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Evidence based practice in a clinical setting
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Evidence Based Practice (EBP) is useful to practice because it aids practitioners development and widens their knowledge and insight, therefore enhancing the experience of the practitioner. This ensures that the best quality of care is given to the patient (Duncan, 2006).
EBP is defined by Sacket et al as 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' (Duncan, 2006) The best evidence in this context could therefore be argued to come from information that has been researched using quantitative methods that is numerical data that tests a hypothesis such as randomized control trials (RCT)(Duncan, 2006).
Therefore a knowledge of EBP would benefit an Occupational therapist because literature and research demonstrates that any interventions are both clinically and cost effective , Also it gives Occupational Therapists the tools and the evidence to justify and back up some of the interventions to the patients they are working with, the management team and to themselves (Taylor 2000).
An example of evidence based practice would be to find relevant studies for a specific topic area being researched. For example, to find the research paper titled ‘The efficiency of cotton cover gowns in reducing infection in nursing Neutropenic patients,’ the journal in which the article was published in this case, The International Journal of Nursing, would need to be found. Medline, an online database would be one method of finding this. A list of relevant search terms would then need to be researched by using the PICO Framework, this limits the search to only relevant items and ensures that a well built clinical question will then be formulated (Drummond,1998).
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...servational Studies: a review of study designs, challenges and strategies to reduce confounding, International Journal of Clinical Practice, 63, issue 5 :691-697, Online available at Wiley Interscience, accessed on 12.11.09
Miller and Wilson. (1983) cited in Drummond,A. (1998). Research Methods For Therapists, 1ST edition, Stanley Thornes Ltd, United Kingdom
Polgar, S. Thomas,S,A. (2000) .INTRODUCTION to Research in the Health Sciences, 4th edition, Harcourt publishers Ltd. London.
Sacket et al, cited in, Duncan, E,A,S, (2006) Foundtions for practice in Occupational Therapy, 4th edition, Elsevier Ltd.
Taylor C.M. (2000) Evidence-based practice for occupational therapists, 1st edition , Blackwell science, Oxford.
Treece and Treece. (1977:25) cited in Drummond,A. (1998). Research Methods For Therapists, 1ST edition, Stanley Thornes Ltd, United Kingdom.
Evaluating Process: First, it is important to review R’s occupational profile for progress from the start of occupational therapy. This is done to determine which assessment fits the needs of R and to ensure that the services rendered fits the client's purpose and goal. Some of the information gathered will include: client's occupational history, ADL patterns, needs and goals, environmental issues, and what the client’s limitations. It is important to evaluate the client’s progress to help facilitate the services that the new occupational therapist will continue. In addition, the client's concerns and interests are assessed in a welcome and open interview to attain additional information that R's family may
EBP is a method of finding evidence and using it in practice: as Blaney (1986) states, it is used to assess health, plan, implement, and evaluate individualized care (p.182). Finotto et al. (2013) breaks EBP down into steps as follows: Formulate a research question; find the most relevant evidence; appraise evidence; integrate evidence with clinical experience and patient values to make practical decisions; and evaluate the outcome (p.460). Carrazzone (2009) and Moch et al. (2010) argue that didactic components with EBP integrated into the education are believed to be beneficial to studen...
It can be given to anyone who wants to learn about occupational therapy in the psychosocial aspect. When I am working in the field and someone wants to learn more about what I do and what my career includes, I can give them this article to get a basic understanding of what I do. After a person reads this article, I can highlight some of the main points in the article to give them a better understanding of what is occupational therapy is in the psychosocial aspect. It is important for me to keep this article on hand because if someone wants to look up what I do and they do not know where to begin, I can give them this article to read to get a basic understanding of what I do and they can get an idea of what to research. This article is not only for clients and client’s friends and family, but it can be used for occupational therapists and occupational therapy assistances. This article can be used as a refresher for a therapist if they are having a hard time remembering something about this
Evidence-Based Practice is a methodology, framework, gathering of ideas or concepts, adopted principles and strategies supported by research (Fixsen et al.,
Townsend & Polatajko (2007) state that “Occupational therapy is the art and science of enabling engagement in everyday living, through occupation; of enabling people to perform the occupations that foster health and well-being; and of enabling a just and inclusive society so that all people may participate to their potential in the daily occupations of life”.
Liddle, H A., Rowe, C L., Dakof, G A., Henderson, C E., Greenbaum, P E.; (Feb, 2009). Journal of Consulting and Clinical Psychology; Vol 77(1); 12-25. Doi: 10.1177/0306624X10366960
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
Occupational therapy was based off of psychology; we evolved from treating mentally ill patients with isolation as an efficient treatment plan. We must never forget we are known to be “the art and science of helping people do the day-to-day activities that are important and meaningful to their health and well being through engagement in valued occupations” (Crepeau, Cohn, & Schell, 2008). To other professional disciplines this article explains the difference between each of us, yet can also express our relation to one another. The basic goal of all therapeutic disciplines is to better our clients life, through physical, speech or occupational therapy. Every discipline targets different goals, may it be body mechanics, reducing a stutter or buttoning a shirt, at the end of the day our clients well being may it be through science, art or both is all that matters. To the occupational therapy field this article means progress for what we do. Reading this article today in the year 2015 did not seem like old information to me, it is still relevant, I am proud that our field is not only evolving with contemporary time but it is also maintaining its
Occupational therapy (OT) theory offers valuable contribution to support professionalization since possessing a unique body of knowledge is essential to define a profession (Cooper, 2012). To utilize theory effectively, it is essential to differentiate between generic and specific theory as knowledge of the core theory helps to form OT identity and action as a practicing practitioner. In this essay, OT theory refers only to philosophy and OT specific models. Frame of references (FOR) will not be included since it can be shared with the other professions (Boniface & Seymour, 2012).
...e-based knowledge to inform the therapy practice. It also assists with furthering the therapist’s knowledge of humans as occupational beings as well as the relationship between occupation and health.(Yexer ,1993) introduced occupational science as a fundamental science supporting occupational therapy, with an aim to refocus the provision of therapy back to occupation. Hence, occupational science provides the therapists with support, justifies the meaning and uniqueness of the profession and distinguishes occupational therapy from other professions. In addition (Wilcock, 2001), also emphasises that occupational science might be another way to avoid the possible failure of the occupational therapy as a practice. With a strong research background, occupational therapists could make a contribution to medical science, which may challenge it from a different standpoint.
Change is something that human have to face often, yet it is still very hard for us to adapt to it. We can, in turn, agree that change is not easy (Jacobs 2002). Occupational therapy has been thought a lot of changes which give rise to new treatment methods, new approaches and a better to communicate with the patients. Below is an analysis of the changes that have been made in the occupational therapy field and their outcomes.
O'Brien, D. (2009). Randomized controlled trials (RCTs). In R. Mullner (Ed.), Encyclopedia of health services research. (pp. 1017-1021). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.proxy1.ncu.edu/10.4135/9781412971942
What are the best ways of achieving this in the reality of the modern NHS? To conclude, Evidence Based Practice is a process of building up accurate information from medical research which has been correlated and assessed. From this, the nurse is capable of advising the best plan of care. For nursing standards to improve, it is vitally important that the nurse is given the time to research and the trust to start off the process of change for better care. References Cullum, N., Ciliska, D. and R. Haynes, Marks (2008).
Cole, M. B., & Tufano, R. (2008). Applied theories in occupational therapy: A practical approach. Thorofare, New Jersey, United States of America: Slack Inc.
In conclusion, Evidence-Based Practice requires explicit use of best evidence and decision making. However, clinical skills, judgment and experience are as critical. The best systematic recording will have a significant impact on increasing the confidence on the effectiveness of the treatments and correct interpretation of evidence. “To practice EB means becoming a better history taker, better clinical examiner, a consumer of empirical evidence and a thoughtful diagnostician and therapist” (Ambrose, B, 2011). As physiotherapists, we are responsible to make contributions and able to provide patients the best treatment and services.