Health Education ▸ Best evidence

1st year - 2nd sem, Finals - Sound scientific evidence from a reputable
source
EVIDENCED – BASED RELATED - Evidence is being evaluated
- The study design and level of evidence is the
TO HEALTH EDUCATION
best available and most appropriate for the
clinical situation
➢ Evidence-based practice (EBP) - the integration of
best research-evidence with clinical expertise and patient
values which when applied by practitioners will Importance of Evidenced Based
ultimately lead to improved patient outcome. Practice (EBP)
➢ Evidence-based practice is a conscientious, ● Well founded decisions
problem-solving approach to clinical practice that ● Stay updated about new medical protocols
incorporates the best evidence from well-designed ● Increase patient’s chances of recovery
studies, patient values and preferences, and a clinician's ● Decrease the demand of healthcare resources
expertise in making decisions about a patient's care ● Reduce expenses

Three Fundamental Components of 5 steps of Evidenced Based Practice

EBP

▸ Clinical Expertise
- The practitioner has sound and current ❖ THE 5 STEPS
academic training 1. Formulate an answerable question
- The practitioner is able to critically reason and - One of the fundamental skills required
apply knowledge for EBP is asking well-built clinical
- The practitioner is able to critically appraise the questions. By formulating an
literature answerable question you focus your
- The practitioner actively participates in clinical efforts specifically on what matters.
decision making These questions are usually triggered
▸ Patient preferences/values by patient encounters which generate
- The patient’s values, needs and wishes are questions about the diagnosis, therapy,
addressed prognosis or etiology.
- The practitioner recognizes that each patient is 2. Find the best available evidence
unique - The second step is to find the relevant
- The focus is on what is best for the specific evidence. This step involves identifying
patient search terms which will be found in
- The practitioner puts the patient’s needs first your carefully constructed question
 from step one; selecting resources in
which to perform your search
3. Appraise the evidence
- It is important to be skilled in critical
appraisal so that you can further filter
out studies that may seem interesting
but are weak.
- Use a simple critical appraisal method
that will answer these questions: What
question did the study address? Were
the methods valid? What are the
results? How do the results apply to
your practice?
4. Implement the evidence
- Individual clinical decisions can then be
made by combining the best available
evidence with your clinical expertise
and your patients values. These clinical
decisions should then be implemented
into your practice which can then be
justified as evidence based.
5. Evaluate the outcome
- The final step in the process is to
evaluate the effectiveness and efficacy of
your decision in direct relation to your
patient.
✓ Was the application of the new
information effective?
✓ Should this new information
continue to be applied to practice?
✓ How could any of the 5 processes
involved in the clinical decision making
process be improved the next time a
question is asked?
PICO Formula
▸ Patient or Problem:
- characteristics of the patient or problem that
are most likely to influence the effects of the
intervention. If you specify the patient or
problem in a very detailed way you will
probably not get an answer, because the
evidence is usually not capable of providing
very specific answers. So a compromise has to
be reached between specifying enough detail to
get a relevant answer, but not too much detail
to preclude getting any answer at all.
▸ Intervention :
- This includes the intervention that we are
interested in and what we want to compare the
effect of that intervention to.
- Type of treatment (drug, procedure, therapy)
- Intervention level (dosage, frequency)
- Stage of intervention (preventative, early,
advanced)
- Delivery (who delivers the intervention?
where?)
▸ Comparison intervention:
- This is relevant when looking at most 'Therapy'
questions. It compares the effect of an
intervention to no intervention, or to another
alternative intervention. There may not always
be a comparison.
▸ Outcome:
- The clinical outcome or effects you are
interested in, for example: improvement of
symptoms, reduction of pain, improved quality
of life, cost effectiveness and benefits for the
service provider.