NURSING 1F03 Lecture Notes - Lecture 6: Gordon Guyatt, Hosiery, Epidemiology
19 Oct 2016
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Week 6 – Introduction to Evidence Informed Decision Making (EIDM) in Nursing:
Prior to Class Readings:
Week of October 21st, 2016
Chapter One: Evidence-based nursing an Introduction
The first documented use of the term evidenced based is credited to Gordon
Guyatt and the evidence based Medicine Working Group in 1992.
They described evidence-based medicine, as a new paradigm for medical practice
evidence from clinical research should be promoted over intuition, unsystematic
clinical experience, and pathophysiology.
Examples of evidence-based everything-
❖ Evidence-based medicine
❖ Evidence-based dentistry
❖ Evidence-based physiotherapy
❖ Evidence-based pharmacy
❖ Evidence-based crime prevention
❖ Etc.
Evidenced-based ways of thinking have emerged form the discipline of clinical
epidemiology, which focuses on the application of epidemiological science to clinical
problems and decisions (epidemiological science is the study of health and disease
in population).
Evidence-based nursing can be defined as the application of valid, relevant,
research-based information in nurse decision-making.
Clinical Decision → Valid, relevant research evidence → patient preference and
circumstances → available resources → Judgment and expertise of the nurse.
More in Depth Example:
Safe and effective compression therapy (hosiery) prescribed → evidence-based
guidelines recommended high-compression bandages → Patient is independent and
able to apply hosiery → Graduated high-compression hosiery is available → you are
not skilled in bandage application; you judge that patient is able to apply hosiery.
Getting started with evidence-based nursing:
We cannot accept the results of research at face value because, irrespective of where
research has been published, and by whom, most research is not fit for immediate
application. This is best illustrated by the fact that only about 5.4% of the
approximately 50,000 articles publishes in 120 journals, and scrutinized for three
evidence-based journals, and ACP Journal, reached the required methodological
standard.
find more resources at oneclass.com
find more resources at oneclass.com
Context:
The role of the nurse is not a fixed phenomenon; it varies by geography and culture
and is heavily influenced by parameters such as the national economy and the
supply of doctors.
Never has the demand for health care been so high and to prove this we can view
the example in the United Kingdom in 2000 where there were 10 new roles for
nurses, and nurses are now adopting the new roles widely.
Nurse education in the UK, outlines in its Code of Conduct an expectation that nurse
will deliver care based on current evidence, best practice and, where applicable,
validated research when it is available.
Chapter Two: Implementing evidence-based nursing: Some misconceptions
The past 10 years have seen a strong movement towards evidence –based clinical
practice. In 1997, the Canadian National Health Forum, chaired by Prime Minister
Jean Chrétien, recommended that a key objective of the health sector should be to
move rapidly toward the development of an evidence-based health system, in which
decisions are made by health care providers, administers, policy makers, patients
and the public on the basis of appropriate, balanced and high quality evidence.
In the United States (US), the Agency for Healthcare Research and Quality (AHRQ)
leads national efforts in the use of evidence to guide health care decisions.
In the United Kingdom (UK), the Department of Health has advocated for evidence-
based practice to enhance the quality of patient care, nursing, midwifery, and health
visiting.
Evidence-based practice isnt new; its what we have been doing for years-
Estabrooks surveyed 1500 randomly selected staff nurses in Alberta Canada, to
identify the frequency of use of various information sources. The respondents most
frequently used experiential information sources (patient data and personal
experience), followed by basic nursing education programs, in-service programs
and conferences, policy and procedure manuals, physician sources, intuition, and
what has worked for years.
Most recently, Pravikoff et al. surveyed 3000 nurses across the US and found that
while nurses reported frequently needing information for practice, they felt more
confident asking colleagues or peers and searching the Internet than using
bibliographic databases such as PubMed or CINAHL to find information.
The reliance on human sources of information found was also found among nurses
in acute care settings, nurse practitioners and practice nurses in primary care.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Week 6 introduction to evidence informed decision making (eidm) in nursing: The first documented use of the term (cid:498)evidenced based(cid:499) is credited to gordon. They described evidence-based medicine, as (cid:494)a new paradigm for medical practice(cid:495) Guyatt and the evidence based medicine working group in 1992. evidence from clinical research should be promoted over intuition, unsystematic clinical experience, and pathophysiology. Evidenced-based ways of thinking have emerged form the discipline of clinical epidemiology, which focuses on the application of epidemiological science to clinical problems and decisions (epidemiological science is the study of health and disease in population). Evidence-based nursing can be defined as the application of valid, relevant, research-based information in nurse decision-making. Clinical decision valid, relevant research evidence patient preference and circumstances available resources judgment and expertise of the nurse. We cannot accept the results of research at face value because, irrespective of where research has been published, and by whom, most research is not fit for immediate application.
