Towards Evidence-Based Guidelines in Neurological Surgery

Neurosurgery ◽  
2018 ◽  
Vol 85 (5) ◽  
pp. 613-621 ◽  
Author(s):  
Christopher D Shank ◽  
Jacob R Lepard ◽  
Beverly C Walters ◽  
Mark N Hadley
Keyword(s):  
Patient Care ◽  
Practice Guidelines ◽  
Development Process ◽  
Evidence Based Practice ◽  
Standards Of Care ◽  
Evidence Based ◽  
Medical Evidence ◽  
Guidelines Development ◽  
Neurological Surgery ◽  
The Impact

AbstractNeurological surgery practice is based on the science of balancing probabilities. A variety of clinical guidance documents have influenced how we collectively practice our art since the early 20th century. The quality of the science within these guidelines varies widely, as does their utility in positively shaping our practice.The guidelines development process in neurological surgery has evolved significantly over the last 30 yr. Historically based in expert opinion, as a specialty we have increasingly relied on objective medical evidence to guide our clinical practice. We assessed the changing practice guidelines development process and the impact of scientifically robust guidelines on patient care.The evolution of the guidelines development process in neurological surgery was chronicled. Several subspecialty guidelines were extracted and reviewed in detail. Their impact on practice patterns was evaluated. The importance of evidence-based research and practice guidelines development was discussed.Evidence-based practice guidelines serve to chronicle multiple acceptable treatment options and help us move towards more standardized care for specific disease processes. They help refute false “standards of care.” Guidelines-based care supported by solid medical evidence has the potential to streamline patient care and improve patient outcomes. The guidelines development process identifies areas, issues, and strategies for which little medical evidence exists, as well as topics that need focused scientific investigation and future study.The production of evidence-based practice recommendations is a vital part of furthering our specialty. Guidelines development advances our science, augments the resident education process, and protects our practice from undue external influence.

scholarly journals Evidence-based Practice (EBP): beliefs, knowledge and behavior of physiotherapists. A survey research.

2021 ◽  
pp. 19-35
Author(s):  
Collebrusco Luca ◽  
Gambacorta Andrea ◽  
Visciano Gennaro
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Practice Guidelines ◽  
Response Rate ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Demographic Information ◽  
Quality Of Patient Care ◽  
And Behaviors

An analytical observational study was conduct using a web-based questionnaire. Evidence-based practice is one of the most relevant concern of all health professions. This research has been done taking account of demographic information, attitudes and skills in reference to Evidence Based Practice (EBP) for application in the daily clinical practice. To describe beliefs and behaviors of physiotherapists from two Italian regions about EBP and its implementation in clinical practice, their knowledge in this field and the perception of its benefits and barrier in application in clinical practice. The participants completed a designed questionnaire, whose purpose was to determine beliefs, attitudes, knowledge, and behaviors regarding EBP, as well as demographic information about themselves and their practice settings. This survey was activated through the TSRM-PSTRP registers of Marche and Umbria regions that sent the questionnaire to all the registered physiotherapists. There was a response rate of 7.64% for Marche region, equal to a sample of 132 physiotherapists, and a response rate of 12.99% for Umbria region, equal to a sample of 110 physiotherapists, for a total sample of 242 physiotherapists. The questionnaire was filled out through an online Google platform called “Forms”. The responses were summarized for each item and the logistic regression analyses and the chi-square test were used to examine relationships among variables. The respondents agreed that the use of evidence in practice was necessary, that the literature was helpful in their practices and that the quality of patient care was better when evidence were used. For physiotherapists from Umbria, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “the application of EBP is necessary in the practice of physical therapy, EBP helps me making decisions about patient care and I actively seek practice guidelines pertaining to areas of my practice and EBP improves the quality of patient care”. For physiotherapists from Marche, with more than 15 years of qualification, the following answers are statistically significant (p<0.05): “EBP helps me making decisions about patient care, I actively seek practice guidelines pertaining to areas of my practice and I am confident in my ability to find relevant research to answer my clinical questions”. Training, familiarity with and confidence in search strategies, use of databases, and critical appraisal tended to be associated to younger therapists with fewer years of qualification. Physical therapists stated they have a positive attitude about EBP and they are interested in learning or improving the necessary skills to implement EBP. They noticed that they needed to increase the use of evidence in their daily practice.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

scholarly journals Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Healthcare Services ◽  
Interdisciplinary Teams ◽  
Evidence Based ◽  
Health Providers ◽  
Cross Sectional ◽  
The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

What Makes or Breaks Evidence-Based Supervision? Staff and Organizational Predictors of Evidence-Based Practice in Probation

2021 ◽  
pp. 0306624X2110491
Author(s):  
Sara Debus-Sherrill ◽  
Alex Breno ◽  
Faye S. Taxman
Keyword(s):  
Organizational Culture ◽  
Survey Data ◽  
Evidence Based Practice ◽  
Organizational Factors ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Weak Evidence ◽  
The Impact

Research on staff and organizational factors that affect receptivity, adoption, feasibility, and utilization of innovations in justice settings is limited. This study uses survey data from 349 employees in one probation agency to assess how staff and perceived organizational factors influence attitudes related to evidence-based practices (EBPs) and their self-reported use. Staff characteristics, including education and knowledge about EBPs, and perceptions of the organization, including cynicism about the organization’s ability to change, predicted EBP outcomes. Staff age, tenure at the agency, and caseload size affected perceptions of organizational culture, but did not predict attitudes or use of EBPs. There is weak evidence for a relationship between self-reported use of EBPs with attitudinal support for EBPs, prior EBP training, and knowledge of EBPs. This study contributes to an emerging body of literature about the impact of various individual and organizational factors on support for EBPs with important lessons for implementation.

Sign in / Sign up

Export Citation Format

Share Document