Evidencebased Nursing 0531 88382201 wangkfsdu edu cn 0
Evidence-based Nursing 王克芳 0531 -88382201 山�大学�理学院 wangkf@sdu. edu. cn
0 Course introduction The course (教学日�) Course Code: 0680022 Day and Time: Tuesday/hursday 1: 30 -4: 30 pm Evidence-based Nursing WKF SON SDU 1
REFERENCE BOOK(参考教材) v 胡雁主编. 循证护理学, 人民卫生出版社, 2012年 v 唐金陵主编. 循证医学基础, 北京大学出版社, 2010年 v Melnyk B. M. Evidence-Based Practice in Nursing and Healthcare, Lippincott Williams & Wilkins, 2011, 2 nd 课程网站: http: //course. sdu. edu. cn/G 2 S/Template/View. aspx? action=view&course. Type= 0&course. Id=619 Evidence-based Nursing WKF SON SDU 2
0 Course introduction EVALUATION Measure Percent Due Date 1. Class Activities(individual) 15 2. Identifying the Clinical Question using the PICO Format( 10 Nov. 28 3. Critical Appraisal of literatures(a RCT+ a SR)(group) 20 Dec. 7 4. Critical Appraisal of a clinical practice guideline(group) 10 Dec. 10 5. Evidence-Based Paper(Oral Presentation, group) 30 Dec 21 6. Quiz(individual) 15 Dec 21 Total 100 group) Evidence-based Nursing WKF SON SDU 3
分 组 Evidence-based Nursing WKF SON SDU 4
1 Chapter 1 Introduction to Evidence-Based Practice WHAT is Evidence-based Practice? WHY need Evidence-based Practice? ORIGIN and development of EBP? HOW can we perform EBP? Evidence-based Nursing WKF SON SDU 5
1 Chapter 1 Introduction to Evidence-Based Practice WHAT is Evidence-based Practice? WHY need Evidence-based Practice? ORIGIN and development of EBP? HOW can we perform EBP? Evidence-based Nursing WKF SON SDU 6
Definition of EBP是指认真、明确和明智地应用现有的最佳证据,同时 结合专业人员的个人专业技能和临床经验,考虑患者的愿望, 对患者 作出医疗决策。 the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual. Health care professionals who perform EBP use research evidence along with clinical expertise and patient values. Evidence-based Nursing WKF SON SDU 7
Knowledge Sources for EBP 1. Valid research evidence The primary basis of clinical decisions 2. Clinical expertise To best use research by filling in gaps and combining it with practice-based evidence to tailor clinical actions for individual patients’ contexts 3. Patient choices and concerns For determining the acceptability of evidence-based care to the individual patient Evidence-based Nursing WKF SON SDU 8
1 Chapter 1 Introduction to Evidence-Based Practice WHAT is Evidence-based Practice? WHY need Evidence-based Practice? ORIGIN and development of EBP? HOW can we perform EBP? Evidence-based Nursing WKF SON SDU 9
Why EBP? 1989年一项震惊整个医学界的研究 Of 226 maneuvers in obstetrics & childbirth (在产科使用的226种方法中, 临床试验或系统综述证明): 20% were beneficial (有效: 疗效大于副作用) 30% were harmful or of doubtful value (有害或疗效可疑) 50% had no RCT evidence available (缺乏随机试验证据) Iain Chalmers et al. Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press, 1989 Evidence-based Nursing WKF SON SDU 10
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Why EBP? Benefits from EBP Highest quality of care and Best patient outcomes Reduction in healthcare costs Reduction in geographic variations in care Promotion of retention of healthcare workers In spite of these benefits, familiarity and implementation of EBP remains low Evidence-based Nursing WKF SON SDU 17
Why EBP? n It is no longer your job to know everything, even in your chosen specialty. n It is your job to be able to find the right information from the right place as and when you and your patients need it. Evidence-based Nursing WKF SON SDU 18
1 Chapter 1 Introduction to Evidence-Based Practice WHAT is Evidence-based Practice? WHY need Evidence-based Practice? ORIGIN and development of EBP? HOW can we perform EBP? Evidence-based Nursing WKF SON SDU 19
Origins and development of EBP? 1992年: 循证医学的诞生 美国医学会杂志 (JAMA) 1992刊登了加拿大Mc. Master大学循 证医学 作组David Sackett等人一篇题名为 “循证医学: 医 学实践教学的新模式” (Evidence-Based Medicine – A New Approach to Teaching the Practice of Medicine) 的文章,循证医 学第一次在医学文献中亮相。 (Source: JAMA 1992; 268: 420 -5) Evidence-based Nursing WKF SON SDU 20
Ø In 1972, he criticized the medical profession for not providing rigorous reviews of evidence to the police makers and organizations Ø He believed that evidence from RCTs was the strongest evidence for clinical decision making. 阿奇. 考科� (1909 -1988) (Archie Cochrane) 英国著名流行病学家 Ø 他根据妊娠与分娩的RCT结果撰写的系统 评价,成为随机对照试验和系统评价方 面的一个真正里程碑,并指出其它专业 也应遵循这种方法。
Origins and development of EBP? v 1992年《Journal of American Medical Association》 发表 了EBM 作组对EBM的全面阐述。 v 1995年以后 国际上其它著名的医学期刊,如 《British Medical Journal》、《The New Eng 1 and Journal of Medicine》、《The Lancet》、《Annals of Internal Medicine》发表有关EBM的系列述评及评论 v 1992年在英国伦敦 成立“Cochrane中心” v 1993年 10月,正式建立了世界范围的Cochrane协作网 v 1998年中国成立Cochrane中心--华西医科大学 Evidence-based Nursing WKF SON SDU 23
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2012年 Evidence-based Nursing WKF SON SDU 27
2016年 Evidence-based Nursing WKF SON SDU 28
1 Chapter 1 Introduction to Evidence-Based Practice WHAT is Evidence-based Practice? WHY need Evidence-based Practice? ORIGIN and development of EBP? HOW can we perform EBP? Evidence-based Nursing WKF SON SDU 29
循证医学实践模式 Evidence-based Nursing WKF SON SDU 30
Steps of the EBN Process v Evidence-based nursing(EBN) the practice of nursing in which the nurse makes clinical decisions on the basis of the best available current research evidence, his or her own clinical expertise, and the needs and preferences of the patient ----Mosby's Medical Dictionary, 8 th edition. © 2009, Elsevier. Evidence-based Nursing WKF SON SDU 32
Steps of the EBN Process Assess the outcome and disseminate the results Ask important questions about the care of individuals, communities, or populations Five steps of EBP Apply the evidence Acquire the best available evidence regarding the question. Critically appraise the evidence for validity and applicability
Barriers to EBP Lack of knowledge Information overload Lack of role models Lack of time or money Resistance to change Misperceptions – require education Evidence-based Nursing WKF SON SDU 34
Facilitators of EBP Support from leaders and peers Adequate time Resources Journal clubs and EBP rounds Determined effort is often required in order to address barriers and facilitate the implementation of EBP Evidence-based Nursing WKF SON SDU 35
Any question? ? Evidence-based Nursing WKF SON SDU 36
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