Improving Evidence-based Medicine in Dietetics: A Non-Traditional Approach
According to Sackett, (1996) evidence–based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about patient care. Straus, Richardson, Glasziou, & Haynes (2005, p. 1) described evidence-based practice (EBP) as “the integration of the best research evidence with clinical expertise and unique patient values and circumstances.” According to Straus et al, (2005, p.3) those practicing evidence based medicine must follow five specific steps: a) Include the need for data into an answerable question, b) Track down the best evidence, c) Critically appraise the evidence for validity, impact, and application, d) Integrate the critical appraisal into clinical practice, and e) Evaluate the effectiveness and efficiency of implementing steps a-e-and seek ways to improve them. Subsequently, without current best evidence, clinical practice cam become out-dated to the detriment of patients, this is an untenable circumstance and one which should never be allowed to happen.
Evidence-based medicine allows clinicians to offer patients the best care that current science can afford. Strauss et al., suggest that the three components of EBP are best research evidence, clinical experience, and patient/client values (Strauss, et al., 2005). All clinicians should strive to include all three components into the care provided to patients. Dietitians are key members of the clinical team and more than 70,000 dietitians work daily across the US (American Dietetic Association, 2010). Dietitians implement medical nutrition therapy (MNT) which the American Dietetic Association (ADA) defines as an essential component of comprehensive he...
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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).
What is meant by evidence-based practice and how is this different from an historical standpoint.
Polly Beam, J. S. (n.d.). Levy Library. Evidence Based Medicine Tutorial. 1.3 What’s Best: The Evidence Hierarchy. Retrieved April 9, 2014, from http://libguides.mssm.edu/hierarchy
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
Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
Evidence Based Practice emerged in the late 20th century, becoming widespread in the 21st century. According to Research and Practice: The Role of Evidence-Based Program Practices in the Youth Mentoring Field ( 2009) “The concept of Evidence Based Practice (EBP) actually has its roots in the medical field, where the work of Archie Cochrane (1972) and others examined the key role that the substantial body of medical research and literature could play in how doctors make decisions in patient care” (para 6); Thus, a doctor’s decision would be an “educated” decision, based on evidence gathered (patient symptoms), history of cases they have overseen, or research of previous case diagnosed by another doctor, with a related case. Evidence Based Practices are defined as “ integration of: (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve” (“Evidence Based Practice (EBP),” 1997-2014); often described as the “Best Practices”. The evidence itself is not the basis of decisions made, but it does help support the process of care given to our clients.
Dietitian meeting the needs if the patients’ needs as ordered from a nutritional point of view.
As dental professionals it is our job to provide nutritional counseling to increase the patient’s awareness to make better choices in regards to nutrition. After
Although the treatment process was often frustrating and challenging, I actually came to enjoy my appointments with the nutritionist in her tiny, cozy office, cluttered with food models and recipes. She taught me the basics of nutrition and helped me form a healthier relationship with food. It took time and quite a few tearful sessions, but I slowly started to view food in terms of the nutrients and benefits it could offer me instead of thinking of food as the enemy. During my recovery, I experienced the powerful impact that proper nutrition could have on overall health. I gained back all the weight I had lost, and my hair stopped falling out. However, the biggest changes were the ones most people could not see just by looking at me; they were the emotional and mental changes that came from properly nourishing my body again. I could concentrate on schoolwork instead of planning out my next meal, and I ...
Cullum, N. Ciliska D. and R. Haynes, Marks (2008;) Evidence – based Nursing: An Introduction.
Evidence-based decision-making entails the process when a practitioner integrates the best research evidence in combination with clinical expertise and patient values to enhance the treatment outcomes. The three fundamental components of evidence-based decision-making include individual clinical expertise, scientific evidence and patient values and preferences (Peterson, Becker, Treasure, Shafran, & Bryant-Waugh, 2016). Scientific evidence entails the adoption of clinically relevant research conducted applying acceptable methodology. Clinical expertise is about the clinician’s cumulated education, skills, and experience in execution of the tasks. Patient values or preferences regard the concerns and expectations
has explored the various reasons why many athletes fail to consume a well balanced diet (1). In some instances athletes seek nutrition guidance from their coaches however this is not always the most effective method as the knowledge of the coach can be limited and biased (1). It has been found in Australia that 88% of exercise professionals such as coaches have limited if any nutrition training thus there is an increased likelihood of poor quality information being conveyed to athletes (12). Coaches also place pressure on body image through expressing concerns of excess weight, which may affect athletic performance(1). In consideration of this, it may prove effective to target not only athletes but coaches also during nutrition education programs.
The importance of Evidence-Based Practice is to ensure the best possible care is provided for patients. Evidence-Based Practice functions by measuring the effectiveness of a treatment and differentiating findings between high-quality and low-quality. It also helps with health development and improves the reliability and facilitates students to become reflecti...
This report aims to describe the role and responsibility of public health dieticians/nutritionists and how they contribute to a more integrated health system. A current health problem for public dieticians/nutritionists in New Zealand (NZ) is an increase in obesity and this report will also discuss this further.