EBP Lecture 1 PDF

Evidence based practice BAS 5158 Lecture 1 Prepared by Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics  Evidence based practice (EBP)...

Evidence based practice BAS 5158 Lecture 1 Prepared by Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics  Evidence based practice (EBP) Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Evidence based practice (EBP) is a method of clinical decision making and practice.  It involves integration of the three criteria including the best scientific research evidence, clinical expertise (practice knowledge) and patient values.  Neither the best scientific evidence nor clinical expertise alone is good enough for decision making in clinical practice.  Without clinical experience, ‘evidence’ can ignore the individual’s needs and circumstances, and without evidence, ‘experience’ can become old-fashioned/out of date.  Evidence based practice (EBP) Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  There is often insufficient high quality clinical research in physical therapy field so some time the best practice can be informed by poor quality.  Dr. Rami Elshazli  Importance of EBP Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Optimize the benefits for the patient as evidence- based therapist will provide care that:  Grounded on scientific research.  Guided by clinical expertise.  Ultimately directed by your patients’ individual values and circumstances.  Optimize the benefits for the general health-care community by increasing expectation that physical therapists will get best result in a very short time.  Enhance the quality and credibility of your services.  Enhance confidence and ability to assist patients in choosing their best options for physical therapy care.  Dr. Rami Elshazli  Importance of EBP Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  EBP moves the physical therapy profession away from practice based on habit toward a careful, systematic assessment of the best available evidence to inform patient care.  Dr. Rami Elshazli  The three pillars of evidence Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Dr. Rami Elshazli  Sources of evidence Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Scientific research evidence  Scientific research evidence is empirical evidence acquired through systematic testing of a hypothesis.  The most common usable research type is Clinical research which involves human subjects and answers questions about diagnosis, intervention, prevention, and prognosis in relation to disease or injury.  Results of clinical research studies are published as articles in peer-reviewed scientific journals.  The abstract is a summary of a study.  Dr. Rami Elshazli  Sources of evidence Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Clinical expertise evidence  Clinical expertise refers to the explicit knowledge about physical therapy diagnosis, treatment, prevention, and prognosis gained from cumulative years of caring for patients with disease and injury and working to improve and refine that care.  Therapists share a collective professional wisdom acquired through decades of providing patient care.  Professional clinical expertise is passed from clinician to clinician in the formal academic setting, post professional education (e.g., continuing education courses, residencies), formal mentorship, and informally between colleagues.  Dr. Rami Elshazli  Sources of evidence Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Patient values and Circumstances  Patient values include the beliefs, preferences, expectations, and cultural identification that the patient brings to the therapy environment.  Patient preferences serve as important evidence for guiding treatment decisions.  For example, some patients excel at completing a therapy exercise program consistently on a daily basis.  They can readily incorporate a prescribed home exercise program into their lifestyle and monitor their progress independently.  Other patients prefer to avoid therapeutic exercise to the fullest extent possible.  Dr. Rami Elshazli  Sources of evidence Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Patient values and Circumstances  Patient circumstances encompasses information about the patient’s medical history (e.g., co- morbidities), access to medical services (e.g., rural versus urban or insured versus uninsured), and family environment (e.g., lives with parents versus lives in foster home.   Barriers to EBP  Time.  Problem of generalizability of research.  Lack of research skills.  Lack of understanding of statistics.  Lack of search and appraisal skills.  Lack of information resources.  Inconsistent culture of EBP in physical therapy. Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt  Dr. Rami Elshazli Associate Professor of Biochemistry and Molecular Genetics, Horus University - Egypt