Implementation of Evidence-Based Practice and the PARIHS Framework

2013 ◽  
pp. 19-36 ◽  
Author(s):  
Shahram Zaheer
Keyword(s):  
Knowledge Translation ◽  
Health Informatics ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Healthcare Setting ◽  
Outcome Data ◽  
Evidence Based ◽  
Sources Of Information ◽  
Implementing Change ◽  
Parihs Framework

Patients receiving healthcare are commonly exposed to harm that is systematic and often severe. Clinical decisions based on inaccurate sources of information can lead to medical errors, high treatment costs, and poor patient outcomes. Evidence-based practice has the potential to overcome these problems by improving clinical decision-making processes. The PARIHS framework was developed to address the inability of traditional unidimensional models to successfully implement evidence-based practice. The PARIHS framework proposes that successful implementation of evidence into practice is a function of evidence, culture, and facilitation. The PARIHS framework can be used to design, implement, and evaluate knowledge translation projects at both acute and chronic care facilities. This chapter discusses the PARIHS framework as well as its advantages for implementing change at a healthcare setting compared to traditional models. The chapter also outlines a feasible knowledge translation project based on the principles of the PARIHS framework while highlighting health informatics and availability of easily accessible high quality patient outcome data as key enablers in designing and successfully implementing such a project at a healthcare setting.

Implementation of Evidence-Based Practice and the PARIHS Framework

2015 ◽  
pp. 323-340 ◽  
Author(s):  
Shahram Zaheer
Keyword(s):  
Knowledge Translation ◽  
Health Informatics ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Healthcare Setting ◽  
Outcome Data ◽  
Evidence Based ◽  
Sources Of Information ◽  
Implementing Change ◽  
Parihs Framework

Patients receiving healthcare are commonly exposed to harm that is systematic and often severe. Clinical decisions based on inaccurate sources of information can lead to medical errors, high treatment costs, and poor patient outcomes. Evidence-based practice has the potential to overcome these problems by improving clinical decision-making processes. The PARIHS framework was developed to address the inability of traditional unidimensional models to successfully implement evidence-based practice. The PARIHS framework proposes that successful implementation of evidence into practice is a function of evidence, culture, and facilitation. The PARIHS framework can be used to design, implement, and evaluate knowledge translation projects at both acute and chronic care facilities. This chapter discusses the PARIHS framework as well as its advantages for implementing change at a healthcare setting compared to traditional models. The chapter also outlines a feasible knowledge translation project based on the principles of the PARIHS framework while highlighting health informatics and availability of easily accessible high quality patient outcome data as key enablers in designing and successfully implementing such a project at a healthcare setting.

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.

Supporting the Development of Clinical Reasoning of Preprofessional Novices in Dysphagia Management

2019 ◽  
Vol 40 (03) ◽  
pp. 151-161 ◽  
Author(s):  
Sebastian Doeltgen ◽  
Stacie Attrill ◽  
Joanne Murray
Keyword(s):  
Clinical Reasoning ◽  
Clinical Decision Making ◽  
Management Practice ◽  
Clinical Decision ◽  
Assessment Process ◽  
Evidence Based ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Implicit Processing ◽  
Reasoning Skills

AbstractProficient clinical reasoning is a critical skill in high-quality, evidence-based management of swallowing impairment (dysphagia). Clinical reasoning in this area of practice is a cognitively complex process, as it requires synthesis of multiple sources of information that are generated during a thorough, evidence-based assessment process and which are moderated by the patient's individual situations, including their social and demographic circumstances, comorbidities, or other health concerns. A growing body of health and medical literature demonstrates that clinical reasoning skills develop with increasing exposure to clinical cases and that the approaches to clinical reasoning differ between novices and experts. It appears that it is not the amount of knowledge held, but the way it is used, that distinguishes a novice from an experienced clinician. In this article, we review the roles of explicit and implicit processing as well as illness scripts in clinical decision making across the continuum of medical expertise and discuss how they relate to the clinical management of swallowing impairment. We also reflect on how this literature may inform educational curricula that support SLP students in developing preclinical reasoning skills that facilitate their transition to early clinical practice. Specifically, we discuss the role of case-based curricula to assist students to develop a meta-cognitive awareness of the different approaches to clinical reasoning, their own capabilities and preferences, and how and when to apply these in dysphagia management practice.

scholarly journals The PICO strategy for the research question construction and evidence search

2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Research Question ◽  
Clinical Decision ◽  
Evidence Based ◽  
Review Of The Literature

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

2021 ◽  
Author(s):  
Alaine E Reschke-Hernández
Keyword(s):  
Clinical Practice ◽  
Music Therapy ◽  
Behavioral Interventions ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Intervention Development ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

Knowledge Translation and Evidence-Based Practice: A Qualitative Study on Clinical Dietitians’ Perceptions and Practices in Switzerland

2019 ◽  
Vol 119 (11) ◽  
pp. 1882-1889 ◽  
Author(s):  
Ludivine Soguel ◽  
Carla Vaucher ◽  
Theresa Bengough ◽  
Bernard Burnand ◽  
Sophie Desroches
Keyword(s):  
Qualitative Study ◽  
Knowledge Translation ◽  
Evidence Based Practice ◽  
Evidence Based

Evidence-Based Practice Patterns Among Speech-Language Pathologists and Audiologists in Saudi Arabia

2019 ◽  
Vol 41 (4) ◽  
pp. 242-249 ◽  
Author(s):  
Abdulsalam Alhaidary
Keyword(s):  
Saudi Arabia ◽  
Clinical Decision Making ◽  
Practice Patterns ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Limited Resources ◽  
Evidence Based ◽  
Speech Language Pathologists ◽  
Insufficient Time ◽  
Ebp Implementation

The goal of this study was to explore the evidence-based practice (EBP) pattern among speech-language pathologists (SLPs) and audiologists in Saudi Arabia. A total of 48 clinicians working in Saudi Arabia completed a questionnaire that investigated patterns, attitudes, skills, and time and resources at the workplace related to EBP. The results showed that SLPs and audiologists held favorable attitudes toward EBP, and the use of research studies to guide clinical decision making was increased among the participants with previous EBP training. Also, the study found that skills and knowledge related to EBP need to be enhanced, but they were not major barriers to EBP implementation. Limited resources appeared to impose some hindrances, whereas insufficient time at the workplace was found to be a major challenge for EBP implementation. Overall, the findings from this study highlight the importance of increasing the continuing education and professional time for EBP activities in the workplace.

The effectiveness of leadership: meta-analysis of trial, cross-sectional, and before after studies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Restivo ◽  
M Gaeta ◽  
A Odone ◽  
C Trucchi ◽  
A Battaglini ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Evidence Based Practice ◽  
Meta Analysis ◽  
Healthcare Setting ◽  
Risk Difference ◽  
Audit And Feedback ◽  
Evidence Based ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
Private Setting

Abstract Background The clinical and surgical procedures are often based on scientifical evidence but 30-40% of patients do not receive treatment according to evidence based medicine. The main aim of this review and meta-analysis is to assess the effectiveness of leadership in healthcare setting. Methods It was conducted a literature research on MEDLINE, Pubmed and Scopus with publication year between 2015 and 2019. The inclusion criteria were studies involving healthcare workers that evaluated effectiveness of opinion leaders in improving behaviour of healthcare workers, according to clinical or patient related outcomes. The quality of studies were assesed with the NHLBI for before after studies and the NOS for other study designs. The effect of leadership was assessed as risk difference for all studies with the exception of cross sectional studies. For the last it was evaluated correlation between leadership level and outcome measurment. Results A total of 3,155 articles were screened and 284 were fully assessed including 22 of them in the final database: 1 randomized trial, 9 cross sectional and 12 before after studies. For the cross-sectional studies there was a correlation of 0.22 (95% CI 0.15-0.28) between leadership level and outcome measurment. In the metaregression analysis the only factor that increased the correlation was private setting (meta regression coefficent =0.52, p = 0.022). The pooled efficacy was 24% (95% CI 10%-17%) for before after studies. Furthermore, a higher effectiveness was revealed in studies conducted on multi professional (24%) than single professional (9%) healthcare workers. Conclusions According to results, the guidelines adherence and task performance increased in a setting with leadership implementation. The leadership effectiveness appears comparable to other strategies as audit and feedback used to implement evidence-based practice in worldwide healthcare. Key messages The translation of evidence into clinical practice is often difficult but this study suggests that leaderhip can had higher effectiveness in multiprofessional healthcare workers and private setting. The effectiveness of leadership in this review suggests that it can be of help in order to make aware healthcare professionals about effectiveness of comply with evidence-based practice.

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