Evidence-Based Practice Process

Define evidence-based practices

Define and explain how we could combine the provider’s clinical expertise with the results of systematic research on the best possible clinical evidence.

Define the EBP professionally using scientific dictionary and show me how the research methodology is controlling the usability and the quality of the evidence and which methodologies are preferred to be used to get the most accurate and reliable evidence. How the strategic KM tools and techniques will lead to discover and develop more evidence through practice and research.

II. Explain the evidence-based practice process

  • Formulate your clinical question using (PICO) formula:
    • Patient problem (P)
    • Intervention/s (I)
    • Comparison intervention (C)
    • Outcomes (O)
  • Find the evidence by searching literature database (PubMed, Medline, Ovid, …..)
    • Decide on the database you are going to search
    • Prepare the  keywords for your search (including alternative terms or abbreviation)
    • Use Boolean operators (AND, OR, NOT)  to further breakdown your search
    • Specify: the time period, language, type of study, …..etc)
  • Analyze an article of your searching results:
    • Assess the evidence
    • Understand and explain the study design and the outcomes being measured
  • Use the research evidence to make an informed decision to implement or forbid the evidence-based intervention

III. Include a research summary on different evidence based practices that are commonly adopted in healthcare

Search two different evidence based practices those have used in healthcare field. Use this template and fill-in the following 13 fields (hint: the information will be from the articles)

Decision Aid Example:

Name of intervention High Flow Nasal Cannula Oxygen Therapy (HFNC)
Aim of decision aid To determine if HFNC use is superior to conventional oxygen therapy or non-invasive mechanical ventilation
Description: (mode of delivery, frequency, restriction) HFNC delivers oxygen at higher flow rates through the nostrils, depending on the condition it could be used continuously or intermittently.
How does it work? HFNC can deliver humidified oxygen through the nasal passages at higher flow rates (max of 60 L/min) than conventional oxygen therapy.
Extent of effectiveness When compared to conventional oxygen therapy, HFNC is associated with lower intubation rates, mechanical ventilation rates. When compared to non-invasive mechanical ventilation, HFNC showed no substantial difference in outcomes.
Goal to be achieved To positively impact the health outcomes for patients suffering from a respiratory failure by improving oxygenation.
What will be required of the patient? There is no real requirement for the patient other than to not remove the nasal cannula.
Benefits Increased Oxygenation, humidified air improves the clearance of sputum, reduced the amount of work to breathe, Higher level of comfort when compared to non-invasive mechanical ventilation.
Risks Of the 907 participants in the study comparing HFNC with conventional oxygen therapy, 7% still had to be intubated in the end. 20.9% of the 810 participants in the study comparing the therapy to non-invasive mechanical ventilation were intubated. So there is the risk that the patient will have to be intubated if the therapy is not effective.
Side effects The use of HFNC is not associated with any direct risks that I could find in my research. Using HFNC without the humidification could lead to the drying out of the airway.
Effect on quality of life The patient who is receiving HFNC oxygen therapy will experience less work required to breathe, and a higher level of comfort.
Sources of further information http://www.rtmagazinedotcom/2013/09/high-flow-oxygen-does-it-make-a-difference/ (hint: search a related website or wiki-page)
References Zhao, H., Wang, H., Sun, F., Lyu, S., & An, Y. (2017, July 12). High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy but not to noninvasive mechanical ventilation on intubation rate: a systematic review and meta-analysis.   Kenneth Miller, MEd, RRT-ACCS, RRT-NPS, AE-C. (n.d.). High Flow Oxygen: Does It Make a Difference?
Other options (it may be necessary to prepare individual sheets for each option) Conventional oxygen therapy, non-invasive and invasive mechanical ventilation

IV. Disease selection and its association to evidence-based practices

Select a disease and how it has been impacted by evidence based practices.

V. Information Technology and Knowledge Management (KM)

             (hint: you might use one of the previous articles as an example).  Answer how the tacit and/or explicit knowledge management were conducted to adopt an evidence to diagnose or treat a specific disease.

VI. Write an executive summary of (400-500 words) on the previous five sections

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Finally, follow all the above 6 required steps in detail.

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