The meaning of evidence-based management to brazilian senior nurse leaders

Purpose: The study objective was to understand the meaning of evidence-based management for senior nurse leaders in accredited, public hospitals in the State of Sao Paulo, Brazil. Design and Method: A phenomenological approach was used to analyze interviews conducted with 10 senior nurse leaders between August 2011 and March 2012. The analytic method was developed by the Brazilian phenomenologist, Martins. Findings: Senior nurse leaders described how they critically appraise many sources of evidence when making managerial decisions. They emphasized the importance of working with their teams to locally adapt and evaluate best evidence associated with managerial decision making and organizational innovations. Their statements also demonstrated how they use evidence-based management to support the adoption of evidence-based practices. They did not, however, provide specific strategies for seeking out and obtaining evidence. Notable challenges were traditional cultures and rigid bureaucracies, while major facilitators included accreditation, teamwork, and shared decision making. Conclusions: Evidence-based management necessitates a continuous process of locating, implementing, and evaluating evidence. In this study leaders provided multiple, concrete examples of all these processes except seeking out and locating evidence. They also gave examples of other leadership skills associated with successful adoption of evidence-based practice and management, particularly interdisciplinary teamwork and shared decision making. Clinical Relevance: This study demonstrates senior nurse leaders' awareness and utilization of evidence-based management. The study also suggests what aspects of evidence-based management need further development, such as more active identification of potential, new organizational innovations. © 2013 Sigma Theta Tau International.

Odontologia baseada em evidências: otimizando a prática e a pesquisa

Clinical decisions in dentistry are often based on the knowledge obtained during graduation, clinical experience, information shared with colleagues and professor, textbooks, seminars, conferences and continuing education courses. However, it is necessary to know if this information is derived from scientifically validated researches since too much information may complicate this process. Initially in medicine and later in other health areas a method which enables a critical evaluation of scientific papers related to a specific issue and also, whenever it is possible, an evaluation of the results by meta-analysis,was developed by Cochrane in order to reduce the bias towards all information obtained. The aim of this work is to present some aspects of the Evidence Based Dentistry (EBD) and to show how this methodology can be used to better substantiate scientifically the clinical decision of the dentist and improve researches design with scientific validity. The paper discusses editorial trends focused on the EBD, shows the differences between a systematic and a conventional review, describes data about Cochrane and the advantages of scientific evidence synthesis and the implications of EBD for clinical practice and research as well as recommendation grades and evidence levels of general scientific studies.

EVIDENCE-BASED PRACTICES PUBLISHED IN BRAZIL: IDENTIFICATION AND ANALYSIS STUDIES ABOUT HUMAN HEALTH PREVENTION

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

Why Do We Think Practice Research is a Good Idea? Comments and Musings Inspired by the Salisbury Statement

In this paper I raise some questions about current understandings of practice research and whether they are worth pursuing. In particular, the notion of a gap between practice and research is examined in terms of how it constricts thinking about this issue. I also attempt to explicate some of the less examined assumptions associated with practice research. Finally, I suggest that we embrace multiplicity, not by trying to accommodate all views under the practice research umbrella, but by accepting that there will be many versions of practice research that will have differential appeal.

Evidence Based Nursing Research Project

Introduction: A need for baccalaureate prepared nurses to find and use evidence in practice exists. Whereas using this evidence in practice may be a masters level expectation, current practice demands that baccalaureate prepared nurses acquire a basic understanding of how to use evidence in practice. Nursing students at the senior level have had exposure to critiquing research, however, they have difficulty translating evidence to practice. [See PDF for complete abstract]

Assessing Distributed Leadership and the Successful Implementation of Evidence-Based Practices

Kelly and Halverson are to be congratulated on their contribution to the field of education. Their efforts in designing The Comprehensive Assessment of Leadership forLearning (CALL) represents a step forward inm the fomative assessment of distributed leadership in schools and their work is noteworthy in its rapid linking of survey assessment data to specific feedback and recommendations for users. Issues relevant to evidence-based practices, implementation, and professional common language are addressed in this commentary.

Sobre la identidad de la ciudad. El estudio de la interacción audiovisual en las nuevas herramientas para el proyecto. El caso de Cuenca

Esta investigación se centra en el estudio de la dimensión audiovisual de la arquitectura, como aproximación intersensorial a la aprehensión e ideación del espacio. Poniendo en evidencia la complejidad de la relación hombre-medio, se plantea la necesidad de desarrollar nuevas metodologías y herramientas que tengan en cuenta dicha complejidad y que favorezcan el desarrollo del proyecto. Nos mueve en esta investigación la convicción de que los cambios rápidos y profundos que caracterizan nuestros tiempos en todos los ámbitos, social, económico, político… entrañan inevita-blemente nuevos modos de conocimiento y experimentación del espacio, y por tanto nuevos ejes de investigación. La creciente valoración, en todos los campos del conocimiento, de los aspectos subjetivos y sensoriales, el desarrollo de las tecnologías que ha cambiado completamente nuestras relaciones interpersonales y con el entorno, las nuevas capacidades de análisis, grabación y conservación y manipulación de datos y por ultimo, aunque no menos importante, la puesta a disposición democrá¬tica y global de todo el saber a través de Internet, imponen otra aproximación al hacer, concebir y vivir la arquitectura. Esta investigación se centra en un análisis crítico del estado de la cuestión, construyendo nue¬vas redes de relación entre disciplinas, que permitan plantear la dimensión audiovisual como un nuevo eje de investigación dentro de la arquitectura, poniendo en evidencia la necesidad de desa¬rrollar análisis de forma trasversal e interdisciplinar. Hemos prestado particular atención a la evolución de lo sonoro y su aproximación cualitativa a la arquitectura, mostrando como el sonido, con su capacidad de introducir el tiempo y los aspectos dinámicos (el movimiento, la presencia del cuerpo…), no es simplemente otro canal sensorial en la aprehensión del espacio, ya que su interacción con lo visual genera un espacio-tiempo indisociable, propio, característico de cada momento y lugar. A partir de este planteamiento se ha hecho una revisión metodológica dirigida a utilizar el reco¬rrido como herramienta de análisis, que permita estudiar la relación entre el espacio, la acción y la percepción audio-visual, cruzando para ello los datos correspondientes a la morfología del espacio, con los datos de la experiencia perceptiva individual y con los de los usos colectivos del espacio, utilizándose finalmente el video como un herramienta, no sólo de representación de lo real, sino también como instrumento de análisis, que permite tomar datos (grabaciones audio, video, obser¬vaciones…), aislarlos, estudiarlos, clasificarlos, ordenarlos, y finalmente, restituirlos mediante el montaje. Se ha realizado una primera experimentación “in situ” que ha servido para explorar la aplicación del método, planteando nuevas preguntas y abriendo líneas de análisis para ulteriores investigacio¬nes. ABSTRACT This research is focused on the study of the audiovisual dimension of architecture, as an in¬tersensorial approach to space apprehension and design. It is posed the necessity to develop new methodologies and tools that keep this complexity, as a contribution to the development of a project, by means of putting into evidence the sophistication of the relationship between man and media The research moves us to the conviction that the quick and relevant changes that confer a distinc-tion to these contemporary times all over the social, economic and political environments, involve, unavoidably, new ways of knowledge and experimentation on space, and therefore, new trends of research. The growing valuation of subjective and sensorial aspects all over the fields of the knowledge and the development of the technologies that have changed completely our interpersonal and environmental relationships, the new tools for analysis, recording, conservation and manipulation of data and, last but not least, the setting to democratic and global availability of the whole knowledge through Inter¬net, impose another approach to the making, conception and experience of architecture. This research deals with a critical analysis of the state–of- the-art of the matter, modelling new webs of relationship among disciplines that allow to outline the audiovisual dimension as a new focus of research on architecture, putting evidence into practice as it is necessary to develop any analysis in a transversal and interdisciplinary way. It is paid a special attention to the evolution of sound objects and their qualitative approach to ar¬chitecture, showing how sound, with its capacity to transmit time and dynamic aspects of things (movement, the presence of the body), it is not simply another sensorial channel in the apprehension of space, since its interaction with the visual thing generates an undetachable association of space and time, an specific one of every moment and place. Starting from this position a methodological revision has been made leading to use a walk as a tool for analysis that allows to study the relationship among the space, the action and the audio-visual perception, by means of crossing data corresponding to the morphology of space, with the data of a perceptive experience from the perspective of an individual observer and with those of the collective uses of the space, as video has been finally used as a tool, not only as a representation of the real thing, but also as a tool for analysis that allows to take isolated data (audio recordings, video, obser¬vations), to be studied, classified, and put into their appropriate place, and finally, to restore them by means of a multimedia set up. A first experimentation in situ has been carried out, being useful to explore a method of appli¬cation, outlining new questions and beginning with new ways of analysis for further research.

Partnering with Parents to Promote High School Graduation: An Evidence-based Program Evaluation

Thesis (Master's)--University of Washington, 2016-06

Building family/general practice research capacity

To promote the range of interventions for building family/general practice (family medicine) research capacity, we describe successful international examples. Such examples of interventions that build research capacity focus on diseases and illness research, as well as process research; monitor the output of research in family/general practice (family medicine); increase the number of family medicine research journals; encourage and enable research skills acquisition (including making it part of professional training); strengthen the academic base; and promote research networks and collaborations. The responsibility for these interventions lies with the government, colleges and academies, and universities. There are exciting and varied methods of building research capacity in family medicine.

Appraising the quality of randomized controlled trials: inter-rater reliability for the OTseeker evidence database

Rationale and aims 'OTseeker' is an online database of randomized controlled trials (RCTs) and systematic reviews relevant to occupational therapy. RCTs are critically appraised and rated for quality using the 'PEDro' scale. We aimed to investigate the inter-rater reliability of the PEDro scale before and after revising rating guidelines. Methods In study 1, five raters scored 100 RCTs using the original PEDro scale guidelines. In study 2, two raters scored 40 different RCTs using revised guidelines. All RCTs were randomly selected from the OTseeker database. Reliability was calculated using Kappa and intraclass correlation coefficients [ICC (model 2,1)]. Results Inter-rater reliability was 'good to excellent' in the first study (Kappas >= 0.53; ICCs >= 0.71). After revising the rating guidelines, the reliability levels were equivalent or higher to those previously obtained (Kappas >= 0.53; ICCs >= 0.89), except for the item, 'groups similar at baseline', which still had moderate reliability (Kappa = 0.53). In study 2, two PEDro scale items, which had their definitions revised, 'less than 15% dropout' and 'point measures and variability', showed higher reliability. In both studies, the PEDro items with the lowest reliability were 'groups similar at baseline' (Kappas = 0.53), 'less than 15% dropout' (Kappas

Evidence-based medicine is affordable: The cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis

Objective. To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Method. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented cut-rent evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. Results. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of $19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden. with a cost-effectiveness ratio of $12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of $25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of $25,000 per YLD averted. Conclusion. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.

The information specialist in the clinical team: Building expertise in evidence-based healthcare

The Clinician Development Program (CDP) is an initiative of Queensland Health’s Quality Improvement and Enhancement Program. At the Royal Brisbane & Royal Women's Hospital Health Service Districts, evidence-base practice (EBP) is an important CDP area in which several projects were carried out in 2002. This paper describes one such project. A medical librarian was invited to accompany the clinical team on morning rounds in the Medical Assessment & Planning Unit (MAPU). The librarian conducted information skills training in the ward and helped clinicians to answer questions directly related to patient care. Questions not answered during the round were followed-up, usually within 48 hours, and responses emailed to the consultant who led the rounds. At the project’s conclusion the librarian was invited to continue as a member of the MAPU clinical team, thus acknowledging the valuable role an information specialist can play in incorporating research evidence into patient care. Clinical librarianship (CL) creates a space, albeit a contentious one, for the health librarian at the bedside. This paper describes an Australian CL project and attempts to demystify the role of an information specialist in EBP. It also highlights some of the challenges facing librarians and clinicians attempting to embed EBP in clinical settings.

Knowledge acquisition and research evidence in autism:researcher and practitioner perspectives and engagement

Background: Government policy and national practice guidelines have created an increasing need for autism services to adopt an evidence-based practice approach. However, a gap continues to exist between research evidence and its application. This study investigated the difference between autism researchers and practitioners in their methods of acquiring knowledge. Methods: In a questionnaire study, 261 practitioners and 422 researchers reported on the methods they use and perceive to be beneficial for increasing research access and knowledge. They also reported on their level of engagement with members of the other professional community. Results: Researchers and practitioners reported different methods used to access information. Each group, however, had similar overall priorities regarding access to research information. While researchers endorsed the use of academic journals significantly more often than practitioners, both groups included academic journals in their top three choices. The groups differed in the levels of engagement they reported; researchers indicated they were more engaged with practitioners than vice versa. Conclusions: Comparison of researcher and practitioner preferences led to several recommendations to improve knowledge sharing and translation, including enhancing access to original research publications, facilitating informal networking opportunities and the development of proposals for the inclusion of practitioners throughout the research process.

Worker, workplace or families: What influences family focused practices in adult mental health?

Introduction: Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions.
Aim: The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services.
Method: Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices.
Thesis: It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child’s connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers.
Implications for practice: Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to