Evidence Based Approach

EVIDENCE BASED APPROACH

EVIDENCE BASED PRACTICE:

DEFINITION: EBP

EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)

DEFINITION OF EVIDENCE BASED PUBLIC HEALTH ( EBPH):

·         “EBPH is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of communities and populations in the domain of health protection, disease prevention, health maintenance and improvement.” Jenicek (1997)

·         “EBPH is the development, implementation, and evaluation of effective programs and policies in public health through application of principles of scientific reasoning, including systematic uses of data and information systems and appropriate use of program planning models.” Brownson (1999)

BASIC REQUIREMENTS OF EBPH:

KEY DIFFERENCES BETWEEN EBM AND EBPH:

Characteristic	Evidence- Based Medicine	Evidence- Based Public Health
Quality of evidence	Experimental studies	Observational and quasi- experimental studies
Volume of evidence	Larger	Smaller
Time  from intervention to outcome	Shorter	Longer
Professional training of workforce	More formal, with certification and/ or licensing	Less formal, no standard certification
Decision Making	Individual	Team

WHY IS EBPH IMPORTANT?

·         Provides assurance that decision making is based on scientific evidence and effective practices

·         Helps ensure the retrieval of up-to-date and reliable information about what works and doesn’t work for a particular public health question

·         Provides assurance that one’s time is being used most efficiently and productively in reviewing the “best of the best” information available on the particular public health question

SOME KEY CHARACTERISTICS OF EBPH:

·         Intervention approaches developed based on the best possible scientific information

·         Theory and systematic planning approaches are followed

·         Problem solving is multi-disciplinary

·         Sound evaluation principles are followed

·         Results are disseminated to others who need to know and take action.

ADVANTAGES TO USING EBPH:

·         Higher likelihood of success

·         Identify common indicators

·         Defend/expand an existing program

·         Advocate for new programs

·         New knowledge is generated to help others

WHEN IS EBPH USED?

·         when it’s important to have scientific evidence to support decision making

·         when evaluating the effectiveness and cost benefits of health programs

·         when establishing new health programs

·         when policies are being implemented

·         when conducting literature reviews for grant projects.

STEPS IN THE EBPH PROCESS:

1.      Formulating a clear question from a public health problem

2.      Searching the literature

3.      Appraising the evidence

4.      Selecting the best evidence for a public health decision

5.      Linking evidence with public health experience, knowledge, practice, and the community’s values and preferences

6.      Implementing findings in public health practice and programs

7.      Evaluating results.

EVIDENCE-BASED PUBLIC HEALTH:

ROLE AND FUNCTIONS OF COMMUNITY HEALTH NURSE IN EVIDENCE BASED APPROACH IN COMMUNITY HEALTH:

·         Epidemiologist /Researcher

·         Nurse practitioner

·         Supervisor

·         Case manager

·         Care giver

·         Team leader