Intensive Diabetes Management: Negotiating Evidence-based Practice

2010 ◽  
Vol 71 (2) ◽  
pp. 62-68 ◽  
Author(s):  
Ann Fox
Keyword(s):  
Stages Of Change ◽  
Diabetes Care ◽  
Health Professionals ◽  
Diabetes Management ◽  
Evidence Based Practice ◽  
Opinion Leaders ◽  
Evidence Based ◽  
Structured Interviews ◽  
Evidence Based Guidelines ◽  
Based Medicine

Purpose: An exploration was completed of health professionals’ experiences implementing evidence-based guidelines that promote intensive management (IM) for people with diabetes. Methods: In-depth, semi-structured interviews were conducted with 50 health professionals from across Canada. These professionals are considered to be opinion leaders in diabetes care. Interviews were audiotaped, transcribed verbatim, and coded with the assistance of NVivo software. Transcripts were analyzed using Potter and Wetherell's approach to discourse analysis. Results: Participants noted that recent clinical trials validated intensive approaches to diabetes management. While they viewed the evidence as sound, they did not feel that it justified IM approaches in all situations. Evidence-based practice therefore gave way to individual patient considerations. Implementing behavioural strategies, such as the stages of change model, allowed participants to modify their practices in ways that accommodated both evidence-based and patient-focused practice paradigms. Conclusions: While evidence-based medicine influenced practice, it was only one discourse that shaped the way health professionals approached diabetes care.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2019 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse.Methods A sequential exploratory mixed-methods design. In-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which was followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support.Conclusion Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

scholarly journals EVIDENCE-BASED PRACTICE TEACHING INTEGRATION IN COLLEGE NURSING STUDIES: HISTORICAL AND LEGAL ASPECTS

2021 ◽  
Vol 1 ◽  
pp. 685-695
Author(s):  
Danguolė Šakalytė ◽  
Valdonė Indrašienė
Keyword(s):  
Health Professionals ◽  
Evidence Based Medicine ◽  
Professional Training ◽  
Evidence Based Practice ◽  
Scientific Information ◽  
Legal Aspects ◽  
Evidence Based ◽  
Nursing Science ◽  
Study Programs ◽  
Based Medicine

To better understand and analyze the education of evidence-based practice, it is necessary to review the context and premises of the formation of evidence-based practice itself. The beginning of the evidence-based practice movement in the teaching of health professionals’ dates back to 1910 and looking at the health care system; first, there was evidence-based medicine. In 1990, Sackett's initiative at McMaster University in Canada, it was decided to change the term "evidence-based medicine" to "evidence-based practice" (Mackey Bassendowski, 2017; Thom Eaves, 2015). In nursing, the beginning of evidence-based practice is linked to the reforms of nursing science and practice by the first nursing researcher, Florence Nightingale, from 1854 to 1910, although the term of “evidence-based practice” was not yet known at the time. The professional training of nurses as one of the leading health professionals is related to health policy and the development of nursing science. The European Qualifications Framework (EHEA) defines the expected learning outcomes for professionals with a bachelor's degree, including the skills to find, evaluate, reflect, and apply scientific information in practice (Bologna Working Group, 2005). Despite international and national recommendations, it is difficult for many higher education institutions to refine the steps of teaching evidence-based practice in nursing study programs. These difficulties are revealed by the ambiguity in the definition of the concept of evidence-based practice (Horntvedt et al. 2018).The problematic question is: What is the basis for integrating evidence-based practice training into college nursing study programs?The study is based on the scientific literature review. 

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2020 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse. Methods A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which were followed by a survey amongst CYHC-professionals on the recognition and use of the concept. Results The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support. Conclusion Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

scholarly journals Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

2019 ◽  
Author(s):  
Jetske Charlotte Erisman ◽  
Kevin de Sabbata ◽  
Teun Zuiderent-Jerak ◽  
Elena V Syurina
Keyword(s):  
Child Abuse ◽  
Well Being ◽  
Evidence Based ◽  
Structured Interviews ◽  
Daily Work ◽  
Tunnel Vision ◽  
Dutch Child ◽  
Secondary Information ◽  
Evidence Based Guidelines ◽  
Based Medicine

Abstract Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse.Methods: A sequential exploratory mixed-methods design. In-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which was followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results: The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support.Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

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.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

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