Evidence‐Based Medicine and Primary Care: Keeping Up Is Hard to Do

Zipkin, Daniella A.; Greenblatt, Lawrence H; Kushinka, Jeffrey

doi:10.1002/msj.21337

Cited by 12 publications

(9 citation statements)

References 49 publications

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“…The importance of EBP point‐of‐care resources to enable healthcare providers to provide effective evidence‐based care has been well discussed (Addison et al., ; Sayyah Ensan, Faghankhani, Javanbakht, Ahmadi, & Baradaran, ; Worster & Haynes, ; Zipkin et al., ); less well addressed, however, is the importance of EBP for nurses, allied health professionals, and other careers for the provision of evidence‐based care. Therefore, it is an interesting observation that among the top quartile resources, three out of five (Nursing Reference Centre, Mosby's Nursing Consult, JBI COnNECT+) are historically associated with a nursing perspective.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence‐based practice (EBP) has been defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, Rosenberg, Gray, Haynes, & Richardson, ). It is increasingly recognized that EBP at every level of health care is vital for ensuring effective and efficient care of patients (Pearson, Wiechula, Court, & Lockwood, ; Zipkin, Greenblatt, & Kushinka, ). However, it is known that clinicians have very limited time to set aside for general research and study (Chan & Stieda, ; Straus, Ball, Balcombe, Sheldon, & McAlister, ), and are, on average, unable to spend more than 2 minutes searching for the answer to a specific clinical question (Ely et al., ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite being widely accepted, numerous barriers to EBP exist, including time constraints, a sense of EBP interfering with physician–patient relationships, perceived threats to professional autonomy, lack of effective access to key information, challenges in applying evidence to individual patients, and skepticism regarding the credibility of evidence (Freeman & Sweeney, ; Mendelson & Carino, ; Tracy, Dantas, & Upshur, ; Zipkin et al., ). The translation of knowledge to practice is a skill‐based process, with identifiable competencies (Melnyk, Gallagher‐Ford, Long, & Fineout‐Overholt, ), educational requirements and resource requirements needed for the research‐to‐practice gap to close.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence‐Based Practice Point‐of‐Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content

Campbell

Umapathysivam

Xue

et al. 2015

Worldviews Ev Based Nurs

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Keywords evidence-based medicine, online systems, point-of-care systems, editorial policies, evidence-based practice, evidence-based nursing ABSTRACTObjective: Clinicians and other healthcare professionals need access to summaries of evidencebased information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP pointof-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources.Design: A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians."Main Outcome Measures: A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume.Results: Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+.Linking Evidence to Action: The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evidence‐Based Practice Point‐of‐Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content

Campbell

Umapathysivam

Xue

et al. 2015

Worldviews Ev Based Nurs

View full text Add to dashboard Cite

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“…These people include patients and their families, practitioners, policy makers, the press, and members of the public (the "5 Ps"). This can be difficult because of multiple factors including time constraints in trying to find information and lack of ability to judge its suitability for a particular clinical situation 8,9 . A challenge for practitioners is keeping up with research findings to ensure that treatment and diagnostic choices are sound, and their practice is effective 6,7 .…”

Section: Rader Et Al: Cochrane Knowledge Translationmentioning

confidence: 99%

Update of Strategies to Translate Evidence from Cochrane Musculoskeletal Group Systematic Reviews for Use by Various Audiences

Rader

Pardo²,

Stacey³

et al. 2013

J Rheumatol

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For rheumatology research to have a real influence on health and well-being, evidence must be tailored to inform the decisions of various audiences. The Cochrane Musculoskeletal Group (CMSG), one of 53 groups of the not-for-profit international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. While systematic reviews provided by the CMSG fill a major gap in meeting the need for high-quality evidence syntheses, our work does not end at the completion of a review. The term "knowledge translation" (KT) refers to the activities involved in bringing research evidence to various audiences in a useful form so it can be used to support decision making and improve practices. Systematic reviews give careful consideration to research methods and analysis. Because the review is often long and detailed, the clinically relevant results may not be apparent or in the optimal form for use by patients and their healthcare practitioners. This paper describes 10 formats, many of them new, for ways that evidence from Cochrane Reviews can be translated with the intention of meeting the needs of various audiences, including patients and their families, practitioners, policy makers, the press, and members of the public (the "5 Ps"). Current and future knowledge tools include summary of findings tables, patient decision aids, plain language summaries, press releases, clinical scenarios in general medical journals, frequently asked questions (Cochrane Clinical Answers), podcasts, Twitter messages, Journal Club materials, and the use of storytelling and narratives to support continuing medical education. Future plans are outlined to explore ways of improving the influence and usefulness of systematic reviews by providing results in formats suitable to our varied audiences.

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“…Furthermore, computerised medical records have been shown to enhance patient care through better adherence to preventive care guidelines and evidence-based decision-making. [250][251][252] There are a number of barriers to the implementation of computerised medical record systems which refers to computerised systems collecting, storing and displaying individual patient information. 253 The primary barriers to computerised medical record implementation reported by a systematic review about physician acceptance of computerised medical records included concerns about technical issues, cost, and time.…”

Section: Moving To Computerised Health Assessmentsmentioning

confidence: 99%

Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

Spurling¹

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There has been insufficient research involving Aboriginal and Torres Strait Islander peoples living in urban areas to inform strategies required to improve inequitable health outcomes and life expectancy for Aboriginal and Torres Strait Islander peoples. The injustice of these health inequities motivated me to investigate the use of computerised Aboriginal and Torres Strait Islander health assessments in primary care as a source of research data which can be used to respond to community priorities. I conducted this research at the Inala Indigenous Health Service, a Queensland Government funded primary health care service for Aboriginal and Torres Strait Islander peoples. Inala is a suburb in south-western Brisbane with a strong sense of community and identity, but also significant social and economic challenges. Staff at the Inala Indigenous Health Service have been using Aboriginal and Torres Strait Islander health assessments for both clinical and research purposes since their introduction in 2004 for adults, and 2006 for children.In this thesis, I used a mixed methods approach. The first two research projects of this thesis are situated in the postpositivist paradigm where researchers accept that scientific research produces evidence which helps establish the probability that a finding is true rather than truth itself. The first research project evaluated the feasibility of implementing computerised health assessments in primary care for dual clinical and research purposes.After finding that it was feasible, the second research project established that computerised health assessment data were sufficiently representative, complete, reliable, and valid to produce credible research findings.The final two research projects of this thesis are situated in the transformative paradigm with the explicit goal of improving the social world. I acknowledge that my position as a white, non-Indigenous, male, medical researcher influenced the conduct and outcome of all the research projects in this inquiry. To minimise the risk that this research would reproduce the damaging effects of research for Aboriginal and Torres Strait Islander peoples conducted by non-Indigenous researchers, I listened to community voices to inform my approach to research using computerised health assessment information.I conducted a qualitative study involving thematic analysis of semi-structured interviews with key informants in the Inala Aboriginal and Torres Strait Islander community regarding their priorities for health and research based on health assessment data. Rather than a discrete set of health priorities, key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural, and environmental determinants of iii health operated in a "cycle" to influence the community's health. Furthermore, some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. These findings supported the addition of questions to health...

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Evidence‐Based Medicine and Primary Care: Keeping Up Is Hard to Do

Cited by 12 publications

References 49 publications

Evidence‐Based Practice Point‐of‐Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content

Evidence‐Based Practice Point‐of‐Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content

Update of Strategies to Translate Evidence from Cochrane Musculoskeletal Group Systematic Reviews for Use by Various Audiences

Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

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