Download - ROBIN STEED, PHD, LOTR CHRISTINE WRIGHT, PHD, LOTR (CO-CONSPIRATORS) Evidence-Based Practice
ROBIN STEED, PHD, LOTRCHRIST INE WRIGHT, PHD, LOTR
(CO -CONSPIRATORS)
Evidence-Based Practice
What is EBP?
Best Practice
Clinical Reasoning
ResearchClient
Factors
Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence based medicine: How to practice and teach EBM (2nd ed.). London: Churchill Livingstone.
Why is EBP important?
Client education
Client trust
Do no harm!
Your own peace of mind
Our clients deserve the BEST!
Yes, you too can be an evidenced
based practitioner in just 5 easy
steps!
The Process of Evidence Based Practice
Identify the clinical problem
I want my clients to: be more functional have a higher quality of life have better outcomes faster transfer skills to home environment have maintained gains at follow-up have better adherence to treatment plan
1
Ask a PICO question
Patient or ProblemInterventionComparison InterventionOutcomes
2
PICO Examples
In children with autism, vigorous vs. mild exercise, on stereotyped behaviors
In clients with Schizophrenia, environmental supports on ability to transition to community
In children with ABI hemiplegia, constraint induced therapy on function
Systematic Review
P: serious or chronic mental illness, psychosis, schizophrenia, mood disorder, anxiety disorder
I: child care, meal preparation, home management, shopping, time management, safety, social participation, education exploration, retirement exploration, employment seeking
O: employment and education
Arbesman, M., & Logsdon, D. (2011). Occupational Therapy Interventions for Employment and Education for Adults With Serious Mental Illness: A Systematic Review. American Journal of Occupational Therapy, 65, 238-246.
3
Where do we find the evidence?
The Cochrane Collaboration Working together to provide the best evidence for health care
JOANNA BRIGGS INSTITUTE
Critically evaluate the evidence
Study Design randomization control for bias ethical control group
Sample size described
Assessment PropertiesIntervention
detailed/replicableStatistical AnalysisThreats to Validity
internal external
4Critical Review Forms at McMaster’s University
Make a decision
Given the quality of the evidence, what are the implications for clinical
practice?
Implement Evaluate
What is the risk?What is the cost?Do you need special
training?Getting client consentFacility support
Choose outcome measures
Keep records of outcomes and adverse events
Do a ROI assessment
Implement and evaluate5
LIKE I AM REALLY GOING TO HAVE TIME
FOR ALL THIS!
Get Real!
EBP in just 10 minutes a day!
Join AOTARead one or two journal articles a monthLook up the quick summaries on EBP web sitesSign up for evidence alerts at McMaster’sStart an EBP file at workJoin a journal club
EBP Books on Evidence
photos: amazon.com
EBP Books on Implementing EBP
PAIN
Creating Evidence: An Efficient Efficacy Study
Reasons to Create Evidence
ReferralsClient self-efficacyFunding for programThird party paymentResource allocationKeep your job !
www.robinsteed.pbworks.com
Resources at LSUHSC Shreveport