to quantify the level of EBP and awareness in Kuwait and identify the factors related to EBP. We used a cross sectional study that enrolled 332 primary care physicians in 57 primary care centres randomly chosen in Kuwait. A self-administered questionnaire was used to collect the data with a response rate of about 93%. Although half of the physicians self reported that they use EBP most of the time, further analysis revealed that only about 24% of this group had a reasonable understanding of EBP. Most of the clinical practice in the Kuwaiti primary care system seems to be based on the clinician's own judgment or what they learned in the medical school and traditional text books, rather than evidence-based sources. None of the physicians had an Internet connection at their work place and a vast majority of them had no access to international journals nor were confident about critical appraisal of published evidence. Overall level of awareness of evidence-based medicine (EBM) among primary care physicians in Kuwait was considerably low. Training in the areas of EBM as well as making sure the Kuwaiti primary care centres have access to evidence-based sources are critically important if primary care in Kuwait were to become evidence based.

Clinical Evidence: a useful tool for promoting evidence-based practice?

PubMed

Formoso, Giulio; Moja, Lorenzo; Nonino, Francesco; Dri, Pietro; Addis, Antonio; Martini, Nello; Liberati, Alessandro

2003-12-23

Research has shown that many healthcare professionals have problems with guidelines as they would prefer to be given all relevant information relevant to decision-making rather than being told what they should do. This study assesses doctors' judgement of the validity, relevance, clarity and usability of the Italian translation of Clinical Evidence (CE) after its free distribution launched by the Italian Ministry of Health. Opinions elicited using a standardised questionnaire delivered either by mail or during educational or professional meetings. Twenty percent (n = 1350) doctors participated the study. Most of them found CE's content valid, useful and relevant for their clinical practice, and said CE can foster communications among clinicians, particularly among GPs and specialists. Hospital doctors (63%) more often than GPs (48%) read the detailed presentation of individual chapters. Twenty-nine percent said CE brought changes in their clinical practice. Doctors appreciated CE's nature of an evidence-based information compendium and would have not preferred a collection of practice guidelines. Overall, the pilot initiative launched by the Italian Ministry of Health seems to have been well received and to support the subsequent decision to make the Italian edition of Clinical Evidence concise available to all doctors practising in the country. Local implementation initiatives should be warranted to favour doctor's use of CE.

Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations.

PubMed

Patterson, David A; Wolf Adelv Unegv Waya, Silver; Dulmus, Catherine N

2012-06-01

This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization's internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations.

Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations

PubMed Central

Patterson, David A.; Wolf (Adelv unegv Waya), Silver; Dulmus, Catherine N.

2012-01-01

This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization’s internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations. PMID:24634639

Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

PubMed

Newhouse, Robin P

2007-01-01

Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

Evidence-Based Practice: The Psychology of EBP Implementation.

PubMed

Rousseau, Denise M; Gunia, Brian C

2016-01-01

Evidence-based practice (EBP) is an approach used in numerous professions that focuses attention on evidence quality in decision making and action. We review research on EBP implementation, identifying critical underlying psychological factors facilitating and impeding its use. In describing EBP and the forms of evidence it employs, we highlight the challenges individuals face in appraising evidence quality, particularly that of their personal experience. We next describe critical EBP competencies and the challenges underlying their acquisition: foundational competencies of critical thinking and domain knowledge, and functional competencies such as question formulation, evidence search and appraisal, and outcome evaluation. We then review research on EBP implementation across diverse fields from medicine to management and organize findings around three key contributors to EBP: practitioner ability, motivation, and opportunity to practice (AMO). Throughout, important links between psychology and EBP are highlighted, along with the contributions psychological research can make to further EBP development and implementation.

Advancing Counselor Education in Evidence-Based Practice

ERIC Educational Resources Information Center

Morrow, Michael T.; Lee, Hsin-Hua; Bartoli, Eleonora; Gillem, Angela R.

2017-01-01

Evidence-based practice (EBP) is a core priority in counselor education. This paper details one United States' counselor education program's self-assessment of its EBP curriculum. Faculty members collaborated to identify challenges and generate solutions to strengthen the EBP emphasis within the program. This paper is intended as a resource for…

Psychiatric mental health evidence-based practice.

PubMed

Rice, Michael J

2008-05-01

This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

Adoption of a novel surgical innovation into clinical practice: protocol for a qualitative systematic review examining surgeon views.

PubMed

Lewis, Thomas L; Furness, Hugh N; Miller, George W; Parsons, Nicholas; Seers, Kate; Underwood, Martin; Metcalfe, Andrew J

2018-04-17

Efficient adoption of clinically effective novel surgical innovations has great potential benefits for patients. Factors affecting the adoption of surgical innovation are not well understood and proposed models of adoption do not accurately correlate with historical evidence. This protocol is for a systematic review that aims to identify the qualitative evidence relating to surgeon views regarding the adoption of novel surgical innovation into clinical practice. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be performed. Two independent reviewers will search the following databases: MEDLINE, Embase, Science Direct, Scopus, Web of Science and the Cochrane Library of Systematic Reviews. Inclusion criteria are studies which report on the views of surgeons who adopt a novel surgical innovation into clinical practice. Each article will be screened for inclusion and assessed according to a Critical Appraisal Skills Programme tool. Data will be synthesised and analysed according to thematic analysis. Given the anticipated yield of a small heterogeneous body of evidence meeting the eligibility criteria for the review, a narrative-based summary is planned. This review does not require formal ethical approval as it does not involve direct patient contact or patient-identifiable data. The results of this review will be published in a peer-reviewed journal and presented at relevant conferences. The results will also inform an empirical qualitative study exploring surgeon and other stakeholder views regarding the introduction of novel surgical technology and procedures into clinical practice. CRD42017076715. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Hecht, Debra B; Silovsky, Jane F; Chaffin, Mark J

2009-04-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children's services system. The study took place in the context of a statewide, regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. In the study 21 teams consisting of 153 home-based service providers were followed over a 29-month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families.

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff retention in a children’s services system. The study took place in the context of a statewide regionally randomized effectiveness trial of an evidence-based intervention designed to reduce child neglect. Twenty-one teams consisting of 153 home-based service providers were followed over a 29 month period. Survival analyses revealed greater staff retention in the condition where the evidence-based practice was implemented along with ongoing fidelity monitoring presented to staff as supportive consultation. These results should help to allay concerns about staff retention when implementing evidence-based practices where there is good values-innovation fit and when fidelity monitoring is designed as an aid and support to service providers in providing a high standard of care for children and families. PMID:19309186

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

PubMed Central

Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors’ alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. PMID:26033871

Implementation of evidence-based knowledge in general practice.

PubMed

Le, Jette Videbæk

2017-12-01

Background Keeping up with the evidence and implementing it into the daily care for patients are fundamental prerequisites for delivering a high quality of care in general practice. However, despite many years of research into dissemination and implementation of evidence-based recommendations, significant challenges remain. In recent years, organisational factors have become widely acknowledged as vitally important for ensuring successful implementation. Further knowledge is needed to understand more about which factors affect the seeking and implementation of evidence-based knowledge in general practice. Aim The overall aim was to investigate how evidence-based knowledge is sought and implemented in general practice and to analyse associations with GP characteristics and quality of care. Three separate studies, each covering a specific part of the overall aim, were undertaken: I. To examine how GPs implement clinical practice guidelines in everyday clinical practice, and how implementation approaches differ between practices. II. To assess GPs’ information seeking behaviour with regard to the use and perceived importance of scientific medical information sources and to investigate associations with GP characteristics. III. To investigate if there are associations between specific formalised implementation activities within general practice and quality of care – exemplified by the use of spirometry testing among first-time users of medication against obstructive lung diseases. Methods The study was designed as a mixed methods study combining qualitative interviews, questionnaire and register data. Study I was a qualitative interview study that involved purposefully selected GPs representing seven different practices. The interviews were analysed using systematic text condensation, and results were used to qualify the development of a national survey of general practitioners regarding their seeking and implementation of evidence-based knowledge. This survey was

The evidence-based practice ideologies.

PubMed

Mantzoukas, Stefanos

2007-10-01

This paper puts forward the argument that there are various, competing, and antithetical evidence-based practice (EBP) definitions and acknowledges that the different EBP definitions are based on different epistemological perspectives. However, this is not enough to understand the way in which nurse professionals choose between the various EBP formations and consequently facilitate them in choosing the most appropriate for their needs. Therefore, the current article goes beyond and behind the various EBP epistemologies to identify how individuals choose an epistemology, which consequently will assist our understanding as to how an individual chooses a specific EBP formation. Individuals choose an epistemology on the mere belief that the specific epistemology offers the ideals or ideas of best explaining or interpreting daily reality. These ideals or ideas are termed by science, history, and politics as ideology. Similarly, individual practitioners choose or should choose between the different EBP formations based on their own personal ideology. Consequently, this article proceeds to analyse the various ideologies behind different EBP definitions as to conclude that there are two broad ideologies that inform the various EBP formations, namely the ideology of truth and the ideology of individual emancipation. These two ideologies are analysed and their connections to the various EBP formations are depicted. Eventually, the article concludes that the in-depth, critical, and intentional analysis by individual nurses of their own ideology will allow them to choose the EBP formation that is most appropriate and fitting for them, and their specific situation. Hence, the conscious analysis of individual ideology becomes the criterion for choosing between competing EBP formations and allows for best evidence to be implemented in practice. Therefore, the best way to teach EBP courses is by facilitating students to analyse their own ideology.

Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

PubMed

Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

2018-03-08

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by

Evaluation of a program to increase evidence-based practice change.

PubMed

Larrabee, June H; Sions, Jacqueline; Fanning, Mary; Withrow, Mary Lynne; Ferretti, Andrea

2007-06-01

The study evaluated a nursing research program designed to achieve systematic evidence-based practice change. Specifically, change in nurse attitudes about use of research and research conduct, practice change projects, and nurse participation in research-related activities were evaluated. Evidence indicates that successful evidence-based practice change in an organization requires senior leadership support and a systematic program for practice change. Evaluation of program effectiveness provides evidence about opportunities for further improvement. Quantitative evaluation used a pretest-posttest design. The site was an academic medical center in rural West Virginia. Participants were registered nurses from all inpatients units, perioperative services, and emergency departments. Surveys used Alcock et al's Staff Nurses and Research Activities scale. Descriptive evaluation included the number of nurses who attended the workshop, practice change projects, scholarly products disseminated, and outcome of a Magnet review. First, knowledge about the availability of support services increased between 1999 and 2002 and was associated with higher attitude scores about research and research utilization. Second, registered nurses who reported participating in research-related activities had more positive scores on all attitudes than registered nurses who reported not participating. Nurse leaders may improve participation and attitudes about research and research utilization by internally marketing the support available for research-related activities.

Establishing CASA as an evidence-based practice.

PubMed

Lawson, Jennifer; Berrick, Jill Duerr

2013-01-01

In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.

Need to Address Evidence-Based Practice in Educational Administration

ERIC Educational Resources Information Center

Kowalski, Theodore

2009-01-01

Purpose: This article presents a case for addressing evidence-based practice (EBP) in educational administration. Content is arranged around four objectives: (a) summarizing the status of educational administration as a profession, (b) defining evidence and the model, (c) explaining EBP's social and professional merit, and (d) identifying barriers…

Chiropractic Attitudes and Utilization of Evidence-Based Practice: The Use of the EBASE Questionnaire.

PubMed

Alcantara, Joel; Leach, Matthew J

2015-01-01

To examine the attitudes and utilization of evidence-based practice by chiropractors. Utilizing a descriptive survey implemented as an online questionnaire, we examined chiropractors׳ perception, skills, and level of training, their engagement in, the barriers and facilitators to, and possible interventions to evidence-based practice. A total of 162 of 500 chiropractors completed the survey, providing a response rate of 32.4%. The majority of respondents were 30-39 years old, female, and worked in solo practice. A high proportion agreed/strongly agreed that evidence-based practice was necessary in the practice of chiropractic. Most respondents considered themselves to have above-average skills in locating professional literature, identifying answerable clinical questions, and identifying knowledge gaps in practice. However, many indicated receiving either no training or minimal education for conducting clinical research and systematic reviews and meta-analyses Most respondents had read or reviewed one to five professional articles and/or clinical research reports pertinent to their practice in the preceding month. Identified minor to moderate barriers to evidence-based practice were lack of time and lack of clinical evidence. Activities "very useful" in participating in evidence-based practice were access to free online databases and the ability to download full-text journal articles. The responders of our survey embraced and considered themselves skillful in evidence-based practice. They utilized a number of resources to practice in such a manner and were not deterred by identified barriers. We support continued research in this field. Copyright © 2015 Elsevier Inc. All rights reserved.

CEC's Standards for Classifying the Evidence Base of Practices in Special Education

ERIC Educational Resources Information Center

Cook, Bryan G.; Buysse, Virginia; Klingner, Janette; Landrum, Timothy J.; McWilliam, R. A.; Tankersley, Melody; Test, David W.

2015-01-01

As an initial step toward improving the outcomes of learners with disabilities, special educators have formulated guidelines for identifying evidence-based practices. We describe the Council of Exceptional Children's new set of standards for identifying evidence-based practices in special education and how they (a) were systematically vetted by…

Evidence-Based Practice and Evaluation: From Insight to Impact

ERIC Educational Resources Information Center

Dunsmuir, Sandra; Brown, Emma; Iyadurai, Suzi; Monsen, Jeremy

2009-01-01

With the growing emphasis on accountability and evidence-based practice, evaluation has become increasingly important in the contexts in which educational psychologists (EPs) practice. This paper describes a Target Monitoring and Evaluation (TME) system, derived from Goal Attainment Scaling (GAS) which was developed to evaluate outcomes of a wide…

Behavior problems, foster home integration, and evidence-based behavioral interventions: What predicts adoption of foster children?

PubMed

Leathers, Sonya J; Spielfogel, Jill E; Gleeson, James P; Rolock, Nancy

2012-05-01

Adoption is particularly important for foster children with special mental health needs who are unable to return home, as adoption increases parental support often critically needed by youth with mental health issues. Unfortunately, significant behavior problems frequently inhibit foster parents from adopting, and little is known about factors that predict adoption when a child has behavior problems. Previous research suggests that foster parent behavioral training could potentially increase rates of successful adoptions for pre-school-aged foster children with behavior problems (Fisher, Kim, & Pears, 2009), but this has not been previously tested in older samples. In older children, effective treatment of behavior problems might also increase adoption by reducing the interference of behavior problems and strengthening the child's foster home integration. This pilot study focused on this question by testing associations between behavior problems, foster home integration, an evidence-based foster parent intervention, and adoption likelihood. This study used an intent-to-treat design to compare foster home integration and adoption likelihood for 31 foster children with histories of abuse and neglect whose foster parents received a foster behavioral parenting intervention (see Chamberlain, 2003) or usual services. Random effect regression analyses were used to estimate outcomes across four time points. As expected, externalizing behavior problems had a negative effect on both integration and adoption, and foster home integration had an independent positive effect on adoption. Internalizing behavior problems (e.g., depression/anxiety) were not related to adoption or integration. However, the intervention did not have a direct effect on either foster home integration or adoption despite its positive effect on behavior problems. Results from this preliminary study provide further evidence of the negative effect of externalizing behavior problems on adoption. Its findings

Behavior problems, foster home integration, and evidence-based behavioral interventions: What predicts adoption of foster children?

PubMed Central

Leathers, Sonya J.; Spielfogel, Jill E.; Gleeson, James P.; Rolock, Nancy

2015-01-01

Objectives Adoption is particularly important for foster children with special mental health needs who are unable to return home, as adoption increases parental support often critically needed by youth with mental health issues. Unfortunately, significant behavior problems frequently inhibit foster parents from adopting, and little is known about factors that predict adoption when a child has behavior problems. Previous research suggests that foster parent behavioral training could potentially increase rates of successful adoptions for pre-school-aged foster children with behavior problems (Fisher, Kim, & Pears, 2009), but this has not been previously tested in older samples. In older children, effective treatment of behavior problems might also increase adoption by reducing the interference of behavior problems and strengthening the child’s foster home integration. This pilot study focused on this question by testing associations between behavior problems, foster home integration, an evidence-based foster parent intervention, and adoption likelihood. Methods This study used an intent-to-treat design to compare foster home integration and adoption likelihood for 31 foster children with histories of abuse and neglect whose foster parents received a foster behavioral parenting intervention (see Chamberlain, 2003) or usual services. Random effect regression analyses were used to estimate outcomes across four time points. Results As expected, externalizing behavior problems had a negative effect on both integration and adoption, and foster home integration had an independent positive effect on adoption. Internalizing behavior problems (e.g., depression/anxiety) were not related to adoption or integration. However, the intervention did not have a direct effect on either foster home integration or adoption despite its positive effect on behavior problems. Conclusions Results from this preliminary study provide further evidence of the negative effect of externalizing

Portable Data Assistants: Potential in Evidence-Based Practice Autism Treatment

ERIC Educational Resources Information Center

Dunkel-Jackson, Sarah M.; Dixon, Mark R.; Szekely, Susan

2012-01-01

The emerging era of "evidence-based practice" emphasizes that human service agencies need to find effective and efficient means of training staff and implementing systems change based on scientific evidence. Additional advancements in technology use across populations and settings within the field have also served as a catalyst for the development…

Cochrane pregnancy and childbirth database: resource for evidence-based practice.

PubMed

Callister, L C; Hobbins-Garbett, D

2000-01-01

The Cochrane Pregnancy and Childbirth database is an ongoing meta-analysis of evidence documenting effective health care practices for childbearing women and their neonates. It is proving invaluable to nurse educators, researchers, clinicians, and administrators working in a variety of health care delivery settings. Evidence-based nursing practice that is safe and effective can enhance rather than overpower pivotal and celebratory life events such as childbirth.

Dissemination of Evidence-Based Practices for Anxiety Disorders in Wyoming: A Survey of Practicing Psychotherapists

ERIC Educational Resources Information Center

Hipol, Leilani J.; Deacon, Brett J.

2013-01-01

Despite the well-established effectiveness of exposure-based cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, therapists have been slow to adopt CBT into their clinical practice. The present study was conducted to examine the utilization of psychotherapy techniques for anxiety disorders among community practitioners in a…

Marketing evidence-based practice: what a CROC™!

PubMed

Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry

2010-10-01

Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.

Creating Synergy in Practice: Promoting Complementarity between Evidence-Based and Postmodern Approaches

ERIC Educational Resources Information Center

Jacobs, Stephanie; Kissil, Karni; Scott, Dalesa; Davey, Maureen

2010-01-01

Postmodern and evidence-based practice (EBP) are compared and contrasted with the primary aim of adapting evidence-based practice with a more flexible epistemological lens. We begin by reviewing the epistemological underpinnings of postmodern and EBP within the field of marriage and family therapy (MFT). We next discuss how these contrasting…

Evidence-Based Practice for Teachers of Children with Autism: A Dynamic Approach

ERIC Educational Resources Information Center

Lubas, Margaret; Mitchell, Jennifer; De Leo, Gianluca

2016-01-01

Evidence-based practice related to autism research is a controversial topic. Governmental entities and national agencies are defining evidence-based practice as a specific set of interventions that educators should implement; however, large-scale efforts to generalize autism research, which are often single-subject case designs, may be a setback…

Teaching evidence-based social work in foundation practice courses: learning from pedagogical choices of allied fields.

PubMed

Traube, Dorian E; Pohle, Cara E; Barley, Melissa

2012-01-01

The field of social work is attuned to the need to incorporate evidence-based practice education into masters-level curriculum. One question remaining is how to integrate evidence-based practice in the foundation practice courses. Integration of evidence-based practice across the foundation-level curriculum coincides with the Council on Social Work Education's mandate that student's engage in research-informed practice and practice-informed research. Through a discussion of definitions, criticisms, and pedagogy across the allied fields of medicine, nursing, and social work the authors address the current status of evidence-based practice curriculum in foundation-level education. The authors incorporate the lessons learned from allied fields and a Masters of Social Work student's analyses of their experience of evidence-based practice learning to propose an adult-learner model to improve evidence-based practice pedagogy in Social Work.

Integrating relationship- and research-based approaches in Australian health promotion practice.

PubMed

Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

2015-12-01

We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Just-in-Time Evidence-Based E-mail “Reminders” in Home Health Care: Impact on Nurse Practices

PubMed Central

Murtaugh, Christopher M; Pezzin, Liliana E; McDonald, Margaret V; Feldman, Penny H; Peng, Timothy R

2005-01-01

Objective To test the effectiveness of two interventions designed to improve the adoption of evidence-based practices by home health nurses caring for heart failure (HF) patients. Data Sources/Study Setting Information on nurse practices was abstracted from the clinical records of patients admitted between June 2000 and November 2001 to the care of 354 study nurses at a large, urban, nonprofit home care agency. Study Design The study employed a randomized design with nurses assigned to usual care or one of two intervention groups upon identification of an eligible patient. The basic intervention was a one-time e-mail reminder highlighting six HF-specific clinical recommendations. The augmented intervention consisted of the initial e-mail reminder supplemented by provider prompts, patient education material, and clinical nurse specialist outreach. Data Collection At each home health visit provided by a study nurse to an eligible HF patient during the 45-day follow-up period, a structured chart abstraction tool was used to collect information on whether the nurse provided the care practices highlighted in the e-mail reminder. Principal Findings Both the basic and the augmented interventions greatly increased the practice of evidence-based care, according to patient records, in the areas of patient assessment and instructions about HF disease management. While not all results were statistically significant at conventional levels, intervention effects were positive in virtually all cases and effect magnitudes frequently were large. Conclusions The results of this randomized trial strongly support the efficacy of just-in-time evidence-based reminders as a means of changing clinical practice among home health nurses who are geographically dispersed and spend much of their time in the field. PMID:15960694

Evidence-Based Diagnosis: Incorporating Diagnostic Instruments into Clinical Practice

ERIC Educational Resources Information Center

Doss, Amanda Jensen

2005-01-01

This article is intended to serve as a practical guide for practitioners interested in incorporating evidence-based diagnosis (EBD) instruments into their clinical practices to refine the diagnostic process. Three measures are used to illustrate this process, the DISC-IV (Shaffer et al., 2000), the Schedule for Affective Disorders and…

Evidence-Based Practice in Communication Disorders: Progress Not Perfection

ERIC Educational Resources Information Center

Kent, Ray D.

2006-01-01

Purpose: This commentary is written in response to a companion paper by Nan Bernstein Ratner ("Evidence-Based Practice: An Examination of its Ramifications for the Practice of Speech-Language Pathology"). Method: The comments reflect my experience as Vice President for Research and Technology of the American Speech-Language-Hearing Association…

A prototype system to support evidence-based practice.

PubMed

Demner-Fushman, Dina; Seckman, Charlotte; Fisher, Cheryl; Hauser, Susan E; Clayton, Jennifer; Thoma, George R

2008-11-06

Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans.

A Prototype System to Support Evidence-based Practice

PubMed Central

Demner-Fushman, Dina; Seckman, Charlotte; Fisher, Cheryl; Hauser, Susan E.; Clayton, Jennifer; Thoma, George R.

2008-01-01

Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients’ problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans. PMID:18998835

Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

ERIC Educational Resources Information Center

Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

2007-01-01

Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

ERIC Educational Resources Information Center

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff…

Evidence-based practice knowledge, attitudes, and practice of online graduate nursing students.

PubMed

Rojjanasrirat, Wilaiporn; Rice, Jan

2017-06-01

This study aimed to evaluate changes in evidence-based practice (EBP) knowledge, attitudes, and practice of nursing students before and after completing an online, graduate level, introductory research/EBP course. A prospective one-group pretest-posttest design. A private university in the Midwestern, USA. Sixty-three online nurse practitioner students in Master's program. A convenient sample of online graduate nursing students who enrolled in the research/EBP course was invited to participate in the study. Study outcomes were measured using the Evidence-Based Practice Questionnaire (EBPQ) before and after completing the course. Descriptive statistics and paired-Samples t-test was used to assess the mean differences between pre-and post-test scores. Overall, students' post-test EBP scores were significantly improved over pre-test scores, t(63)=-9.034, p<0.001). Statistically significant differences were found for practice of EBP mean scores t(63)=-12.78, p=0.001). No significant differences were found between pre and post-tests on knowledge and attitudes toward EBP scores. Most frequently cited barriers to EBP were lack of understanding of statistics, interpretation of findings, lack of time, and lack of library resources. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Thematic Analysis of Health Care Workers' Adoption of Mindfulness Practices.

PubMed

Valley, Morgan; Stallones, Lorann

2018-05-01

Mindfulness training, which teaches individuals to bring awareness and acceptance to the present moment, has been effective in improving the well-being of health care workers. Limited research examines the adoption of mindfulness practices using health behavior theories. The current study sought to conceptualize hospital health care workers' experiences in adopting mindfulness practices using the Health Belief Model (HBM), a theoretical framework used by health promotion practitioners to design and implement health behavior change interventions. Hospital health care workers in Colorado participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) course. Participants ( n = 19) answered open-ended questions about their experiences adopting mindfulness practices. A theory-driven thematic analysis approach was used to analyze data with key constructs of the HBM acting as the framework for the analysis. Results showed that HBM constructs, including internal cues to action, perceived benefits and barriers, and self-efficacy, helped portray the participants' experiences and challenges in adopting and adhering to the mindfulness practices taught in the MBSR course.

Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

PubMed

Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

2015-08-01

Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

Professional values and competencies as explanatory factors for the use of evidence-based practice in nursing.

PubMed

Skela-Savič, Brigita; Hvalič-Touzery, Simona; Pesjak, Katja

2017-08-01

To establish the connection between values, competencies, selected job characteristics and evidence-based practice use. Nurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies. A cross-sectional, non-experimental quantitative explorative research design. Standardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015. The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low. Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association. © 2017 John Wiley & Sons Ltd.

Pressure ulcers: implementation of evidence-based nursing practice.

PubMed

Clarke, Heather F; Bradley, Chris; Whytock, Sandra; Handfield, Shannon; van der Wal, Rena; Gundry, Sharon

2005-03-01

A 2-year project was carried out to evaluate the use of multi-component, computer-assisted strategies for implementing clinical practice guidelines. This paper describes the implementation of the project and lessons learned. The evaluation and outcomes of implementing clinical practice guidelines to prevent and treat pressure ulcers will be reported in a separate paper. The prevalence and incidence rates of pressure ulcers, coupled with the cost of treatment, constitute a substantial burden for our health care system. It is estimated that treating a pressure ulcer can increase nursing time up to 50%, and that treatment costs per ulcer can range from US$10,000 to $86,000, with median costs of $27,000. Although evidence-based guidelines for prevention and optimum treatment of pressure ulcers have been developed, there is little empirical evidence about the effectiveness of implementation strategies. The study was conducted across the continuum of care (primary, secondary and tertiary) in a Canadian urban Health Region involving seven health care organizations (acute, home and extended care). Trained surveyors (Registered Nurses) determined the prevalence and incidence of pressure ulcers among patients in these organizations. The use of a computerized decision-support system assisted staff to select optimal, evidence-based care strategies, record information and analyse individual and aggregate data. Evaluation indicated an increase in knowledge relating to pressure ulcer prevention, treatment strategies, resources required, and the role of the interdisciplinary team. Lack of visible senior nurse leadership; time required to acquire computer skills and to implement new guidelines; and difficulties with the computer system were identified as barriers. There is a need for a comprehensive, supported and sustained approach to implementation of evidence-based practice for pressure ulcer prevention and treatment, greater understanding of organization-specific barriers, and

Clinical nurse specialist practice domains and evidence-based practice competencies: a matrix of influence.

PubMed

Kring, Daria L

2008-01-01

The purpose of this article is to describe master's-level evidence-based practice (EBP) competencies as determined by a national consensus panel and present an EBP matrix that illustrates the influence that the clinical nurse specialist (CNS) practice can have on driving EBP change. Evidence-based practice is a growing and necessary paradigm for nursing care. The ACE Star Model conceptualizes the knowledge transformation that must occur in an EBP environment as 5 distinct points: discovery, summary, translation, integration, and evaluation. Master's-level EBP competencies based on these 5 steps were established by a national consensus panel. The CNS's practice can be organized around 5 domains: expert practitioner, researcher, consultant, educator, and leader. The master's-level EBP competencies can be transposed on a crosswalk of the ACE Star Model and the 5 CNS practice domains to form a matrix representing the influence that CNSs can have over the EBP process. Each competency falls well within the practice domains of the CNS, making the CNS an ideal person to lead the EBP movement forward, providing tangible outcomes to further demonstrate the need for the CNS role.

CDMBE: A Case Description Model Based on Evidence

PubMed Central

Zhu, Jianlin; Yang, Xiaoping; Zhou, Jing

2015-01-01

By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE), which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users' ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model. PMID:26421006

Evidence-based health promotion: applying it in practice.

PubMed

Wong, M L

2002-09-01

In health promotion, we should use interventions established by evidence to be effective in improving the health of the community. This paper reviews the concepts, evaluation and use of evidence in health promotion. A literature search of evidence-based health promotion and evaluation of health promotion was conducted using Medline, Social Science Citation Index (SSCI), PsycLIT and evidence-based web sites on health promotion, health education and community preventive services. Recent issues of key journals on health promotion, health education and public health were also hand-searched. The concept of evidence in health promotion interventions is complex due to its multidimensional nature. Evidence of effectiveness in health promotion is assessed by combining quantitative data on effect change in outcome measures and qualitative data on process evaluation of health promotion activities. Limitations to the use of randomised trials in community-based health promotion interventions include ethical and logistic problems in maintaining randomisation of subjects over long periods, absence of experimental conditions in the real-world setting, contamination of control subjects and the multidimensional nature of health promotion interventions. Randomised controlled trials should be used to evaluate the effectiveness of most health education and behavioural interventions in clinical settings. When such trials are not feasible as in community-based health promotion interventions, quasi-experimental designs provide strong evidence. Multiple methods are needed to assess evidence of effectiveness of health promotion programmes. Appropriate practice of evidence-based health promotion requires consideration of quality of available evidence, local values and prevailing resources.

The Effects of Practice-Based Training on Graduate Teaching Assistants' Classroom Practices.

PubMed

Becker, Erin A; Easlon, Erin J; Potter, Sarah C; Guzman-Alvarez, Alberto; Spear, Jensen M; Facciotti, Marc T; Igo, Michele M; Singer, Mitchell; Pagliarulo, Christopher

2017-01-01

Evidence-based teaching is a highly complex skill, requiring repeated cycles of deliberate practice and feedback to master. Despite existing well-characterized frameworks for practice-based training in K-12 teacher education, the major principles of these frameworks have not yet been transferred to instructor development in higher educational contexts, including training of graduate teaching assistants (GTAs). We sought to determine whether a practice-based training program could help GTAs learn and use evidence-based teaching methods in their classrooms. We implemented a weekly training program for introductory biology GTAs that included structured drills of techniques selected to enhance student practice, logic development, and accountability and reduce apprehension. These elements were selected based on their previous characterization as dimensions of active learning. GTAs received regular performance feedback based on classroom observations. To quantify use of target techniques and levels of student participation, we collected and coded 160 h of video footage. We investigated the relationship between frequency of GTA implementation of target techniques and student exam scores; however, we observed no significant relationship. Although GTAs adopted and used many of the target techniques with high frequency, techniques that enforced student participation were not stably adopted, and their use was unresponsive to formal feedback. We also found that techniques discussed in training, but not practiced, were not used at quantifiable frequencies, further supporting the importance of practice-based training for influencing instructional practices. © 2017 E. A. Becker et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License

Antibiotics and Facial Fractures: Evidence-Based Recommendations Compared with Experience-Based Practice

PubMed Central

Mundinger, Gerhard S.; Borsuk, Daniel E.; Okhah, Zachary; Christy, Michael R.; Bojovic, Branko; Dorafshar, Amir H.; Rodriguez, Eduardo D.

2014-01-01

Efficacy of prophylactic antibiotics in craniofacial fracture management is controversial. The purpose of this study was to compare evidence-based literature recommendations regarding antibiotic prophylaxis in facial fracture management with expert-based practice. A systematic review of the literature was performed to identify published studies evaluating pre-, peri-, and postoperative efficacy of antibiotics in facial fracture management by facial third. Study level of evidence was assessed according to the American Society of Plastic Surgery criteria, and graded practice recommendations were made based on these assessments. Expert opinions were garnered during the Advanced Orbital Surgery Symposium in the form of surveys evaluating senior surgeon clinical antibiotic prescribing practices by time point and facial third. A total of 44 studies addressing antibiotic prophylaxis and facial fracture management were identified. Overall, studies were of poor quality, precluding formal quantitative analysis. Studies supported the use of perioperative antibiotics in all facial thirds, and preoperative antibiotics in comminuted mandible fractures. Postoperative antibiotics were not supported in any facial third. Survey respondents (n = 17) cumulatively reported their antibiotic prescribing practices over 286 practice years and 24,012 facial fracture cases. Percentages of prescribers administering pre-, intra-, and postoperative antibiotics, respectively, by facial third were as follows: upper face 47.1, 94.1, 70.6; midface 47.1, 100, 70.6%; and mandible 68.8, 94.1, 64.7%. Preoperative but not postoperative antibiotic use is recommended for comminuted mandible fractures. Frequent use of pre- and postoperative antibiotics in upper and midface fractures is not supported by literature recommendations, but with low-level evidence. Higher level studies may better guide clinical antibiotic prescribing practices. PMID:25709755

Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans.

PubMed

Maxwell, Annette E; Danao, Leda L; Cayetano, Reggie T; Crespi, Catherine M; Bastani, Roshan

2014-03-12

Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption - the proportion and representativeness of organizations that decided to implement the program. During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having≥150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14=79%) and among organizations that were referred to us by community partners (5/10=50%) and lowest among new organizations (6/20=30%). Few organizational differences were found between adopters and non-adopters. The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings.

Relationships between evidence-based practice, quality improvement and clinical error experience of nurses in Korean hospitals.

PubMed

Hwang, Jee-In; Park, Hyeoun-Ae

2015-07-01

This study investigated individual and work-related factors associated with nurses' perceptions of evidence-based practice (EBP) and quality improvement (QI), and the relationships between evidence-based practice, quality improvement and clinical errors. Understanding the factors affecting evidence-based practice and quality improvement activities and their relationships with clinical errors is important for designing strategies to promote evidence-based practice, quality improvement and patient safety. A cross-sectional survey was conducted with 594 nurses in two Korean teaching hospitals using the evidence-based practice Questionnaire and quality improvement scale developed in this study. Four hundred and forty-three nurses (74.6%) returned the completed survey. Nurses' ages and educational levels were significantly associated with evidence-based practice scores whereas age and job position were associated with quality improvement scores. There were positive, moderate correlations between evidence-based practice and quality improvement scores. Nurses who had not made any clinical errors during the past 12 months had significantly higher quality improvement skills scores than those who had. The findings indicated the necessity of educational support regarding evidence-based practice and quality improvement for younger staff nurses who have no master degrees. Enhancing quality improvement skills may reduce clinical errors. Nurse managers should consider the characteristics of their staff when implementing educational and clinical strategies for evidence-based practice and quality improvement. © 2013 John Wiley & Sons Ltd.

Building Capacity for Evidence-Based Practice: Understanding How Licensed Practical Nurses (LPNs) Source Knowledge.

PubMed

Phillips, Leah; Neumeier, Melanie

2018-03-23

In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses' (LPNs') information seeking behaviors or preferred sources of knowledge to conduct EBP. Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice. A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment. LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice. Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Evidence-Based Rehabilitation Counseling Practice: A Pedagogical Imperative

ERIC Educational Resources Information Center

Kosciulek, John F.

2010-01-01

This article describes how rehabilitation educators can aid students and practitioners in learning about and engaging in evidence-based rehabilitation counseling practice (EBRCP). Information describing (a) the definition and rationale for EBRCP, (b) controversies surrounding EBRCP, (c) facilitating rehabilitation counselor enthusiasm for EBRCP,…

Pulmonary Metastasectomy: A Common Practice Based on Weak Evidence

PubMed Central

Treasure, Tom

2007-01-01

The resection of secondary metastases from the lungs is a wide-spread surgical practice. Patients are referred from coloproctology teams to thoracic surgeons specifically for this surgery. What is the expected benefit? I have explored the rationale and searched the literature in order to present these patients with a well-informed opinion for their consideration. I find only weak evidence based on uncontrolled retrospective series which have been interpreted as showing a survival benefit. This has been extrapolated to policy and practice that do not stand up to scrutiny. The practice has never been subjected to randomised trial and I will argue that the present evidence is insufficient to justify the uncontrolled use of an intervention with inescapable short-term morbidity, permanent loss of function, and major cost implications. I propose ways in which the evidence may be improved, including a trial in the areas of most uncertainty. PMID:17999813

Cross-sectional study to examine evidence-based practice skills and behaviors of physical therapy graduates: is there a knowledge-to-practice gap?

PubMed

Manns, Patricia J; Norton, Amy V; Darrah, Johanna

2015-04-01

Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. A cross-sectional study with 4 graduating cohorts was conducted. Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1-15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. This study used a convenience sample of therapists who agreed to volunteer for the study. The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings. © 2015 American Physical Therapy Association.

[Obstacles perceived by nurses for evidence-based practice: a qualitative study].

PubMed

Sánchez-García, Inmaculada; López-Medina, Isabel M; Pancorbo-Hidalgo, Pedro L

2013-01-01

To examine the obstacles perceived by nurses to implement an evidence-based clinical practice. A qualitative study through semi-structured interviews conducted in 2010-2011 including 11 nurses purposively selected from public hospitals and community centres in Jaén and Córdoba (Spain). A content analysis was performed, using Miles and Huberman as a reference and comprising the following steps: data reduction, data presentation, and data conclusion/verification. Data saturation was reached in these categories (obstacles). The obstacles perceived by nurses to introduce an evidence-based clinical practice (EBCP) were grouped into 3 major categories: obstacles related with professionals (routine-based practice, unwilling and stagnant attitudes, and lack of training in EBCP), obstacles related to the social context (reluctance from other professionals and from patients or families), and obstacles related to the organization (obsolete cultures that do not promote innovation in nursing care). This study highlights the persistence of various factors that hinder the use of research findings in clinical practice. The results underline the need to change the culture of healthcare organizations, to motivate professionals, and to break some of the resistance attitudes that hinder the implementation of evidence-based practice. Copyright © 2012 Elsevier España, S.L. All rights reserved.

The STROBE statement and neuropsychology: lighting the way toward evidence-based practice.

PubMed

Loring, David W; Bowden, Stephen C

2014-01-01

Reporting appropriate research detail across clinical disciplines is often inconsistent or incomplete. Insufficient report detail reduces confidence in findings, makes study replication more difficult, and decreases the precision of data available for critical review including meta-analysis. In response to these concerns, cooperative attempts across multiple specialties have developed explicit research reporting standards to guide publication detail. These recommendations have been widely adopted by high impact medical journals, but have not yet been widely embraced by neuropsychology. The STROBE Statement (STrengthening the Reporting of Observational studies in Epidemiology) is particularly relevant to neuropsychology since clinical research is often based on non-funded studies of patient samples. In this paper we describe the STROBE Statement and demonstrate how STROBE criteria, applied to reporting of neuropsychological findings, will maintain neuropsychology's position as a leader in quantifying brain-behavior relationships. We also provide specific recommendations for data reporting and disclosure of perceived conflicts of interest that will further enhance reporting transparency for possible perceived sources of bias. In an era in which evidence-based practice assumes an increasingly prominent role, improved reporting standards will promote better patient care, assist in developing quality practice guidelines, and ensure that neuropsychology remains a vigorous discipline in the clinical neurosciences that consciously aspires to high methodological rigor.

Clinical review: Checklists - translating evidence into practice

PubMed Central

2009-01-01

Checklists are common tools used in many industries. Unfortunately, their adoption in the field of medicine has been limited to equipment operations or part of specific algorithms. Yet they have tremendous potential to improve patient outcomes by democratizing knowledge and helping ensure that all patients receive evidence-based best practices and safe high-quality care. Checklist adoption has been slowed by a variety of factors, including provider resistance, delays in knowledge dissemination and integration, limited methodology to guide development and maintenance, and lack of effective technical strategies to make them available and easy to use. In this article, we explore some of the principles and possible strategies to further develop and encourage the implementation of checklists into medical practice. We describe different types of checklists using examples and explore the benefits they offer to improve care. We suggest methods to create checklists and offer suggestions for how we might apply them, using some examples from our own experience, and finally, offer some possible directions for future research. PMID:20064195

Reconciling evidence-based practice and cultural competence in mental health services: introduction to a special issue.

PubMed

Gone, Joseph P

2015-04-01

The calls for evidence-based practice (EBP) and cultural competence (CC) represent two increasingly influential mandates within the mental health professions. Advocates of EBP seek to standardize clinical practice by ensuring that only treatment techniques that have demonstrated therapeutic outcomes under scientifically controlled conditions would be adopted and promoted in mental health services. Advocates of CC seek to diversify clinical practice by ensuring that treatment approaches are designed and refined for a multicultural clientele that reflects a wide variety of psychological orientations and life experiences. As these two powerful mandates collide, the fundamental challenge becomes how to accommodate substantive cultural divergences in psychosocial experience using narrowly prescriptive clinical practices and approaches, without trivializing either professional knowledge or cultural difference. In this Introduction to a special issue of Transcultural Psychiatry, the virtue of an interdisciplinary conversation between and among anthropologists, psychologists, psychiatrists, and social work researchers in addressing these tensions is extolled. © The Author(s) 2015.

Concept and practice of evidence-based psychiatry and its application in Nigerian psychiatry: a critical review.

PubMed

Onifade, P O; Oluwole, L O

2006-01-01

The practice of Evidence-Based Psychiatry started in the 1990's, however prior to this time the practice of psychiatry did have an evidenced base though not structured and systematically spelt out. This study aimed to review the development of the concept and practice of Evidence-Based Psychiatry and to identify position of Nigerian psychiatry in it. Narrative reviews were made from information obtained from scientific publications i.e. (books and journals) and internet-based electronic articles. Evidence-Based Psychiatry emerged from Evidence-Based Medicine in the 1990's and aims to base practice on the best available evidence. The evidence is graded into A, B, and C, depending on the study design. Also critical to the practice of Evidence-Based Psychiatry is the availability of high-grade evidence and an efficient means of storing and retrieving it. Evidence-Based Psychiatry uses a systematic approach and involves five steps. Its scope covers aetiology, diagnosis, intervention, and prognosis. A comprehensive definition of Evidence-Based Psychiatry is given. There is a suggestion to change the term 'Evidence-Based' to 'Systematic Evidence-Based'. The right way to determine if a therapeutic intervention is evidence-based is to consider if the process that led to it is systematic in terms of the five steps of Evidence-Based Psychiatry. Nigeria is yet to develop structures required for Systematic Evidence-Based Psychiatry.

PROMISE AND PLAUSIBILITY: HEALTH TECHNOLOGY ADOPTION DECISIONS WITH LIMITED EVIDENCE.

PubMed

Campbell, Bruce; Knox, Paul

2016-01-01

The adoption of new medical devices and diagnostics is often hampered by lack of published evidence which makes conventional health technology assessment (HTA) difficult. We now have 5 years' experience of the Medical Technologies Advisory Committee of the National Institute for Health and Care Excellence (NICE) in the United Kingdom, addressing this problem. This committee assesses devices and diagnostics against claims of advantage, to produce guidance on adoption for the health service. We have reflected on the practical, technical, and intellectual processes we have used in developing guidance for the health service. When scientific and clinical evidence is sparse, promise and plausibility play an increased part in decision-making. Drivers of promise include a clear design and mechanism of action, the possibility of radical improvement in care and/or resource use, and improving health outcomes for large numbers of patients. Plausibility relates to judgements about the whether the promise is likely to be delivered in a "real world" setting. Promise and plausibility need to be balanced against the amount of evidence available. We examine the influence they may have on decision-making compared with other factors such as risk and cost. Decisions about adoption of new devices and diagnostics with little evidence are influenced by judgements of their promise and the plausibility of claims that they will provide benefits in a real-world setting. This kind of decision making needs to be transparent and this article explains how these influences can be balanced against the use of more familiar criteria.

A university and health care organization partnership to prepare nurses for evidence-based practice.

PubMed

Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A

2010-08-01

This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.

Evidence-Based Implementation: The Role of Sustained Community-Based Practice and Research Partnerships

PubMed Central

Kilbourne, Amy M.; Neumann, Mary Spink; Waxmonsky, Jeanette; Bauer, Mark S.; Kim, Hyungin Myra; Pincus, Harold Alan; Thomas, Marshall

2017-01-01

This column describes a process for adapting an evidence-based practice in community clinics in which researchers and community providers participated and the resulting framework for implementation of the practice—Replicating Effective Programs–Facilitation. A two-day meeting for the Recovery-Oriented Collaborative Care study was conducted to elicit input from more than 50 stakeholders, including community providers, health care administrators, and implementation researchers. The process illustrates an effective researcher-community partnership in which stakeholders worked together not only to adapt the evidence-based practice to the needs of the clinical settings but also to develop the implementation strategy. PMID:22388527

Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

PubMed Central

Welch, Cailee E.; Hankemeier, Dorice A.; Wyant, Aimee L.; Hays, Danica G.; Pitney, William A.; Van Lunen, Bonnie L.

2014-01-01

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs

Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

PubMed Central

Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

2013-01-01

Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

Evidence-Based Practice in Liposuction.

PubMed

Collins, Patrick S; Moyer, Kurtis E

2018-06-01

The goal of this study is to examine the existing peer reviewed literature comparing modern adjunctive techniques in liposuction including laser-assisted liposuction (LAL) and ultrasound-assisted liposuction (UAL) to standard suction-assisted liposuction (SAL). We intend to interpret these findings into a literature-based clinical application to influence practice patterns. A literature review was conducted using a keyword search in PubMed. Keyword search items included liposuction, lipoplasty, suction assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction, tumescent, liposuction comparison, liposuction review, and combinations therein. Exclusion criteria included articles with a primary focus on histologic effects of energy devices, primary animal models, primary opinion papers with no reference to available data, and industry-sponsored publications. Inclusion criteria included articles with direct comparison of liposuction modalities, randomized or blinded studies, and studies with objective outcomes. Twenty-five articles that met the inclusion criteria comparing SAL to UAL or LAL out of 9972 articles identified were obtained. The selected literature was assigned into 3 categories: evidence demonstrating an advantage of 1 modality (SAL, UAL, or LAL) over another, evidence that showed no benefit of 1 modality over another, and evidence that demonstrated risks of complications of 1 modality over another. The benefits of UAL and LAL over SAL include the following: (1) UAL over SAL in the treatment of gynecomastia, (2) LAL and UAL over SAL with decreased hemoglobin/hematocrit in high-volume lipoaspirates, and (3) LAL over SAL with skin tightening in select areas specifically the submental area. Otherwise, the literature demonstrates equivocal results among the described techniques with no clear benefit to set one apart from the other. There appears to be no demonstrable added benefit to the addition of either UAL or LAL that would urge a

Evidence-based ethics? On evidence-based practice and the "empirical turn" from normative bioethics

PubMed Central

Goldenberg, Maya J

2005-01-01

Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for

Practice to research: integrating evidence-based practices with culture and context.

PubMed

Weisner, Thomas S; Hay, M Cameron

2015-04-01

There are ways to integrate culturally competent services (CCS) and evidence-based practices (EBP) which can improve the experiences of patients and their families and communities when faced with health problems, as well as the effectiveness and positive experiences of practitioners. CCS and EBP evidence should be jointly deployed for helping patients and clinicians. Partnership research models are useful for achieving the integration of CCS and EBP, since they involve close observation of and participation by clinicians and practitioners in the research process, and often use integrated qualitative and quantitative mixed methods. We illustrate this with 3 examples of work that can help integrate CCS and EBP: ongoing collection of information from patients, clinicians and staff, or "evidence farming"; close study and continuous improvement of activities and accommodations; and use of evidence of tacit, implicit cultural scripts and norms, such as being "productive," as well as explicit scripts. From a research practice point of view, collaborative partnerships will likely produce research with culture and context bracketed in, and will contribute stronger research models, methods, and units of analysis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Evidence-based treatments in child and adolescent psychiatry: an inventory.

PubMed

McClellan, Jon M; Werry, John Scott

2003-12-01

To provide a list of evidence-based psychopharmacology and psychotherapy treatments for child psychiatry. Published reviews and Medline searches were examined to generate a list of treatments supported by randomized controlled trials. For psychopharmacology, the best evidence to date supports the use of stimulant medications for attention-deficit/hyperactivity disorder and selective serotonin reuptake inhibitors (SSRIs) for obsessive-compulsive disorder. There is also reasonable evidence addressing SSRIs for anxiety disorders and moderate to severe major depressive disorder, and risperidone for autism. The psychosocial interventions best supported by well-designed studies are cognitive-behavioral and behavioral interventions, especially for mood, anxiety, and behavioral disorders. Family-based and systems of care interventions also have been found effective. Although the number of evidence-based treatments for child psychiatry is growing, much of clinical practice remains based on the adult literature and traditional models of care. Challenges toward adopting evidence-based practices are discussed.

Nurses' perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran.

PubMed

Shafiei, Ebrahim; Baratimarnani, Ahmad; Goharinezhad, Salime; Kalhor, Rohollah; Azmal, Mohammad

2014-01-01

Evidence-based practice (EBP) provides nurses a method to use critically appraised and scientifically proven evidence for delivering quality health care and the best decision that leads to quality outcomes. The purpose of this study was to measure the practice, attitude and knowledge/skill of evidence-based practice of nurses in a teaching hospital in Iran. This cross-sectional study was conducted in 2011.The study sample was composed of 195 nurses who were working at the Fatemeh Zahra Hospital affiliated to Bushehr University of Medical Sciences (BPUMS). The survey instrument was a questionnaire based on Upton and Upton study. This tool measures Nurses' perceptions in the three sub-scales of practice, attitude and knowledge/skill of evidence-based practice. Descriptive statistical analysis was used to analyze the data. Pearson correlation coefficients were used to examine the relationship between subscales. The overall mean score of the evidence-based practice in this study was 4.48±1.26 from 7, and the three subscales of practice, attitude and knowledge/skill in evidence-based practice were, 4.58±1.24, 4.57±1.35 and 4.39±1.20, respectively. There was a strong relationship between knowledge and performance subscale (r=0.73,p<0.01). Findings of the study indicate that more training and education are required for evidence-based nursing. Successful implementation of evidence-based nursing depends on organizational plans and empowerment programs in hospitals. Hence, hospital managers should formulate a comprehensive strategy for improving EBP.

Development of a competency framework for evidence-based practice in nursing.

PubMed

Leung, Kat; Trevena, Lyndal; Waters, Donna

2016-04-01

The measurement of competence in evidence-based practice (EBP) remains challenging to many educators and academics due to the lack of explicit competency criteria. Much uncertainty exists about what specific EBP competencies nurses should meet and how these should be measured. The objectives of this study are to develop a competency framework for measuring evidence-based knowledge and skills in nursing and to elicit the views of health educators/researchers about elements within the framework. A descriptive survey design with questionnaire. Between August and December 2013, forty-two health academics/educators, clinicians; and researchers from the medical and nursing schools at the University of Sydney and the Nurse Teacher's Society in Australia were invited to comment on proposed elements for measuring evidence-based knowledge and skills. The EBP competency framework was designed to measure nurses' knowledge and skills for using evidence in practice. Participants were invited to rate their agreement on the structure and relevance of the framework and to state their opinion about the measurement criteria for evidence-based nursing practice. Participant agreement on the structure and relevance of the framework was substantial, ICC: 0.80, 95% CI: 0.67-0.88, P<0.0001. Qualitative analysis of two open-ended survey questions revealed three common themes in participants' opinion of the competency elements: (1) a useful EBP framework; (2) varying expectations of EBP competence; and (3) challenges to EBP implementation. The findings of this study suggested that the EBP competency framework is of credible value for facilitating evidence-based practice education and research in nursing. However, there remains some uncertainty and disagreement about the levels of EBP competence required for nurses. These challenges further implicate the need for setting a reasonable competency benchmark with a broader group of stakeholders in nursing. Copyright © 2016 Elsevier Ltd. All

Evidence-based practice for pain identification in cognitively impaired nursing home residents.

PubMed

Sacoco, Christina; Ishikawa, Sally

2014-09-01

Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. Copyright © 2014 Elsevier Inc. All rights reserved.

Single-Subject Experimental Design for Evidence-Based Practice

ERIC Educational Resources Information Center

Byiers, Breanne J.; Reichle, Joe; Symons, Frank J.

2012-01-01

Purpose: Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research. Method: The authors…

[Practice-based evidence in prevention and health promotion among socially disadvantaged communities].

PubMed

Wright, M T; Kilian, H; Brandes, S

2013-06-01

In recent years numerous health promotion and prevention efforts have been created for socially disadvantaged communities. There is a broad consensus that such measures should be scientifically sound; however, the criteria for evidence-based medicine (EBM) have been shown to have limited applicability in this area. It is widely debated which scientific approaches are most appropriate. Several authors have called for the production of "practice-based evidence"(PBE) as an alternative, focusing on ways to produce evidence based directly on practical experience. Implied is a variety of methodological and epistemological approaches for generating knowledge about the effectiveness of interventions. In contrast to the usual means of generating evidence, PBE suggests that practitioners instead of researchers take on the leading role in the generation and interpretation of intervention data. To date, PBE is an idea in need of further definition, both in terms of theory and practice. On the basis of recent research the authors present a definition for PBE and a model for how it could be generated. The authors propose an "Evidence Cycle" which would synthesize the findings from local evaluations for the purpose of generating practice guidelines (Good Practice Criteria) which can be developed in an ongoing way as new data becomes available. In this way local theories of disease causation and development and local evidence for intervention effectiveness could be drawn together to produce empirically-based, generalizable statements about effective health promotion and prevention for disadvantaged communities. © Georg Thieme Verlag KG Stuttgart · New York.

Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans

PubMed Central

2014-01-01

Background Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption – the proportion and representativeness of organizations that decided to implement the program. Methods During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having ≥ 150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Results Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14 = 79%) and among organizations that were referred to us by community partners (5/10 = 50%) and lowest among new organizations (6/20 = 30%). Few organizational differences were found between adopters and non-adopters. Conclusions The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings. PMID:24618267

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

PubMed

Oh, Eui Geum; Kim, Sunah; Kim, So Sun; Kim, Sue; Cho, Eun Yong; Yoo, Ji-Soo; Kim, Hee Soon; Lee, Ju Hee; You, Mi Ae; Lee, Hyejung

2010-07-01

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum. Copyright 2010, SLACK Incorporated.

The professional clothing bank as evidence-based practice.

PubMed

Bishop, SueZanne Monique

2015-01-01

Little research exists linking interview-appropriate attire to improved employment outcomes for women. Thus, it appears that the professional clothing bank has not been investigated as evidence-based practice. To provide preliminary evidence for clothing banks, in this article the author synthesizes findings from existing research on the provision of a professional clothing bank as a means for offering interview-appropriate attire to poor women in job readiness programming. For context, job readiness programs are explored and a case study of one program operating a professional clothing bank is presented. Finally, preliminary considerations for planning and implementing clothing banks based on this literature review are given.

Clinical data warehousing for evidence based decision making.

PubMed

Narra, Lekha; Sahama, Tony; Stapleton, Peta

2015-01-01

Large volumes of heterogeneous health data silos pose a big challenge when exploring for information to allow for evidence based decision making and ensuring quality outcomes. In this paper, we present a proof of concept for adopting data warehousing technology to aggregate and analyse disparate health data in order to understand the impact various lifestyle factors on obesity. We present a practical model for data warehousing with detailed explanation which can be adopted similarly for studying various other health issues.

Staff views on supporting evidence based practice for children with ASD.

PubMed

Trembath, David; Sulek, Rhylee; Paynter, Jessica; Simpson, Kate; Keen, Deb

2017-11-22

A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Two central themes, comprising six categories, emerged to account for the participants' views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

Query-oriented evidence extraction to support evidence-based medicine practice.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cecile

2016-02-01

Evidence-based medicine practice requires medical practitioners to rely on the best available evidence, in addition to their expertise, when making clinical decisions. The medical domain boasts a large amount of published medical research data, indexed in various medical databases such as MEDLINE. As the size of this data grows, practitioners increasingly face the problem of information overload, and past research has established the time-associated obstacles faced by evidence-based medicine practitioners. In this paper, we focus on the problem of automatic text summarisation to help practitioners quickly find query-focused information from relevant documents. We utilise an annotated corpus that is specialised for the task of evidence-based summarisation of text. In contrast to past summarisation approaches, which mostly rely on surface level features to identify salient pieces of texts that form the summaries, our approach focuses on the use of corpus-based statistics, and domain-specific lexical knowledge for the identification of summary contents. We also apply a target-sentence-specific summarisation technique that reduces the problem of underfitting that persists in generic summarisation models. In automatic evaluations run over a large number of annotated summaries, our extractive summarisation technique statistically outperforms various baseline and benchmark summarisation models with a percentile rank of 96.8%. A manual evaluation shows that our extractive summarisation approach is capable of selecting content with high recall and precision, and may thus be used to generate bottom-line answers to practitioners' queries. Our research shows that the incorporation of specialised data and domain-specific knowledge can significantly improve text summarisation performance in the medical domain. Due to the vast amounts of medical text available, and the high growth of this form of data, we suspect that such summarisation techniques will address the time

Evidence-Based Review of Wilderness First Aid Practices

ERIC Educational Resources Information Center

Schimelpfenig, Tod; Johnson, David E.; Lipman, Grant S.; McEvoy, David H.; Bennett, Brad L.

2017-01-01

Wilderness First Aid is a common certification for outdoor recreationists, educators, and trip leaders. A panel of educators, researchers, and clinicians evaluated 15 core and eight elective WFA practices for strength of recommendations based on the quality of supporting evidence and balance between the benefits and risks/burdens according to the…

Evidence-based practice for mere mortals: the role of informatics and health services research.

PubMed

Sim, Ida; Sanders, Gillian D; McDonald, Kathryn M

2002-04-01

The poor translation of evidence into practice is a well-known problem. Hopes are high that information technology can help make evidence-based practice feasible for mere mortal physicians. In this paper, we draw upon the methods and perspectives of clinical practice, medical informatics, and health services research to analyze the gap between evidence and action, and to argue that computing systems for bridging this gap should incorporate both informatics and health services research expertise. We discuss 2 illustrative systems--trial banks and a web-based system to develop and disseminate evidence-based guidelines (alchemist)--and conclude with a research and training agenda.

Three Collaborative Models for Scaling Up Evidence-Based Practices

PubMed Central

Roberts, Rosemarie; Jones, Helen; Marsenich, Lynne; Sosna, Todd; Price, Joseph M.

2015-01-01

The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed. PMID:21484449

Measures for Predictors of Innovation Adoption

PubMed Central

Chor, Ka Ho Brian; Wisdom, Jennifer P.; Olin, Su-Chin Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.

2014-01-01

Building on a narrative synthesis of adoption theories by Wisdom et al. (2013), this review identifies 118 measures associated with the 27 adoption predictors in the synthesis. The distribution of measures is uneven across the predictors and predictors vary in modifiability. Multiple dimensions and definitions of predictors further complicate measurement efforts. For state policymakers and researchers, more effective and integrated measurement can advance the adoption of complex innovations such as evidence-based practices. PMID:24740175

Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol.

PubMed

Parsons Leigh, Jeanna; Niven, Daniel J; Boyd, Jamie M; Stelfox, Henry T

2017-01-19

descriptive using a combination of qualitative and quantitative analyses. There is a growing body of literature suggesting that the de-adoption of ineffective or harmful practices from patient care is integral to the delivery of high quality care and healthcare sustainability. The framework developed in this study will map barriers and facilitators to de-adoption to the most appropriate interventions, allowing stakeholders to effectively initiate, execute and sustain this process in an evidence-based manner.

Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments.

PubMed

Stern, Robert A; Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G; Alosco, Michael L; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C; Baugh, Christine M; Holsapple, James W

2017-02-15

Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting.

Concussion Care Practices and Utilization of Evidence-Based Guidelines in the Evaluation and Management of Concussion: A Survey of New England Emergency Departments

PubMed Central

Seichepine, Daniel; Tschoe, Christine; Fritts, Nathan G.; Alosco, Michael L.; Berkowitz, Oren; Burke, Peter; Howland, Jonathan; Olshaker, Jonathan; Cantu, Robert C.; Baugh, Christine M.; Holsapple, James W.

2017-01-01

Abstract Evidence-based clinical practice guidelines can facilitate proper evaluation and management of concussions in the emergency department (ED), often the initial and primary point of contact for concussion care. There is no universally adopted set of guidelines for concussion management, and extant evidence suggests that there may be variability in concussion care practices and limited application of clinical practice guidelines in the ED. This study surveyed EDs throughout New England to examine current practices of concussion care and utilization of evidence-based clinical practice guidelines in the evaluation and management of concussions. In 2013, a 32-item online survey was e-mailed to 149/168 EDs throughout New England (Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire, Maine). Respondents included senior administrators asked to report on their EDs use of clinical practice guidelines, neuroimaging decision-making, and discharge instructions for concussion management. Of the 72/78 respondents included, 35% reported absence of clinical practice guidelines, and 57% reported inconsistency in the type of guidelines used. Practitioner preference guided neuroimaging decision-making for 57%. Although 94% provided written discharge instructions, there was inconsistency in the recommended time frame for follow-up care (13% provided no specific time frame), the referral specialist to be seen (25% did not recommend any specialist), and return to activity instructions were inconsistent. There is much variability in concussion care practices and application of evidence-based clinical practice guidelines in the evaluation and management of concussions in New England EDs. Knowledge translational efforts will be critical to improve concussion management in the ED setting. PMID:27112592

Introducing research and evidence-based practice for nurses Jeremy Jolley Introducing research and evidence-based practice for nurses Pearson Education £19.99 168 9780273719168 0273719165 [Formula: see text].

PubMed

2011-04-15

EVIDENCE BASED practice is an increasingly hot topic and this book is timely because of both the move towards an all-graduate profession and the increase in the use of evidence in nursing. Nurses need to understand the relationship between research, evidence and practice and then to be able to use that understanding to provide the best possible care for the patient.

Implementing evidence-based practice during an economic downturn.

PubMed

Beck, Mary S; Staffileno, Beth A

2012-01-01

Building a sustainable evidence-based practice (EBP) infrastructure during times of financial constraints poses challenges for nurse leaders. To be successful, plans need to be creative and adaptive, while mindful of limited resources. This commentary describes change management strategies used to implement an EBP infrastructure at a hospital after organizational restructuring occurred.

Promoting evidence-based practice: managing change in the assessment of pressure damage risk.

PubMed

Gerrish, K; Clayton, J; Nolan, M; Parker, K; Morgan, L

1999-11-01

This study set out to facilitate the development of evidence-based practice in the assessment of pressure damage risk to patients within a large acute hospital. The importance of nursing practice being based on the best available evidence is emphasized in recent health policy. Meeting this objective is not easy as both individual and organizational factors create barriers to the implementation of research findings and the achievement of change. The study was based on an action research model. It comprised three stages: a review of the research evidence; a survey of qualified nurses' knowledge of risk assessment of pressure damage and an audit of record keeping, and a multifaceted approach to achieving change in which researchers, managers, practitioners and clinical nurse specialists worked together collaboratively. The findings from the survey and audit indicated a shortfall in nurses' knowledge of risk assessment of pressure damage and in their record keeping. The researchers, with the help of the clinical nurse specialist, built upon these findings by assisting practitioners and managers to take ownership of the need to base practice on the appropriate evidence. Achieving evidence-based practice is a complex undertaking that requires the development of an evaluative culture and a commitment by practitioners and managers to change practice. Researchers can play a valuable role in facilitating this process.

The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care

PubMed Central

Brodsky, Beth S.; Spruch-Feiner, Aliza; Stanley, Barbara

2018-01-01

Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS) Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP) as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods. PMID:29527178

Agency-University Partnership for Evidence-Based Practice in Social Work

ERIC Educational Resources Information Center

Bellamy, Jennifer L.; Bledsoe, Sarah E.; Mullen, Edward J.; Fang, Lin; Manuel, Jennifer I.

2008-01-01

Little is known about evidence-based practice (EBP) in social service agencies beyond studies of researcher, practitioner, and educator opinions. The Bringing Evidence for Social Work Training (BEST) Project involved 16 participants from 3 social service agencies. The experiential training, delivered by 2 doctoral students, focused on a…

Today's challenge, tomorrow's excellence: the practice of evidence-based education.

PubMed

Emerson, Roberta J; Records, Kathie

2008-08-01

Nurse educators are being challenged to maintain quality in light of increasing numbers of students, declining numbers of experienced faculty, societal mandates, and rapid changes in health care. The scholarship underlying the practice of nursing education, or evidence-based education, must continue to be explored through the design, testing, and refinement of education strategies from nursing and other disciplines. The involvement of every educator in this process will help create institutional valuing that serves to retain inquisitive and reflective educators in academic settings, while expanding evidence-based education in nursing. This article describes a literature review of the scholarship of nursing education practice and suggests approaches to generate a dynamic explosion of growth in nursing education to inform our students, promote optimal client health outcomes, and challenge each of us to reach higher levels of excellence in the practice of nursing education.

Why practice yoga? Practitioners' motivations for adopting and maintaining yoga practice.

PubMed

Park, Crystal L; Riley, Kristen E; Bedesin, Elena; Stewart, V Michelle

2016-06-01

We examined motives for adopting and maintaining yoga practice in a national survey of yoga practitioners (360 yoga students, 156 yoga teachers). Both students and teachers adopted yoga practice primarily for exercise and stress relief, but reported many other reasons, including flexibility, getting into shape, and depression/anxiety relief. Over 62 percent of students and 85 percent of teachers reported having changed their primary reason for practicing or discovering other reasons; for both, the top changed primary reason was spirituality. Findings suggest that most initiate yoga practice for exercise and stress relief, but for many, spirituality becomes their primary reason for maintaining practice. © The Author(s) 2014.

Supporting Evidence-Based Practice in Schools with an Online Database of Best Practices

ERIC Educational Resources Information Center

Powers, Joelle D.; Bowen, Natasha K.; Bowen, Gary L.

2011-01-01

In spite of multidisciplinary recommendations to use evidence-based interventions in schools and a growing knowledge base of such practices, most schools are not using empirically supported interventions. On the basis of a careful analysis of barriers to the implementation of the best researched programs, an online, free, and publicly available…

Adapting evidence-based interventions using a common theory, practices, and principles.

PubMed

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D

2014-01-01

Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.

Attitudes, knowledge and behavior of Japanese physical therapists with regard to evidence-based practice and clinical practice guidelines: a cross-sectional mail survey

PubMed Central

Fujimoto, Shuhei; Kon, Noriko; Takasugi, Jun; Nakayama, Takeo

2017-01-01

[Purpose] This study aimed to investigate Japanese physical therapists’ attitudes of evidence-based practice and clinical practice guidelines. [Subjects and Methods] In 2014, a cross-sectional postal mail survey using a self-administered questionnaire was conducted. Of 2,982 physical therapists belonging to the Chiba Prefecture Physical Therapist Association, 1,000 were randomly selected. The questionnaire comprised 42 items pertaining to the attitudes of and behavior toward evidence-based practice and clinical practice guidelines. It was investigated to reveal the relationship between clinical practice guidelines/evidence-based practice and therapist characteristics. [Results] The response rate was 39.6%, and 384 questionnaires were available. The main results were as follows: 83.3% participants agreed to the importance of evidence-based practice, 77.1% agree to that evidence-based practice supports clinical decision of physical therapists, and about 11% agreed to have been educated about evidence-based practice. Then, 29.2% used, 54.9% agreed to the importance of, and 13.3% agreed to the utility of clinical practice guidelines. An important factor related mostly to a positive attitude, knowledge and behavior of evidence-based practice and clinical practice guidelines was participating in research activities. [Conclusion] Many of physical therapists do not use and understand the importance of clinical practice guidelines. Participating in research activities may partially contribute to improving these conditions. PMID:28265139

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

The Application of Evidence-Based Practice to Nonspeech Oral Motor Treatments

ERIC Educational Resources Information Center

Lass, Norman J.; Pannbacker, Mary

2008-01-01

Purpose: The purpose of this article is to help speech-language pathologists (SLPs) apply the principles of evidence-based practice (EBP) to nonspeech oral motor treatments (NSOMTs) in order to make valid, evidence-based decisions about NSOMTs and thus determine if they are viable treatment approaches for the management of communication disorders.…

Evidence-Based Language Practice

ERIC Educational Resources Information Center

Pollock, Eric J.

2005-01-01

The purpose of this paper was to examine evidence-based procedures in medicine and to demonstrate that the same protocols can be used in English language instruction. In the evidence-based methodology, studies are divided into those that address specific language problems. Integrated studies are presented as a systematic overview, meta-analysis,…

Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

PubMed

McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

2015-12-01

Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

[Use of PubMed to improve evidence-based medicine in routine urological practice].

PubMed

Rink, M; Kluth, L A; Shariat, S F; Chun, F K; Fisch, M; Dahm, P

2013-03-01

Applying evidence-based medicine in daily clinical practice is the basis of patient-centered medicine and knowledge of accurate literature acquisition skills is necessary for informed clinical decision-making. PubMed is an easy accessible, free bibliographic database comprising over 21 million citations from the medical field, life-science journals and online books. The article summarizes the effective use of PubMed in routine urological clinical practice based on a common case scenario. This article explains the simple use of PubMed to obtain the best search results with the highest evidence. Accurate knowledge about the use of PubMed in routine clinical practice can improve evidence-based medicine and also patient treatment.

Are Online Sources for Identifying Evidence-Based Practices Trustworthy? An Evaluation

ERIC Educational Resources Information Center

Test, David W.; Kemp-Inman, Amy; Diegelmann, Karen; Hitt, Sara Beth; Bethune, Lauren

2015-01-01

The use of evidence-based practices has become a focus in education since the No Child Left Behind Act of 2001 and the Individuals with Disabilities Education Act reauthorization of 2004 required using practices based on scientific research to improve student outcomes. Although many teachers may not have the time or expertise to evaluate the…

Strategies to promote practice nurse capacity to deliver evidence-based care: An example from sexual healthcare.

PubMed

Dadich, Ann; Abbott, Penny; Hosseinzadeh, Hassan

2015-01-01

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice. A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare - namely, a clinical aide and online training. The perceived impact of both resources was determined by views on relevance and design - particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues. This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare. Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited. Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

Barriers Facing Physicians Practicing Evidence-Based Medicine in Saudi Arabia

ERIC Educational Resources Information Center

Al-Almaie, Sameeh M.; Al-Baghli, Nadira

2004-01-01

Introduction: Tremendous advances in health care have been made through the development of evidence-based medicine (EBM). Studies show that physicians face barriers in practice, preventing the effective use of the best evidence available. Insight into these barriers should pave the way for an action plan to remove them. The aim of this study was…

Assessing and Treating Pain in Hospices: Current State of Evidence-Based Practices

PubMed Central

Herr, Keela; Titler, Marita; Fine, Perry; Sanders, Sara; Cavanaugh, Joe; Swegle, John; Forcucci, Chris; Tang, Xiongwen

2010-01-01

The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index (CPPI), a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of the those key evidence-based practices (EBPs) that were applicable to their situation. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps including: additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the Pain Treatment Plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by pain medication increases (15.8%); monitoring of analgesic- induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both non-pharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices. PMID:20471542

A Critical Assessment of Evidence-Based Policy and Practice in Social Work.

PubMed

Diaz, Clive; Drewery, Sian

2016-01-01

In this article the authors consider how effective social work has been in terms of evidence-based policies and practice. They consider the role that "evidence" plays in policy making both in the wider context and, in particular, in relation to social work. The authors argue that there are numerous voices in the policy-making process and evidence only plays a minor role in terms of policy development and practice in social work.

Right at Your Fingertips: Important Web-Based Resources for Understanding Evidence-Based Practices

ERIC Educational Resources Information Center

Purper, Cammy J.

2016-01-01

The era of educational accountability has drawn attention to a need for the use of evidence-based practices (EBPs) in today's classrooms. The existence of a research-to-practice gap is well established in the field of early childhood education (ECE), and significant barriers to the use of EBPs by practitioners have been documented through…

Multisite Studies Demonstrate Positive Relationship Between Practice Environments and Smoking Cessation Counseling Evidence-Based Practices.

PubMed

Newhouse, Robin; Byon, Ha Do; Storkman Wolf, Emily; Johantgen, Meg

2018-06-01

High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices. Cross-sectional secondary analysis of survey data from two multisite studies. The sample included responses from registered nurses (N = 844) in 45 hospitals (22 rural hospitals from the Eastern United States and 23 Magnet hospitals across the United States). Linear mixed model was used to adjust intradependency among the responses of individual nurses nested within hospitals. Data were abstracted from survey responses including nurse characteristics, the Smoking Cessation Counseling Scale (SCCS), and the Practice Environment Scale-Nursing Work Index (PES). Increasing positive relationships exist between PES and SCCS total and subscales scores. Also, SCCS total scores were significantly related with favorable PES total scores (SCCS score difference of 0.26 between favorable and unfavorable PES scores, SE = .08, p = .002) controlling for other covariates. Non-White respondents (vs. White) demonstrated a positive association with SCCS total scores (difference of .18, SE = .07, p = .010), but not in advanced counseling. Nurse practice environments are positively associated with the use of evidence-based smoking cessation practices by nurses. As practice environments become more favorable, higher level counseling practices occur more often. Healthcare leaders should focus on enhancing the practice environment using a quality improvement approach and framework for evidence translation. Quality improvement initiatives should be prioritized in

Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India.

PubMed

Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap

2015-06-01

The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use

Developing evidence-based librarianship: practical steps for implementation.

PubMed

Crumley, Ellen; Koufogiannakis, Denise

2002-06-01

Evidence-based librarianship (EBL) is a relatively new concept for librarians. This paper lays out a practical framework for the implementation of EBL. A new way of thinking about research in librarianship is introduced using the well-built question process and the assignment of librarian research questions to one of six domains specific to librarianship. As a profession, librarianship tends to reflect more qualitative, social sciences/humanities in its research methods and study types which tend to be less rigorous and more prone to bias. Randomised controlled trials (RCT) do not have to be placed at the top of an evidence 'hierarchy' for librarianship. Instead, a more encompassing model reflecting librarianship as a whole and the kind of research likely to be done by librarians is proposed. 'Evidence' from a number of disciplines including health sciences, business and education can be utilized by librarians and applied to their practice. However, access to and availability of librarianship literature needs to be further studied. While using other disciplines (e.g. EBHC) as a model for EBL has been explored in the literature, the authors develop models unique to librarianship. While research has always been a minor focus in the profession, moving research into practice is becoming more important and librarians need to consider the issues surrounding research in order to move EBL forward.

Johns Hopkins nursing evidence-based practice Johns Hopkins nursing evidence-based practice Sandra L Dearholt and Deborah Dang Sigma Theta Tau International £24.70 256pp 9781935476764 1935476769 [Formula: see text].

PubMed

2012-10-26

EVIDENCE-BASED PRACTICE has become the accepted term for a systematic approach by all healthcare professionals to service provision. However, as this and other recent publications demonstrate, even though there is acceptance in theory that practice should be evidence based, making the concept a reality in clinical and educational settings still requires work.

Evidence-Based and Best Practice Addiction Treatment Resources: A Primer for Librarians.