Evidence-based practice

JStyles1 · Sep 8, 2009

get emails with new research articles from different organizations

read them

compare to other articles to see what the evidence shows

apply it to practice

i dont understand the question you are asking. are you wanting a specific example of something? like introducing sterile lubrication/lidocaine into the male urethra prior to catheterization?

Tweety, BSN, RN · Sep 8, 2009

We started using biopatches on our central lines because the evidence was out there that this helped to prevent infections.

We started brushing patients teeth on ventilators q4h because the evidence was out there that this decreased ventilator associated pneumonias

Help?

J9G2008 · Sep 8, 2009

Not my practice per se, since I'm still a student. But when my son had a trach, the common practice was to humidify the trach mask that went over his trach at night with warm mist. His second hospital researched this, set up an experiment, and found out that warm mist leads to more infection, since the water is a breeding ground for bacteria. So, we were told to switch him to room temperature mist, and he had no more respiratory infections. Yay, evidence-based practice!

sallieyaj · Sep 8, 2009

pineapple devil,

yes, a specific example will be very helpful.

thanks you

misswoosie · Sep 8, 2009

Yes, we no longer use anti-embolism stockings in our stroke patients because the evidence from the CLOTS II study showed no benefit.

RedCell · Sep 8, 2009

can anyone give me an example how you applied evidence-based practice to your clinical practice?

always carefully read literature you believe to be "evidence-based practice". studies are often biased and not always accurate. here is an example or parody on ebp that was published in the british medical journal.

smith gcs, pell jp. (2003). parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. bmj, 327(7429), 1459-1461.

objectives to determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

design systematic review of randomised controlled trials.

data sources: medline, web of science, embase, and the cochrane library databases; appropriate internet sites and citation lists.

study selection: studies showing the effects of using a parachute during free fall.

main outcome measure death or major trauma, defined as an injury severity score > 15.

results we were unable to identify any randomised controlled trials of parachute intervention.

conclusions as with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. we think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute:d

nminodob · Sep 9, 2009

That parody of EBP was hysterical - and properly makes fun of the inane lengths some researchers will go in order to be published! In school some students undertook a study on what effect on patient outcomes having your ID badge flipped backwards had -and they were serious!

GilaRRT · Sep 9, 2009

I was thinking about running my own study with regards to the parachute concept. Any volunteers for the control group?

misswoosie · Sep 9, 2009

always carefully read literature you believe to be "evidence-based practice". studies are often biased and not always accurate. here is an example or parody on ebp that was published in the british medical journal.
smith gcs, pell jp. (2003). parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. bmj, 327(7429), 1459-1461.
objectives to determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
design systematic review of randomised controlled trials.
data sources: medline, web of science, embase, and the cochrane library databases; appropriate internet sites and citation lists.
study selection: studies showing the effects of using a parachute during free fall.
main outcome measure death or major trauma, defined as an injury severity score > 15.
results we were unable to identify any randomised controlled trials of parachute intervention.
conclusions as with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. we think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute:d

yes -good to look at systematic reviews and national best practice guidelines

http://www.nice.org.uk/

http://www.cochrane.org/reviews/

these are both british, but will include international studies.sure there will be us ones too.

misswoosie · Sep 9, 2009

That parody of EBP was hysterical - and properly makes fun of the inane lengths some researchers will go in order to be published! In school some students undertook a study on what effect on patient outcomes having your ID badge flipped backwards had -and they were serious!

Aaah-research for researchs sake!

Very common-I think millions must be spent each year on worthless medical/nursing/healthcare research that will never translate into any benefit for anyone.