Improving Evidence-based Medicine in Dietetics: A Non-Traditional Approach
According to Sackett, (1996) evidence–based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about patient care. Straus, Richardson, Glasziou, & Haynes (2005, p. 1) described evidence-based practice (EBP) as “the integration of the best research evidence with clinical expertise and unique patient values and circumstances.” According to Straus et al, (2005, p.3) those practicing evidence based medicine must follow five specific steps: a) Include the need for data into an answerable question, b) Track down the best evidence, c) Critically appraise the evidence for validity, impact, and application, d) Integrate the critical appraisal into clinical practice, and e) Evaluate the effectiveness and efficiency of implementing steps a-e-and seek ways to improve them. Subsequently, without current best evidence, clinical practice cam become out-dated to the detriment of patients, this is an untenable circumstance and one which should never be allowed to happen.
Evidence-based medicine allows clinicians to offer patients the best care that current science can afford. Strauss et al., suggest that the three components of EBP are best research evidence, clinical experience, and patient/client values (Strauss, et al., 2005). All clinicians should strive to include all three components into the care provided to patients. Dietitians are key members of the clinical team and more than 70,000 dietitians work daily across the US (American Dietetic Association, 2010). Dietitians implement medical nutrition therapy (MNT) which the American Dietetic Association (ADA) defines as an essential component of comprehensive he...
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Evidence Based Practice emerged in the late 20th century, becoming widespread in the 21st century. According to Research and Practice: The Role of Evidence-Based Program Practices in the Youth Mentoring Field ( 2009) “The concept of Evidence Based Practice (EBP) actually has its roots in the medical field, where the work of Archie Cochrane (1972) and others examined the key role that the substantial body of medical research and literature could play in how doctors make decisions in patient care” (para 6); Thus, a doctor’s decision would be an “educated” decision, based on evidence gathered (patient symptoms), history of cases they have overseen, or research of previous case diagnosed by another doctor, with a related case. Evidence Based Practices are defined as “ integration of: (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve” (“Evidence Based Practice (EBP),” 1997-2014); often described as the “Best Practices”. The evidence itself is not the basis of decisions made, but it does help support the process of care given to our clients.
Evidence Based Practice (EBP) is useful to practice because it aids practitioners development and widens their knowledge and insight, therefore enhancing the experience of the practitioner. This ensures that the best quality of care is given to the patient (Duncan, 2006).
The next stage is for the team to jointly develop an evidence-based practice standard based on the information compiled during the research process (Doody & Doody, 2011). An important concept of evidence-based practice as pointed out by Doody & Doody (2011) is the involvement of the patient in the development of new standards. The developed standard should apply to the research topic that is being addressed, however; it should also be modified from person to person based on morals and values for the standard to truly be evidence-based (Doody & Doody,
Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.
Evidence-based practice is giving apt and effective care to patient based on integration of best evidence supporting the practice, clinical experience and patient’s preference (8). Studies has shown that health care workers are aware of the benefits of evidence bases practice such as ensuring quality and providing consistent care, practicing updated interventions or techniques and giving effective services but there is a mismatch in actual practice. This part of the paper will looked at barriers anticipated in adopting evidence based parctise among healthcare workers and will end with recommendations that could manage this problems.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
Polly Beam, J. S. (n.d.). Levy Library. Evidence Based Medicine Tutorial. 1.3 What’s Best: The Evidence Hierarchy. Retrieved April 9, 2014, from http://libguides.mssm.edu/hierarchy
When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most resent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457
One of the pros of evidence based practice is its proven to offer favorable outcome. The findings in research and other discipline has guided health care professionals to make solid decision to improve patient care. Many health insurance companies depend of the evidence to dispense coverage for patients when a treatment has proven effective in a similar process. treatment for any ailment is based on facts rather than traditional methods and is backed by firm knowledge of the methods usefulness. Patient overall outcome is favorable due to the combination of observations made by healthcare professional, the feedback from patients, coupled with research and scientific
Evidence-base practice has been defined as “the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care” [1] Evidence-based practice is the mix of best clinical research ,prove clinical ability and patient qualities. The utilization of the evidence for basic leadership, as opposed to the formation of the confirmation through the examination procedure accordingly appears to be a basic contrast amongst research and evidence-based practice. Research is utilized to direct an examination, the after effects of which will add to existing confirmation. Evidence based practice means to look for and evaluate best confirmation, some of which will be given by research.
“The roots of evidence-based practice [EBP] are in evidence-based medicine [EBM]… In 1972, Archie Cochrane pointed out the importance of properly testing the effectiveness of health care strategies, and stressed the role of randomised controlled studies to provide evidence on which health care is based. The term "evidence-based medicine" was introduced by Guyatt et al in 1992 to shift the emphasis in clinical decision making from "intuition, unsystematic clinical experience, and pathophysiologic rationale" to scientific, clinically relevant research. “("A Brief History of Evidence-based Practice | Evidence Based Practice in Optometry EBP Australia UNSW", 2017). “Historically, EBM primarily involved physicians and concentrated on the“treatment”
As Dr. David Sackett put it, ‘evidence-based medicine (EBM) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’ (White, 2004). The practice of EBM involves integrating clinical expertise of each clinician with sound and reputable clinical guidelines established based on high quality clinical research. Largely, EBM consists of three components of clinical expertise, patients’ values and preferences, and sound clinical evidence to support decision making process in caring for patients. As the British Medical Journal calls EMB as one of the greatest breakthroughs in medicine, it has replaced the previous model of expert-based medicine and brought a dramatic change
Evidence-based decision-making entails the process when a practitioner integrates the best research evidence in combination with clinical expertise and patient values to enhance the treatment outcomes. The three fundamental components of evidence-based decision-making include individual clinical expertise, scientific evidence and patient values and preferences (Peterson, Becker, Treasure, Shafran, & Bryant-Waugh, 2016). Scientific evidence entails the adoption of clinically relevant research conducted applying acceptable methodology. Clinical expertise is about the clinician’s cumulated education, skills, and experience in execution of the tasks. Patient values or preferences regard the concerns and expectations
The importance of Evidence-Based Practice is to ensure the best possible care is provided for patients. Evidence-Based Practice functions by measuring the effectiveness of a treatment and differentiating findings between high-quality and low-quality. It also helps with health development and improves the reliability and facilitates students to become reflecti...