Evidence Based Practice

This article reports an evidence-based practice project using the Iowa Model of Evidence-Based Practice to Promote Quality Care for a common nursing procedure, nasogastric tube placement verification in children. Little research exists regarding the care of nasogastric tubes in children, and traditional verification methods prevail. Auscultation of air insufflation over the abdomen is still used to check placement in many settings, despite research dating back to the 1980s questioning this approach. X-ray remains the only certain way to verify placement, but getting an X-ray before each feeding would be costly and impractical. Additional bedside methods are needed. Project results demonstrate a decrease (93.3% to 46.2%) in the use of auscultation and improved use of other, more reliable methods to determine nasogastric tube placement. Changing practice can be challenging. However, with persistence and re-infusion, this project provides an important example of how the evidence-based ...

Evidence-based practice provides the most effective care that is available with the aim of improving clients' outcome. However, despite existing policies related to encouragement to or requirement of evidence-based practice (EBP), results of reviewed studies show nurses do not generally incorporate research evidence in their daily practice. This study aimed to assess nurses' attitudes towards knowledge and use of EBP in a teaching hospital in Kuala Lumpur. This study used descriptive cross-sectional survey among 265 nurses (out of 851), working in the different adult medical-surgical wards, who were selected through the quota sampling. Participants in this study, reported positive attitudes towards EBP, good knowledge of EBP, but poor utilization of evidence in their practice. Results of this study affirmed the findings of previous researches, showed despite having positive attitude and perception of good knowledge/skill regarding EBP; nurses did not incorporate evidence into practice. Application of EBP in clinical setting increases the quality of patient care, clients' outcome and nurses' job satisfaction and retention. In this regard, nursing managers and authorities have an important role in providing supports, facilities and persuading environment to focus nurses on evidence-based practice. It is recommended that the effect of personal and professional agents on actual EBP activities among nurses should be assessed through the observational studies rather than self-report questionnaire.

Getting research into policy and practice (GRIPP) is a process of going from research evidence to decisions and action. To integrate research findings into the policy making process and to communicate research findings to policymakers is a key challenge world-wide. This paper reports the experiences of a research group in a Nigerian university when seeking to 'do' GRIPP, and the important features and challenges of this process within the African context. In-depth interviews were conducted with nine purposively selected policy makers in various organizations and six researchers from the universities and research institute in a Nigerian who had been involved in 15 selected joint studies/projects with Health Policy Research Group (HPRG). The interviews explored their understanding and experience of the methods and processes used by the HPRG to generate research questions and research results; their involvement in the process and whether the methods were perceived as effective ...

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided in...

Background and Purpose A hospital-based pediatric outpatient center, wanting to weave evidence into practice, initiated an update of knowledge, skills, and documentation patterns with its staff physical therapists and occupational therapists who treat people with congenital muscular torticollis (CMT). This case report describes 2 cycles of implementation: (1) the facilitators and barriers to implementation and (2) selected quality improvement outcomes aligned with published clinical practice guidelines (CPGs). Case Description The Pediatric Therapy Services of St Joseph's Regional Medical Center in New Jersey has 4 full-time, 1 part-time, and 3 per diem staff. Chart audits in 2012 revealed variations in measurement, interventions, and documentation that led to quality improvement initiatives. An iterative process, loosely following the knowledge-to-action cycle, included a series of in-service training sessions to review the basic anatomy, pathokinesiology, and treatment strateg...

The Collaborative Model for Promoting Competence and Success (COMPASS) is an evidence-based, student-centered consultation and coaching intervention developed specifically for students with ASD.

What is COMPASS? It starts with parent-teacher consultation with a COMPASS trained consultant resulting in individualized goals and teaching plans using an Evidence Based Practice in Psychology (EBPP) framework. After the consultation, teachers receive evidence-based coaching with performance feedback and progress monitoring towards IEP progress.

What are the theoretical frameworks that inform COMPASS? COMPASS is an implementation strategy influenced by the framework  of Dunst, Trivette, and Raab (2013) (Figure 3) that considers the relationships between what the COMPASS consultant does (implementation practice) to impact what the teacher does (intervention practice) to improve child educational outcomes (practice outcomes).

What has the previous research on COMPASS found? Three previous randomized controlled trials found that COMPASS results in better IEP quality and goal attainment progress over the course of an academic year compared to control groups.

What is this study about? All previous studies have been delivered by the original developers. This study sought to train local, school-based consultants to implement COMPASS with high fidelity and satisfaction.

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT. Through a systematic review of published studies and a structured appraisal process, key action statements were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms, based on the key action statements, were developed that can assist with cl...

Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due to the lack of evidence based treatment guidelines. The purpose of this study was to promote a holistic evidence-based approach which implemented Level of Evidence and Strength of Recommendation for the treatment of HS. Based upon the European Dermatology Forumguidelines for the management of HS, evidence-based approach was explored for the treatment of HS. The diagnosis of HS should be made by a dermatologist or other healthcare professional with expert knowledge in HS. All patients should be offered adjuvant therapy as needed (pain management, weight loss, tobacco cessation, treatment of super infections, and application of appropriate dressings). The treating physician should be familiar ...

In the past century, school science has been dominated by the educational requirements of our future scientists. That is, it has become and remained fundamentally an education in science for those who wish to pursue scientific and technically related careers. However, during ...

During the last decades, the importance of adopting Evidence Based Practice (EBP) to support pupils with Autism Spectrum Disorder has become pivotal. However, scientific literature on the theme highlights the challenges when attempting to apply and maintain the same levels of effectiveness of these practices within the school system which may compromise the effectiveness of the practices itself. This seems to be also due to a low degree of acceptability, a lack of intentionality in the adoption of an EBP and a low consideration of its appropriateness by stakeholders who do not consider it satisfactory or usable in their context (Davis, 1993; Rogers , 1995; Proctor et al., 2011).Based on these premises, this study is aimed at exploring the degree of acceptability, adoptability and appropriateness of the G-ESDM by teachers of the Italian preschools in order to later investigate the possible implementation of the model in Italian preschools

This article examines the separate but sometimes overlapping foci of domestic violence (DV) and child protection services. When these sectors interact, the resulting tension becomes part of a complex dialectic and multiple opposing propositions that are explored here with respect for how they affect practice. A review of 30 years of DV discourse leads to systematic examinations of the DV literature for battered women, mental health, children, and offenders. The article proposes a radical shift by pairing a harm reduction approach with an evidence-based practice model when DV and child protection intersect. The implications of Stage of Change theory are considered in relationship to the harm reduction approach. [Brief Treatment and Crisis Intervention 7:345–363 (2007)]

Pulmonary diseases are increasingly important causes of morbidity and mortality in the modern world. The COPDs are the most common chronic lung diseases, and are a major cause of lung-related death and disability. [1] Pulmonary rehabilitation has emerged as a ...

The independent evaluation of Project Oracle. It shows that Project Oracle is a much needed initiative, helping to grow the evidence behind youth services, and then helping link this into the funding and commissioning process.

Project Oracle is the only city–wide evidence generation campaign of its kind anywhere in the world. Led by the Greater London Authority with a consortium of co–funders, it strives to bring evaluations of youth programmes – many of which are delivered by small or charitable organisations – in line with academically rigorous and internationally recognised Standards of Evidence, improving consistency and quality in understanding what does – and does not – work.

- See more at: http://www.nesta.org.uk/blog/evaluation-project-oracle#sthash.Hmfx6fFA.dpuf