scholarly journals P055: State of the evidence for emergency medical services (EMS) provision of palliative care: an analysis of appraised research from the Canadian Prehospital Evidence-based Practice (PEP) Project

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S97-S97
Author(s):  
A. Carter ◽  
J. Greene ◽  
J. Cook ◽  
J. Goldstein ◽  
J. Jensen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Full Text ◽  
Evidence Based Practice ◽  
Symptom Relief ◽  
Included Study ◽  
Evidence Based ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Relevant Evidence ◽  
Pubmed Search

Introduction: Patients who require end of life (EoL)/palliative care occasionally need assistance from paramedics. This review evaluated the evidence for paramedic-delivered EoL/palliative care interventions. Methods: The Canadian Prehospital Evidence-based Practice (PEP) Project methodology was used. A PubMed search was conducted, using Medical Subject headings and title/abstract key words. Titles and abstracts were reviewed for relevance. Studies were not required to be EMS based but must have focused on interventions available to EMS personnel. Included full text studies were scored by trained primary appraisers on a three-point Level of Evidence (LOE) scale (high = 1, moderate = 2 and low = 3) and three-point Direction of Evidence (DOE) scale (supportive, neutral, or opposing). Studies were categorized by clinical condition (n=5) and by intervention (n=25), and plotted on 3×3 (DOE × LOE) tables. The study primary outcome and setting were determined. Results: The search returned 3255 articles; 86 were selected for abstract review; with 30 full text articles ultimately included. Intervention recommendations were: LOE 1-supportive (n=3, 12%), 2-supportive (n=2, 8%), 3-supportive (n=2, 8%), 1-neutral (n=2, 8%), 2-neutral (n=2, 8%), 3-neutral (n=4, 16%). No primary studies were identified for 10 (40%) interventions. Conditions with 1-supportive studies were: ‘breathlessness’ and ‘analgesia’. ‘Secretions’ condition had no relevant evidence. Interventions with 1-supportive evidence were: Haldol for agitation (n=1), fentanyl and morphine for analgesia (n=3 and n=1), narcotics for breathlessness (n=1). No intervention had opposing evidence. Primary outcomes were more commonly related to symptom relief (n=26, 87%), safety (n=3, 10%), or tolerability (n=1, 3%). Only one included study was conducted in the EMS setting. Conclusion: Evidence for interventions used by paramedics in the treatment of patients requiring EoL/palliative care was identified, as were evidence gaps. Little research was conducted in the EMS setting, and most interventions had few studies. These PEP findings highlight topics requiring high quality EMS research specific to EoL/palliative care to inform this growing aspect of paramedic practice.

scholarly journals Using MeSH (Medical Subject Headings) to Enhance PubMed Search Strategies for Evidence-Based Practice in Physical Therapy

2012 ◽  
Vol 92 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Randy R. Richter ◽  
Tricia M. Austin
Keyword(s):  
Search Strategy ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Mesh Term ◽  
Evidence Based ◽  
Medical Subject Headings ◽  
Search Terms ◽  
Mesh Terms ◽  
Subject Headings ◽  
Pubmed Search

Background Evidence-based practice (EBP) is an important paradigm in health care. Physical therapists report lack of knowledge and time constraints as barriers to EBP. Objective The purpose of this technical report is to illustrate how Medical Subject Headings (MeSH), a controlled vocabulary thesaurus of indexing terms, is used to efficiently search MEDLINE, the largest component of PubMed. Using clinical questions, this report illustrates how search terms common to physical therapist practice do or do not map to appropriate MeSH terms. A PubMed search strategy that takes advantage of text words and MeSH terms is provided. Results A search of 139 terms and 13 acronyms was conducted to determine whether they appropriately mapped to a MeSH term. The search results were categorized into 1 of 5 outcomes. Nearly half (66/139) of the search terms mapped to an appropriate MeSH term (outcome 1). When a search term did not appropriately map to a MeSH term, it was entered into the MeSH database to search for an appropriate MeSH term. Twenty-one appropriate MeSH terms were found (outcomes 2 and 4), and there were 52 search terms for which an appropriate MeSH term was not found (outcomes 3 and 5). Nearly half of the acronyms did not map to an appropriate MeSH term, and an appropriate MeSH term was not found in the database. Limitations The results are based on a limited number of search terms and acronyms. Conclusions Understanding how search terms map to MeSH terms and using the PubMed search strategy can enable physical therapists to take full advantage of available MeSH terms and should result in more-efficient and better-informed searches.

scholarly journals Sykepleiestudenters læringsutbytte belyst gjennom to kunnskapsbaserte samarbeidsprosjekter. Fagutviklingsarbeid med studenter i hjemmesykepleiepraksis

2015 ◽  
Vol 11 (2) ◽  
pp. 163
Author(s):  
Bente Bjørsland ◽  
Reidun Hov
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Pain Relief ◽  
Health Services ◽  
Learning Outcomes ◽  
Evidence Based Practice ◽  
Health Workers ◽  
Evidence Based ◽  
Next Of Kin ◽  
Evaluation Form

Health services are constantly met by greater demands on offering the best treatment and care based on quality and research. For that reason health workers and teachers in health care institutions and universities are working evidence-based. Hedmark University College and Hamar municipality have collaborated in two projects. The aim of this article is to illuminate the students’ learning outcomes in palliative care after participated in two evidence-based projects. Different written guides for conversations with patients, next of kin and staff, a log-book and an evaluation form were developed. Results show that the students learned about the significance of continuity in patients’ pain relief, spiritual and existential needs, and about palliative care in the municipality. The students concluded that they in some areas experienced greater learning outcomes from working with evidence-based practice than in their ordinary practice in the municipality.

scholarly journals Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review

2016 ◽  
Vol 13 ◽  
pp. 34 ◽  
Author(s):  
Konstantinos Kyriakoulis ◽  
Athina Patelarou ◽  
Aggelos Laliotis ◽  
Andrew C Wan ◽  
Michail Matalliotakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Evidence Based Practice ◽  
Journal Club ◽  
Educational Interventions ◽  
Free Text ◽  
Evidence Based ◽  
Educational Strategies ◽  
Medical Subject Headings ◽  
Journal Clubs ◽  
Use Of Technology

Purpose: The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. Methods: The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Results: Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Conclusion: Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students’ EBP competence.

Factors influencing evidence-based practice in prosthetics and orthotics

2011 ◽  
Vol 35 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Jan Andrysek ◽  
James Christensen ◽  
Annie Dupuis
Keyword(s):  
Evidence Based Practice ◽  
Principal Component ◽  
Barriers And Facilitators ◽  
Internet Survey ◽  
Evidence Based ◽  
Principal Component Factor Analysis ◽  
Clinical Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Relevant Evidence

Background: The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources.Objective: The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics.Study design: Cross sectional survey.Methods: An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada.Results: A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice.Conclusions: Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice.Clinical relevanceThis study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.

scholarly journals P056: The state of the evidence for emergency medical services (EMS) care of blunt spinal trauma: an analysis of appraised research from the Canadian Prehospital Evidence-based Practice (PEP) Project

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S97-S97
Author(s):  
A. Carter ◽  
J. Greene ◽  
J. Cook ◽  
J. Goldstein ◽  
J. Jensen
Keyword(s):  
Evidence Based Practice ◽  
Spinal Injury ◽  
Spinal Trauma ◽  
Future Research ◽  
Evidence Based ◽  
High Quality ◽  
Level Of Evidence ◽  
Spinal Motion ◽  
Moderate Quality ◽  
Point Level

Introduction: The Canadian Prehospital Evidence-based Practice (PEP) project is an online, freely accessible, continuously updated EMS evidence repository. The summary of research evidence for EMS interventions used to care for blunt spinal trauma is described. Methods: PubMed was systematically searched. One author reviewed titles and abstracts for relevance. Included studies were scored by trained appraisers on a three-point Level of Evidence (LOE) scale (based on study design and quality) and three-point Direction of Evidence (DOE) scale (supportive, neutral, or opposing results). Second party appraisal was conducted for included studies. Interventions were plotted on a 3x3 table (DOE × LOE) for the spinal injury condition based on appraisal scores. The primary outcome was identified for each study and categorized. Results: Seventy-seven studies were included. Evidence for adult and paediatric blunt spinal trauma interventions was: supportive-high quality (n=1, 7 %), supportive-moderate quality (n=3, 21.4%), supportive-low quality (n=1, 7%), neutral-high quality (n=1, 7%), neutral-moderate quality (n=5, 35.7%), neutral-low quality (n=1, 7%), opposing-high quality (n=0, 0%), opposing-moderate quality (n=0, 0%), opposing-low quality (n=1, 7%). One (7%) intervention had no evidence. Interventions with supportive evidence were: steroids, cervical-spine clearance, scoop stretcher, self-extrication and “leaving helmet in place”. The evidence weakly opposed use of short extrication devices. Leading study primary outcomes were spinal motion, diagnostic accuracy, and pressure/discomfort. Conclusion: EMS blunt spinal trauma interventions are informed by moderate quality supportive and neutral evidence. Future research should focus on high quality studies filling identified evidence gaps using patient-oriented outcomes to best inform EMS care of blunt spinal injury.

Quality Appraisal: Part I

2015 ◽  
Vol 34 (4) ◽  
pp. 245-247
Author(s):  
Deborah A. Raines
Keyword(s):  
Evidence Based Practice ◽  
Scientific Research ◽  
Evidence Based ◽  
Quality Appraisal ◽  
Level Of Evidence ◽  
Essential Step

AbstractQuality appraisal is an essential step in the evidence-based practice process. This column focuses on designating the level of evidence of the scientific research.

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