Carl and other contributors
just caught up with this discussion on return from hols and would
like to make follwing contribution
1) early e-mails seemed to be on both nurse-decision and evidence
based health lists - I think there should be more x fertilization
between these two lists and especially that nurses should look at
and be contributors to evidence based health - so I am including this
message on both
2) EBP is systematic approach to problem solving using research
evidence and therfore just as applicable to nursing as any other
h.care discipline - Nurses just like doctors do not formulate
questions in such a way that they can use research to find them
hence the scott richardson 3(4) part model is a very useful tool for
learning how to formulate problems into questions which can be
answered using research.
3)As someone who been around these parts awhile - even though I have
not seen the actual questions carl gives below before I can already
identify the papers which could be used to answer them. However a big
problem in the 'practice' is that much of the research which
answers questions which nurses might pose is not of good enough
quality to use the answers to make a clinical decision (this applies
whatever research design the question requires - and is probably
more of a problem for questions of interest to nurses especially as
EBM has been around longer )
4) CATS are great and equally applicable to nursing - Problem is as
referred to above with the research. there isn't good research or
data to put the resulkst from a single papar in a CAT - therefore
will end up using several pieces of research evidence of lower
quality in answering a question. Challenge is to find nice neat way
of summarising this.
5) Our colleagues in the Southern Hemisphere have taken on EBP more
quickly in nursing than in U.K - there The Joanna Briggs Institute
for Evidence Based Nursing has sites in Australia, New Zealand, Hong
Kong and several other south east asian countries. The centre
produces evidence based procedure manuals and best practice sheets.
These are a useful resource and good demonstration of the application
of EBP concepts to nursing - check out the website at
http://www.joannabriggs.edu.au/welcome.html
Look forward to seeing more discussion on this issue
Mark
> Further to last weeks posts on this topic and Carmel's request for
> examples here are the questions used for the forthcoming nursing
> contribution to the 2nd edition of Sackett's EBM book (compiled by the
> editorial team from EBN). Each follows the four part (population,
> intervention, counter intervention (if appropriate) and outcome)
> evidence based approach, each is focussed and can be answered (as
> opposed to questions such as 'are Drs better than Nurses?' or 'are
> Health Visitors a good idea?'). That said, these are a starting point
> only and are far from perfect or representative - although they do give
> a flavour of the possibilities.
>
> So having received offers of collaborative help from John Platt at
> Sheffield and a very supportive e-mail from Chris Ball (senior ed.
> evidence based on call) regarding the idea of establishing a database of
> clinical questions as a precursor to full scale 'cats' why not get those
> questions flowing....e-mail them to the list or myself and they will be
> posted on our web site and back to the list once a month. So please talk
> to practitioners and help develop those questions...
>
> a useful start point for those of you who haven't had a go at asking
> questions in this way is:
>
> http://cebm.jr2.ox.ac.uk/docs/focusquest.html
>
> Diagnosis
> In patients with suspected depression what is the accuracy of a
> two-question case-finding instrument for depression compared with six
> previously validated instruments?
>
> Prognosis
> In healthy women who have recently had a miscarriage, what is the usual
> grieving process and are any factors associated with longer than normal
> grieving?
>
> Treatment
> in children with colds are zinc lozenges safe and effective for relief
> of cold symptoms?
> Is a self-management programme that includes asthma education plus
> regular review by health professionals, effective in improving health
> outcomes for adults with asthma?
>
> Causation/harm
> In women taking oral contraceptives, is there an association between
> their use and cardiovascular disease?
>
> Qualitative (experiential/value-based) type
> In elderly people living at home, what are the likely issues they will
> be considering when deciding to seek out long-term care services?
>
> Chris Ball also wanted advice on how CATs might be adapted to the needs
> of nurses (and nursing!) and so it might be worth checking out the CAT
> page so that you know what he is talking about and you can post your
> ideas to the list.
>
> http://cebm.jr2.ox.ac.uk/docs/catbank.html
>
>
> all the best
>
> C.
> --------------------
> Carl Thompson D.Phil RGN
> Research Fellow
> Centre for Evidence Based Nursing
> Dept of Health Studies
> Genesis 6
> Science Park
> University of York, York
> United Kingdom, YO10 5DQ
>
> tel: +44(1904)434115
> fax: +44(1904)434102
> e-mail: [log in to unmask]
> www.cebn.co.uk
>
>
>
Mark Newman
Senior Lecturer:
School of Health, Biological & Environmental Sciences (HeBES)
Middlesex University &
Barnet & Chase Farm Hospitals NHS Trust
Furnival Building, Archway Campus
Highgate Hill
London N19 3UA
Tel: 0181 362 6627 or 0181 366 6600 ex 5775
Fax: 0181 362 6299
E-Mail: [log in to unmask]
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