...Matt Fowler RES 297 11/12/13 Evidence Based Medicine Research Assignment 1) In Vitro Evaluation of Heat and Moisture Exchangers Designed for Spontaneously Breathing Tracheostomized Patients Claudia Brusasco, MD⇑ Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesco Corradi, MD PhD Dipartimento Cardio-Nefro-Polmonare, Sezione Terapia Intensiva Cardiochirurgica, Azienda Ospedaliero Universitaria di Parma, Italy. Maria Vargas, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Dipartimento di Anestesia e Terapia Intensiva, Università di Napoli Federico II, Napoli, Italy. Margherita Bona, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Federica Bruno, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Maria Marsili, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesca Simonassi, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Gregorio Santori, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliera Universitaria San Martino, Genova, Italy. Paolo Severgnini, MD Dipartimento Scienza ed Alta Tecnologia, Sezione Ambiente Salute Sicurezza...
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...find traditional Chinese medicines and practices that I can integrate into my Western, allopathic-style family practice. I’ve been struggling to find Chinese herbal medicines that I am comfortable prescribing, usually due to lack of evidence for a clear benefit. As for acupuncture, there are actually a lot more well-designed studies done on this field when compared to Chinese herbs, mostly because Europe and the West have become very interested over the last couple decades and are funding better clinical trials. The evidence trail is building, which is great for everyone. So, what works, and what doesn’t? The New York Times has a very readable article (http://well.blogs.nytimes.com/2010/08/23/studying-acupuncture-one-needle-prick-at-a-time/?hpw) which covers this issue. The gist of the article discusses the most recent, well-designed studies on back pains and other disorders; the studies usually show no difference between acupuncture and placebo (usually a “sham” needle that doesn’t penetrate the skin). In other words, the best studies lately are usually showing that most of the perceived effect from acupuncture is simply a placebo effect. These recent findings are by no means surprising, as most of the best studies have been reporting similar conclusions for many years. The best collection of acupuncture research is from the Cochrane Review Group, which performs the world’s most rigorous reviews of all treatments, including alternative medicines. They have an outstanding...
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...Evidence-based practice has gained particular salience in nursing and health care and is also applicable to social practice.(Photo: Medioimages/Photodisc/Photodisc/Getty Images) In theory, practice and theory are the same. In practice, they are not. Evidence-based practice has gained prominence over more theoretical approaches in several areas, particularly in the field of health care. Theory-guided and evidence-based practice share the common goal of making the right decision and finding the most effective solution for a perceived problem. However, they have some core philosophical differences. Sponsored Links * Full-Text Journal Library Browse millions of journal articles from top academic publications. www.questia.com/Journals Features Greek philosopher(Photo: Maros Markovic/iStock/Getty Images) At its core, the divide between evidence-based practice and theory-guided practice can be traced back to an ancient divide often found in science and philosophy: That of rationalism versus empiricism. Extreme rationalists claim that our senses are limited and place all their trust in reason. In contrast, empiricists claim that sense experience is the source of all our concepts and knowledge. While their positions are not so extreme, theory-guided practice follows a rather rationalist approach, while evidence-based practice favor empirical knowledge. Read more : http://www.ehow.com/about_6646089_difference-practice-evidence-based-practice.html The movement for evidence-based...
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...HPNA Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through...
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...Barriers to Using Evidence-Based Medicine Melanie Ossman Granite State College Professor Philip Wyzik HLTC 600 March 4, 2011 Thesis The Institute of Medicine recommends the use of evidence-based medicine as a primary tool for achieving the aims outlined by their six themes of improvement. Specifically, EBM relates to their aim to make health care more effective: “to provide health care that is effective and efficient.” (Institute of Medicine, 2001) In recent years, evidence-based medicine has gained increasingly broad-based support in health care, but many doctors still aren’t using it. With a lean towards Pharmacy management, I researched the barriers providers and institutions are faced with in successfully incorporating evidence-based medicine and how initiating organizational improvements can help. The research highlights some important considerations to be aware of that gives evidence-based medicine a bad name, the pitfalls to avoid, and some ways providers and institutions are working to overcome them. Introduction This paper begins by giving an overview of evidence-based medicine, what it is, and the benefits to be realized by providers, insurers, and patients. I compared that to what providers were using before EBM. Next, I examine the barriers to successfully incorporating evidence-based medicine, and the negative perceptions that dissuade their use by clinicians. Identified are the disadvantages such as source information bias, ethics considerations...
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...Promoting Evidence-Based Education: The Role of Practitioners Round table presented at the British Educational Research Association Conference, Cardiff University, 7-10 September 2000 Robert Coe, Carol Fitz-Gibbon and Peter Tymms Curriculum, Evaluation and Management Centre, Durham University Mountjoy Research Centre 4, Stockton Road, Durham DH1 3UZ Tel: 0191 374 4504; Fax: 0191 374 1900; Email: r.j.coe@dur.ac.uk http://www.cem.dur.ac.uk/ebeuk Abstract A number of recent initiatives from Durham University’s Curriculum, Evaluation and Management Centre have sought to involve teachers in creating, accessing and applying evidence about what works in their practice. The ‘gold-standard’ of evidence in this context is taken to be multiple replications of small scale, randomised controlled trials of feasible interventions in real-life settings. The aims, form and progress of these initiatives will be reported, and a number of questions will be raised: What do we mean by ‘Evidence-Based Education’? How can it best be promoted? What kinds of research can teachers do? How good can it be? Can it genuinely contribute to knowledge? Is it a distraction or enhancement of teachers’ core role? How do traditional models of Action Research fit with this approach? Is there an existing body of knowledge that can inform practice? How can teachers gain access to it? Under what conditions might such knowledge have an impact on practice? ...
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...Title: Evidence Based Practice in Nursing Name Course Tutor April 20th, 2013 Introduction The paper herein provides a critical discussion of evidence based practice (EBP) in nursing. It clearly elaborates on the meaning and definition of EBP as used by nurses as well as the importance of evidence based decision making as it relates to nursing care. It broadly examines the concept of EBP in nursing care and its relevance to nursing practice and to the delivery of quality patient care. Subsequently, the essay will also expound on the broad research methods that are used in evidence based nursing and conclusively show how this evidence can be applied in day to day health care practice. The Definition and Importance of EBP Evidence based practice in nursing has wide and varied definitions among the nurses in practice and in academic centres. However, the most generally accepted definition is the integration of the best research evidence with clinical expertise and patient values (Sacket et al., 2000). Van, Schoonhoven & Grol (2008 at p. 382) while citing Sacket et al., (2000), define evidence based nursing as the conscientious, explicit and judicious use of current best evidence available in making decisions that are pertinent to the care of individual patients. It is the optimal use of the available research evidence in nursing (Van, Schoonhoven & Grol, 2008). In other literature, evidence based practice (EBP), in nursing has been defined to mean the...
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...eight or nine years after Heinlein’s publication, these kinds of remote manipulators popularly known as "Waldoes" were developed in the real world. Using cable and linkages, they were used to move and manipulate hazardous materials and enter hazardous environments inhospitable to humans. The first telepresence robotic arm was developed in the 1950s for the same purpose. Raymond Goertz, an early pioneer in the field of robotics, developed the first master/slave manipulator to handle radioactive material while working for the Atomic Energy Commission at Argonne National Laboratory. . Analysis of Global Context Intuitive Surgical for over a decade has centered their studies on the technology of surgical robotics. The studies were based on the philosophy the da Vinci Sugical System. This invasive surgery has been enforced all over the world and has treated millions of patients. The surgical robot is very appropriate and safe. Intuitive Surgical and performed several research studies to check the accuracy and safety of the product. In order for the company to get the best results of the product...
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...Evidence Based: For me to step forward with my destination, I had to ensure that my target was being supported by the best available evidence to attain success in reaching my goal. As a practicing healthcare professional, I was able to identify and narrow my search to the best available evidence that supported my strategies. I had to face the hard facts about what worked and didn’t work. I ensured myself that I had an understanding of the dangers in half-truth that constitute to conventional wisdom. I began my search strategy with cycling and weight loss. I limited my search to find articles that involved Complimentary Alternative Medicine. I then proceeded with review articles, published and research studies that were identified by...
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...Family therapy is a type of psychological counseling that helps family members improve communication and resolve conflicts. Family therapy is usually provided by a psychologist, clinical social worker or licensed therapist. With family therapy it may include all of the family members and anyone that is willing to participate. It caters to your specific therapy plan and often short term. Family therapy sessions will deepen the family connections by teaching all the family members skills to get through the stressful times, even after completing therapy. In this research paper this articles presents and illustrates historical underpinnings, key concepts therapeutic process of treatment, multicultural perspective and criticisms of evidence based treatment of family therapy. Family therapy was formed in the 1950’s due the clinicians and Theoretician who were in the lead of those experimenting with the treating family members conjointly were motivated by several factors according to Florence w. Kaslow. PhD is in Inependent Practice as a Life & Executive coach. Kaslow states that the first factor was because the leaders of experiment were disconnected by the slow progress made when doing individual psychoanalysis or psychotherapy. She states the second factor is that they recognized that the changes in the patient and his/her attitudes and behaviors could have a strong impact on other family members, and that if significant others had no one with whom to explore what was transpiring...
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...Researching Team Building There are many things may arise in the workplace that can cause conflict between employees and negatively affect the production or quality of work. In this paper I will give a summary of an article called becoming an evidence based HR practitioner. This article is relevant to this paper because it gives background on how to address issues in the workplace, using evidence based solutions. Also, I have chosen to focus on team building exercises and how they affect employees in the workplace. I will include evidence to support my argument whether or not this is a useful technique. Becoming an Evidence-Based HR Practitioner Becoming an evidenced based HR practitioner was a very insightful article to read. The article described EBHR as a decision making process that combines critical thinking and scientific evidence along with business information. It also informs the reader how to get started as an EBHR practitioner. The key aspect to EBHR is to actively manage professional decisions. This involves making decisions using practices supported by high research. The article also includes step by step set of approaches to becoming an evidence based HR practitioner. It offers guidance for evidence- based practice the article underscores the connection between effective practice and organizational research. Team Building and Employee Relationships The question I decided to focus on was “Do team building exercises improve relationships...
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...One significant event in nursing research which created greater awareness for the need of utilizing research in clinical practice was the establishment in 1986 of the National Center for Nursing Research by congressional mandate. A primary function of the Center for Nursing Research was promotion of research projects that related to patient care. In this period nurses began formal projects to help with research utilization in clinical practice to enhance patient outcomes. During this time factors outside of nursing helped shape nursing research also. A clinical learning strategy designed by McMaster Medical School in Canada called evidence-based medicine had a major effect on all health care professions and how physicians and nurses made clinical decisions. This learning strategy paved the way for nursing research to incorporate evidence-based practice into the daily clinical practices and enhance patient outcomes. Nursing research focused on improved patient-nurse relationships and improved patient outcomes, strategies that nurses could utilize at the bedside to enhance patient care. With use of this learning strategy nursing developed nursing strategies that were centered around nursing diagnosis and not on medical diagnosis to effect patient outcomes. Interventions that nursing could use that were nursing related and did not require a physician’s order to implement. Today the National Center for Nursing Research continues to develop knowledge to build the scientific...
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...RUNNING HEAD: CHANGE USING EVIDENCE BASED RESEARCH Change Using Evidence Based Research Glenda Doctor Western Governor’s University Procedure, basis for practice, rationale and explanation The procedure for the use of povidone-iodine for surgical cite antisepsis is: skin preparation for surgery includes the use of sterile drapes to drape the patient and square off surgical area with sterile towels to absorb excess solution. The incision site is where the prep begins and proceeds outward from that point. Iodine soap or scrub, wet the skin with sterile water the iodine scrub will be added to the point of lather, the site is to be scrubbed for 5 minutes. Excess solution is to be blotted with sterile towels or sterile gauze. When iodine paint is used the iodine paint will be applied and allowed to dry before first incision. This practice of surgical skin preparation has been a standard for many years. At this facility povidone-iodine is used predominantly however a few surgeons do use chlorhexidine, it has typically been surgeon choice for skin preparation. Studies have shown that Chlorhexidine-alcohol is a superior product to povidone-iodine to reduce skin colonization and reduce surgical site infection, (Darouiche, Wall, Itani, Otterson, Webb, Carrick, & ... Berger, 2010). No specific use for either product was found in the policy and procedures for the hospital on the hospital web site. There were no available protocols involving the products that...
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...Examine the ways that health professionals can use the five steps of evidence-based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying best research evidence. Use an occupational health and safety practice as an example. Examples of occupational health and safety practices include: * Use of professional protective equipment (e.g. gloves) * Safety considerations when using equipment (e.g. sharps) * (or a topic you select yourself in negotiation with your LIC) Health professionals are very good at seeking information from their clients and their families and also from the settings in which they work but however they have not been as aware of the information that they can gain from research. Although they need information from many sources, evidence based practice shows how research can also play a role in informing clinical decisions, (Hoffmann ,2010). Health professionals use the five steps of evidence-based practice (EBP) as a structure to overcoming barriers and applying best research. Examples of this include use of professional protective equipment and safety considerations when using equipment. Liamputtong (2010) states that evidence based practice is a “process that requires the practitioner to find empirical evidence about the effectiveness or efficacy of different treatment options and then determine the relevance of the evidence to a particular clients situation” (pp. 252). Sackett (1996, pp.71)...
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...EVIDENCE BASED PRACTICE BENCY GNANASIGHAMANI AMERICAN SENTINEL UNIVERSITY Introduction Medical and health care is one of the most dynamic human disciplines, and large amounts of money are spent annually on high-quality and sophisticated research, resulting in an exponential growth in health care literature. Regularly, new and more effective medicines, medical devices, and procedures are invented. One major objective behind all these efforts is to help doctors, nurses, and medical technicians provide the best possible care and treatment to patients. In addition to using traditional and well-established procedures and practices, health care practitioners are adopting innovative interventions that are based on best practices as well as solid research-based evidence. Evidence-based practice is one such technique and is quickly gaining popularity due to its potential to effectively handle clinical issues and provide better patient care (ANA 2003). Implementation of Evidence Based Practice places additional demands on nurses to apply credible evidence to individual client situations through searching related evidence, using clinical judgments, and considering client values and system resources. To effectively apply the Evidence Based Practice process, in addition to the basic skills required to undertake nursing work, a nurse must have the ability to: identify knowledge gaps, formulate relevant questions, conduct an efficient...
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