Evidence Based Practice The Setting up of an evidence based practice group within our neurology unit

CONTENT What is Evidence Based Practice? Stages involved Plans for development of group First project achieved Barriers to E.B.P. Discussions/Questions

1. What is Evidence Based Practice? 2. Is there a need?

Evidence Based Medicine “Evidence based medicine is the conscientious, explicit & judicious use of current best evidence in making decisions about the are of the individual patient” (Sacket al 1996)

Evidence Based Nursing “Evidence based care concerns the incorporation of evidence from research, clinical expertise and patient preferences into decisions about the health care of individual patients.” (Sacket 1988)

Evidence based health care is about applying the best available evidence to a specific clinical question

Is this a new concept?

“Nursing should become a research based profession” (Hunt 1981) “Nursing performing too many tasks & not within a framework of scientific verification” (Roper 1977)

Barriers to E.B.P. Time constraints Limited access to literature Lack of training & information seeking & critical appraisal skills Practice V Intellect Work culture

Need for E.B.P. Diminished health care resources Patients protected from outdated interventions Health care professional may be safeguarded from potential litigation

Stages Involved 1. Convert needs into answerable questions 2. Find best evidence 3. Critically appraise evidence 4. Apply results to practice 5. Evaluate performance

Aims of Group To increase awareness & understanding of E.B.P. through teaching sessions To promote the use of E.B.P. to inform our clinical practice

Initial Plans for First Meeting Aims & plans to develop Regular meetings Identified facilitator Open to all Documentation/minutes Ground rules

The Cochrane Centre Critically appraisal skills teaching programmes Centres for E.B.P. RCN Audit services/Good Practice Network Research utilisation conferences Evidence based journals

Main Areas of Interest Peripheral Neuropathic /diabetic ulcer care S/C pumps, IV care Urinary catheters NG tubes Gastrostomy tubes

First Project Best evidence available in relation to the care of various foot/leg ulcers patients have within our unit

Identified question tracked down best evidence Critically appraised evidence as group Applied to practice using file with guidelines

File Guidelines Assessing, planning, implementing & evaluating care for leg/foot ulcers Holistic care List of best dressings for which ulcer Samples of journals used/evidence

Thoughts for the Future Easier Access Greater dissemination

Kirrane C (2000) Evidence-based practice in neurology: a team approach to development. Nursing Standard, 14, 52,