Evidence-based Practice Approach Research Articles

Quality Care in Residential Care and Treatment Settings in North America: From Complex Research to Four Everyday Principles for Practice

Quality is a central topic in contemporary discussions about residential care, and specifically about group or congregate care. Such care settings have been contested in recent years specifically resulting from anecdotal evidence that quality is lacking. To this end, the response has focused on the development of quality indicators and standards. In this essay, the author argues that, although such approaches are necessary and have helped to embed evidence-based practices in residential care settings, they are not easily translated into everyday practice. Quality care must mean more than frameworks for care that are governed by professional system designs. Quality care also must include the experiences of young people living life in these settings. To this end, to help with the translation of quality care standards for residential care, the essay presents four core principles that, on the one hand, are familiar and easily translatable for youth workers and social workers in these settings, and on the other hand, honour and are congruent with core elements of almost all evidence-based practice approaches.

Evidence-Based Practice Approach on Clinical Empathy Skills Among Health Professionals: A Systematic Review Protocol

Evidence-Based Practice Approach on Clinical Empathy Skills Among Health Professionals: A Systematic Review Protocol

Toward Redefining Library Research Support Services in Australia and Aotearoa New Zealand: An Evidence-Based Practice Approach

An increasingly complex and demanding research landscape has seen university libraries rapidly evolve their services. While research data management, bibliometrics, and research impact services have predominantly featured in the literature to date, the full scope of support libraries are currently providing to their institutions is unknown. This paper aims to present an up-to-date view of the scope and extent of research support services by university libraries across Australia and Aotearoa New Zealand. A coding process analyzed content data from university library websites. Eleven research support areas were identified. Service delivery is split between synchronous and asynchronous modes. This paper describes a lived experience of an evidence-based library and information practice approach to improving research support services at two Australian university libraries, and while it highlights continued maturation of research support services, more research is needed to better understand influences on service development.

Nurses' experiences and perspectives regarding evidence-based practice implementation in healthcare context: A qualitative study.

To explore nurses' experiences and perspectives about evidence-based practice (EBP) implementation in the healthcare context. A qualitative descriptive study design using focus group discussions (FGDs). Sixty-four nurses who purposefully selected and worked at various healthcare organizations in Bisha Governorate, Saudi Arabia, were included. Eight FGDs were used to obtain data using open-ended questions. The collected data underwent inductive qualitative content analysis. Two main categories were extracted: experiences and perspectives towards EBP. The experiences category emerged into four sub-categories: familiarity with concepts and benefits, steps, dissemination sources of EBP and sources of EBP knowledge, while perspectives towards the EBP category included four sub-categories: application of EBP in clinical practice, barriers, facilitators and EBP application methods. The participants experienced being in a non-supportive and non-encouraging atmosphere which results from a lack of organizational commitment to EBP implementation and illuminates the complexities involved in the integration process. The nurses' experience with EBP indicated that there was limited support for the implementation of this approach. Furthermore, they experienced varying barriers to EBP implementation. They viewed EBP as a complex technique as they lacked knowledge and skills related to the formulation of research questions, and retrieving, applying and disseminating of EBP in clinical practice decision-making. That is due to barriers pertinent to the individual, organizational and patient factors. The key to successfully implementing an EBP in nursing practice is to promote professional development, comprehensive and continuous training, a culture of change, organizational support and motivation. Through the construction and provision of ongoing educational interventions and mentoring programmes about EBP, healthcare organizations and nursing leadership may develop a comprehensive strategy to encourage staff nurses' participation in the EBP process. This is to enhance nurses' experiences and perspectives towards the EBP approach and overcome the barriers to effective implementation. Patients or the general public were not involved in the design, analysis or interpretation of the data in this study.

Weight Restoration and Symptom Remission for Longstanding, Untreated Anorexia Nervosa in a Remote Eating Disorder Treatment Program: A Case Study

For severe cases of anorexia nervosa (AN), including when poor prognostic factors like low body mass index (BMI) and longer illness duration are present, intermediate levels of care are often indicated. Current guidelines call for treatment programs to use an evidence-based practice approach to individualize treatment and optimize outcomes. Research supports the effectiveness of intermediate levels of care, including remote programs which increase access to treatment. However, conflicting evidence exists regarding the ability to safely weight restore clients during remote care, necessitating further research. This case report highlights the viability of treating clients with AN remotely using an evidence-based practice approach, resulting in weight restoration and symptom remission. The client presented with a longstanding history of severe binge-eating/purging AN with numerous medical complications but was motivated and treatment-compliant. Her eating disorder (ED) was conceptualized using a biopsychosocial perspective and treated using a multidisciplinary, evidence-based practice approach encompassing individual, group, and supportive interventions. She was successfully discharged from treatment after 150 days, having restored weight to a healthy range and showing substantial improvements in ED, depressive, and anxiety symptoms based on validated measures. This case contributes to the evidence that remote care can be an accessible and effective treatment option, even in cases of severe AN. The case highlights how an evidence-based practice approach can enable safe weight restoration via a personalized treatment plan that emphasizes the use of remote devices and self-monitoring.

American College of Gastroenterology Guidelines: Management of Acute Pancreatitis

Acute pancreatitis (AP), defined as acute inflammation of the pancreas, is one of the most common diseases of the gastrointestinal tract leading to hospital admission in the United States. It is important for clinicians to appreciate that AP is heterogenous, progressing differently among patients and is often unpredictable. While most patients experience symptoms lasting a few days, almost one-fifth of patients will go on to experience complications, including pancreatic necrosis and/or organ failure, at times requiring prolonged hospitalization, intensive care, and radiologic, surgical, and/or endoscopic intervention. Early management is essential to identify and treat patients with AP to prevent complications. Patients with biliary pancreatitis typically will require surgery to prevent recurrent disease and may need early endoscopic retrograde cholangiopancreatography if the disease is complicated by cholangitis. Nutrition plays an important role in treating patients with AP. The safety of early refeeding and importance in preventing complications from AP are addressed. This guideline will provide an evidence-based practical approach to the management of patients with AP.

The role of aspirin, statins, colchicine, and IL-1 inhibitors in prevention of cardiovascular events: a systematic integrative review.

Cardiovascular disease (CVD) is the leading cause of death in the United States. As such, an unmet need exists in the primary and secondary prevention of adverse cardiovascular events (CVEs). Specifically, identifying drugs that can reduce the progression of CVD and serious adverse events is much needed. Drugs that work by reducing platelet aggregation, blocking cholesterol formation (3-hydroxy-3-methyl-glutaryl-coenzyme A [HMG-CoA] reductase inhibitors), and/or blocking inflammation pathways (mainly interleukin-1b [IL-1b]) have been linked to preventing adverse CVEs, including acetylsalicylic acid (ASA, aspirin), statins, colchicine, and IL-1 inhibitors (interleukin-1 receptor antagonists). This systematic review aims to provide insight into utilizing these four agents for the primary and/or secondary prevention of CVD. In this systematic review, we opted to review the efficacy of aspirin, statins, colchicine, and IL-1 inhibitors in the primary and secondary prevention of CVE to provide clinical practitioners with evidence-based practice approaches and determine any unmet needs in their utilization. Between October 1 and 12, 2021, a search was conducted and completed on five databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Biomedical Reference Collection: Comprehensive. A total of 13 researchers (V.A., A.H., S.B., V.G., D.C., C.C., C.B., C.A., S.K., J.H., A.K., S.F., and S.E.) were involved in the search and screening of the articles. Search terms included "aspirin, statins, colchicine, IL-1 inhibitors, and primary, secondary, myocardial infarction (MI)." Inclusion criteria included clinical study design, English language articles, all genders older than 50 years old, and established patient history of CVD, including MI. In addition, articles were excluded if they were animal models, invitro studies, pharmacokinetic studies, systematic reviews, literature reviews, and studies exploring therapies other than those listed in the inclusion criteria. First, five individuals independently sorted through abstracts or articles based on the inclusion and exclusion criteria. Then, a team of 13 individuals sorted through full-text articles of selected abstracts based on the same criteria. A separate researcher resolved conflicts between the team. A total of 725 articles were identified from all databases, from which 256 duplicated articles were removed. Thus, a total of 469 articles abstracts were screened, of which 425 articles either did not meet the inclusion criteria or met the exclusion criteria. A total of 42 articles were retrieved and assessed for full-text review, from which 15 articles were retrieved for analysis. Statins may prevent primary CVEs based on their role in preventing cholesterol formation. Aspirin, canakinumab, and colchicine may be helpful in the secondary prevention of CVEs due to their blocking of various steps in the inflammation pathway leading to CVD. Future research should primarily focus on the use of canakinumab and colchicine in preventing CVD due to the limited number of studies on these drugs.

How Teaching and Internship Influence the Evidence-Based Practice Approach of Nursing Students: A Longitudinal Study.

The study aimed to analyze students' approach to evidence-based practice and evaluate the effect of teaching (based on lessons in statistics, epidemiology, evidence-based nursing, bioengineering, English language) and internship experiences on the attitude of nursing students to evidence-based practice. In 2019,one hundred nineteen second-year nursing students from an Italian university were involved in a pre-post longitudinal study. The Italian version of the Student-Evidence Based Practice Questionnaire was administered to nursing student in four moments of one academic year. The Student-Evidence Based Practice Questionnaire showed different mean scores based on the four moments of the survey with a significant increase after the experience of planning clinical cases with an online simulation system. In particular, the aptitude subscale does not have significant improvements in the various phases of the study. Conversely, the support of the clinical tutor affects student performance. The didactic module on evidence-based nursing develops the ability to assess the quality of the information found and its sharing. Basic English proficiency is not significantly correlated. To develop evidence-based practice knowledge, aptitude, and skills in nursing students, it is necessary to strengthen the learning opportunities both in classroom lessons and in simulation and internship experiences.

Improving the Evidence-Based Practice Skills of Entry-Level Physiotherapy Students through Educational Interventions: A Scoping Review of Literature.

Evidence-based practice (EBP) is an essential approach in healthcare, attracting growing interest among both practitioners and researchers. This scoping review aims to (1) systematically investigate the effectiveness of pedagogical methods used to facilitate learning of the EBP approach, and (2) explore the perceptions, experiences, and issues related to these learning methods. The overarching purpose is to identify the state of the art in pedagogical methods, instruments, influences, and barriers in teaching and learning EBP within entry-level physiotherapy education programs. This scoping review was conducted following PRISMA guidelines, with PubMed and Eric databases being searched for peer-reviewed original research articles using a combination of keywords. Excluding non-pertinent articles from the initial 465 identified, 12 were eligible for final inclusion (5 quantitative, 3 qualitative, and 4 mixed-methodology studies). A range of pedagogical methods and instruments for teaching EBP in physiotherapy education were detected, all of which having the capability to positively affect physiotherapy outcomes. Findings from this study support the significant influence that EBP exerts on the improving of the quality of teaching, together with the necessities that the involvement of EBP in physiotherapy education programs provide. Several barriers were identified, which should be taken into consideration when designing population-specific EBP strategies tailored to these particular needs.

Detection, management, and prevention of diabetes-related foot disease in the Australian context.

Diabetes-related foot disease (DFD) is a widely feared complication among people who live with diabetes. In Australia and globally, rates of disability, cardio-vascular disease, lower extremity amputation, and mortality are significantly increased in patients with DFD. In order to understand and prevent these outcomes, we analyse the common pathogenetic processes of neuropathy, arterial disease, and infection. The review then summarises important management considerations through the interdisciplinary lens. Using Australian and international guidelines, we offer a stepwise, evidence-based practical approach to the care of patients with DFD.

How do Trained and Prospective Physiotherapists and Radiologic Technologists Face Knee Joint Effusion Profession-Specifically and Interdisciplinary?-A Cross-Sectional Study

Objective: Knee osteoarthritis (OA) is often accompanied by joint effusion that requires accurate detecting and diagnosing. In an interprofessional evidence-based practice (EBP) approach to this, physiotherapists (PTs) and radiologic technologists (RTs) should be included. While researchissults regarding the 1st pillar (external clinical evidence) and the 2nd (patients´side) pillar of EBP are available, these are still missing concerning the 3rd pillar (clinical experts´ side). Therefore, the aim of this study is to investigate how PTs and RTs deal with knee joint effusion detection in the course of knee OA patients’ profession-specifically as well as how they rate the other occupational group´s competencies. Methods: An online survey consisting of open and closed questions was conducted in the period from 31st of January 2023 till 6th of March 2023 to collect data. PTs, RTs as well as physiotherapy students (PTSs) and radiologic technology students (RTSs) were defined as target groups. A structuring content analysis was used to evaluate open questions. Descriptive and inferential statistics were used to analyses closed questions. Results: PTs and PTSs determined at least one of the cardinal symptoms of inflammation, inspection, palpation, the patellar tap test, and circumference measurement as knee effusion detection possibilities in patients´ with knee OA. In contrast, the modified stroke test and the bulge sign were hardly mentioned. The majority of RTs and RTSs stated that MRI was the first-choice imaging to detect effusion followed by sonography. Focusing on specific signs in radiologic imaging modalities fluid on T2 sequences in MRI, hypoechoic area on sonography, swelling on conventional radiography, fluid accumulation on CT and radionuclide uptake on scintigraphy were frequently mentioned. Among all 4 participating occupational groups, PTs and RTs were among the top 5 mentioned professions that have knee effusion detection competencies. There is no significant difference regarding the other occupational group´s knee effusion detection competencies. The participants rated them consistently as “rather competent” most frequently. Conclusion: The authors study results indicate that there are some discrepancies among PTs, PTSs, RTs and RTSs in regard to the 1st and 3rd pillar of EBP. All occupational groups show partly contradictory or lack of in-depth knowledge regarding frequently applied and suggested diagnostic procedures in literature. Implementing relevant training formats should be considered in the future.

Stress Reduction Interventions for Parents of Children with Autism Spectrum Disorder: A Focused Literature Review

Parents of autistic children report higher levels of parenting stress than any other child-related disabilities, with atypical child behaviour being identified as a key contributor to stress. As stress causes many negative health problems, it is important to understand what interventions are reportedly effective to reduce parenting stress in the literature. Five electronic databases—Cochrane, ProQuest, Pubmed, ScienceDirect, and Scopus—were searched for relevant literature focusing on stress reduction intervention studies, studies on parents of children diagnosed with ASD, and publications no older than ten years. The PRISMA 2020 checklist was used for reporting. A total of 11 articles from 169 were included, including 22 interventions identified and categorised based on theoretical approach, i.e., Applied Behavioural Analysis, Cognitive Behavioural Therapy, Humanistics, and psychoeducation. The evidence synthesised advocates for an integrative approach, such as Mindfulness-Based Positive Behaviour Support, an evidence-based practice approach that appears to offer greater advantages in reducing parenting stress. The implications of our results can inform educators and practitioners regarding available stress interventions for parents of children with ASD. Our findings warrant rigorous design research such as randomised controlled trials to be conducted to further identify the effects of these interventions.

Evaluations of Probation Specialists on Evidence-Based Probation Practices: A Qualitative Study from Turkey

ABSTRACT Purpose This research explores the views of probation specialists working with young offenders about their professional process, professional problems, and the evidence-based practice approach. Method The qualitative method was used in the research and the phenomenology pattern forms the basis of the research. The data deciphered and conceptualized with descriptive analysis by the organizing and senior researcher. Results According to data from in-depth interviews, due to the dual structure of the probation system, which includes both execution and rehabilitation, professional staff experience role conflict. Professional problems such as excessive workload, inadequate physical conditions, not separating the job descriptions of probation specialists according to their fields of expertise, job dissatisfaction, and burnout are common. In addition, there are no scientific tools to measure the effectiveness of the intervention programs and monitoring process in the probation system. Discussion There is a need for developing the effectiveness of intervention programs in the probation system and an evidence-based intervention system. At the end of the article, some suggestions on effective social work practices in the probation system are presented from the perspective of evidence-based practice.

De-adopting low-value care: The missing step in evidence-based practice?

BackgroundLow-value care provides little or no benefit to pediatric patients, has the potential to cause harm, waste healthcare resources, and increase healthcare costs. Nursing has a responsibility to identify and de-adopt low-value practices to help promote quality care. Purpose1) Describe the process of identifying and de-adopting low-value clinical practices guided by a conceptual model using a case study approach.2) Identify facilitators and barriers to de-adoption practices, including levels of stakeholder engagement, organizational structures, and the quality of available scientific and non-scientific evidence. MethodologyAn evidence-based practice (EBP) project investigating the efficacy of antihistamines in decreasing infusion reactions to infliximab identified a low-value practice within a pediatric infusion center. The Synthesis Model for the Process of De-adoption was then applied to guide the de-adoption of this low-value practice. Case study analysis highlighted facilitators and barriers to de-adoption efforts. ConclusionsThe process for de-adopting care is an essential component of EBP and, as such, should be explicated through robust, standardized EBP processes and education. Practice implicationsNurses are best positioned to identify, assess and prioritize low-value practices and facilitate the de-adoption of low-value practice that impact pediatric patients and families.Models to support de-adoption and a focus on site-specific practices including a prepared nursing workforce, continuous evaluation of care processes and the use of resources to assess for contextual determinants facilitates success and sustainability of this essential EBP approach.

Praksa zasnovana na dokazima u središtu paradigmatskog preokreta u socijalnom radu?

Evidence-based practice in social work elicits a broad spectrum of reactions which reflect the dynamics of modern and postmodern approaches, where the traditional emphasis on empirical methods and objectivity confronts the challenges of postmodern skepticism and relativism. Drawing on Thomas Kuhn's model of scientific development as a theoretical-analytical framework, this paper aims to analyze the debate between modern and postmodern approaches regarding evidence-based practice in social work. Using the methods of content analysis, comparative and narrative analysis, as well as synthesis, the paper focuses on the current debate as an expression of the crisis and conflict between these two paradigms, considering their fundamental ontological, epistemological, methodological, and axiological assumptions. The development of evidence-based practice through the succession of stages of normal science and crisis is presented, followed by the discussion of the main modernist and postmodernist arguments. This opens up the question of the implications of this conflict on the application and the further development of the evidence-based practice approach in social work. It is concluded that, despite the apparent irreconcilability of these approaches, their critical interaction, illuminated through Kuhn's ideas on scientific paradigms, plays a key role in the development of evidence-based practice.

Case Study of Progressive Muscle Relaxation Intervention to Reduce Pain in Appendicitis Patient

Objective: This case study was conducted to describe a progressive muscle relaxation intervention in reducing pain in appendicitis patients. Method: This study uses a case study design with an evidence-based practice approach that focuses on nursing interventions. This research was conducted at the BLUD RSU Banjar City on 27-31 May 2022. Participants in this study were Ny patients. C, 35 years old, female, complains of right lower quadrant abdominal pain. The process of assessing and establishing a diagnosis is focused on the main problem. Objective and subjective data becomes a reference for periodic evaluation of nursing implementation. Results: Patients gave recognition of decreased pain after being given a progressive muscle relaxation intervention with a pain scale of 4 out of 5 (0-10) and a scale of 3 out of 4 (0-10). Conclusion: Progressive muscle relaxation intervention should be suspected to be effective in reducing pain in appendicitis patients as evidenced by subjective patient recognition. Theoretically, this study does not conflict with previous research so that it can be a reference in future research. Theoretically, this research does not conflict with previous research so that it can be a reference in future research. Clinically, progressive muscle relaxation intervention can be an alternative intervention to reduce pain levels in patients with chronic diseases such as appendicitis in hospitals and health centers.

Antipsychotic Medications and Cognitive Behavior Therapy in Pregnant Women with Bipolar Disorder

One of the most difficult clinical tasks is treating pregnant women with bipolar disorder. Decisions that patients and physicians make are challenging, and no strategy is without risks nor prevents potential malpractice litigation. There is debate about whether to continue or discontinue antipsychotic medications during pregnancy. While discontinuation of antipsychotics may increase the risk of relapse, continued use of these medications may lead to fetal and maternal adverse outcomes. Some antipsychotics effectively treat symptoms related to bipolar disorder, including manic episodes and mood swings between mania and depression. Though antipsychotics may be useful for the treatment and management of bipolar disorder, the medications are not always favorable and are associated with adverse effects which have influenced some medical professionals to practice defensive medicine for decades that, in some cases, may coincide or conflict with medical ethics. While antipsychotics have a less safe yet effective impact on bipolar disorder in pregnant women, an alternative therapeutic approach such as Cognitive Behavior Therapy (CBT) should be considered. CBT psychotherapy is an evidence-based practice approach that can be beneficial in the treatment of bipolar disorder in pregnant women while bypassing the associated adverse reactions of antipsychotics. Attention is needed to explore the use and associated risks and benefits of antipsychotic medications during prenatal and postnatal, the debate of whether to continue or discontinue antipsychotic medication during pregnancy, and the role of CBT in the treatment of pregnant women with bipolar disorder. While antipsychotics may have beneficial effects that should not be underscored, the risks associated with the usage of antipsychotics during pregnancy cannot be minimized.

Tracheostomy Thursday: Journey of a staff-driven COVID-19 initiative to international recognition.

In Brief An evidence-based practice and interprofessional approach helped enhance staff knowledge and improve outcomes for adults with tracheostomies.

Transitioning from heparin to saline locks for central venous access devices in oncology: An evidence-based practice approach.

Central vascular access devices (CVADs) are often essential to the care of patients undergoing long-term cancer treatment. CVAD maintenance is an essential oncology nurse competency. Evidence-based practice (EBP) in flushing and locking help to prevent intraluminal occlusion, a common complication. Heparinized saline (HS) has been the standard locking solution for CVADs. However, research indicates no superiority of HS over normal saline (NS). The objectives of this EBP project were 1) to evaluate whether a significant difference in intraluminal occlusion was associated with the change from HS to NS use for locking CVADs in ambulatory oncology care, and 2) to evaluate the effects of peer nurse mentoring on nurses' and patients' perspectives about the practice change. Analysis of data revealed decreases in alteplase usage after transitioning to NS locking. Patient and nurse surveys indicated that peer nurse mentoring increased nurse and patient confidence and competence in making the practice transition.

Sleep protocol-Use of evidence-based practice (EBP) to improve patient outcomes and patient satisfaction while hospitalized.

Anecdotal observation at a 55-bed training hospital indicated decreased patient satisfaction from patients not feeling rested during hospitalization related to staggered nighttime nursing care. The main aim of this study is to implement a new culture of patient centeredness to enhance patient care and improve outcomes at a 34-bed Medical-Surgical Inpatient Unit (MSIU) within the training hospital. An evidence-based practice approach was chosen to address the aim. This included the development of a PICOT (population, intervention, comparison, outcome, and time frame) question, a systematic search of the literature, a critical appraisal of the evidence, implementation of the intervention, evaluation of outcomes, and dissemination of the results. Twenty-three articles were critically appraised, resulting in 11 keeper articles. The body of evidence reviewed demonstrated that minimizing nighttime patient interruptions through bundled care could improve patient sleep, pain perception, and patient outcomes and reduce fatigue. Bundled care was implemented in the MSIU for 1year. During this year, there was a significant reduction in hydrocodone administration, a notable reduction in prescription sleep aid administration, a 75% reduction in fall rates, a cost savings of $64,000, and a decrease in patient length of stay. Allowing patients to rest could have benefits. Rest improves outcomes, length of stay, satisfaction scores, and fall rates and reduces the need for medications. Clustering care allows patients to receive uninterrupted rest.