IU Indianapolis ScholarWorks :: Browsing by Subject "Evidence-Based Practice"

Browsing by Subject "Evidence-Based Practice"

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Commentary: Launch of a quality improvement network for evidence-based management of uncommon pediatric endocrine disorders: Turner syndrome as a prototype
(Oxford University Press, 2015-04) Rosenfeld, Robert L.; DiMeglio, Linda A.; Mauras, Nelly; Ross, Judith; Shaw, Natalie D.; Greeley, Siri A.W.; Haymond, Morey; Rubin, Karen; Rhodes, Errin T.; Medicine, School of Medicine
BACKGROUND: Traditional, hypothesis-oriented research approaches have thus far failed to generate sufficient evidence to achieve consensus about the management of children with many endocrine disorders, partly because of the rarity of these disorders and because of regulatory burdens unique to research in children. OBJECTIVE: The Pediatric Endocrine Society is launching a quality improvement network in spring 2015 for the management of pediatric endocrine disorders that are relatively uncommon in any single practice and/or for which there is no consensus on management. DESIGN: The first of the quality improvement programs to be implemented seeks to improve the care of 11- to 17-year-old girls with Turner syndrome who require initiation of estrogen replacement therapy by providing a standardized clinical assessment and management plan (SCAMP) for transdermal estradiol treatment to induce pubertal development. The SCAMP algorithm represents a starting point within current best practice that is meant to undergo refinement through an iterative process of analysis of deidentified data collected in the course of clinical care by a network of pediatric endocrinologists. CONCLUSION: It is anticipated that this program will not only improve care, but will also result in actionable data that will generate new research hypotheses and changes in management of pediatric endocrine disorders.
Decreasing Phantom Limb Pain for Amputees with Phantom Limb Pain and Brachial Plexus Avulsions Through Various Therapy Interventions: A Systematic Review
(2021-04-30) Stevens, Sydney; Hoseinpour, Niki; Martin, Kylee; Stuckwisch, Devin; Barker, Haylee; Kramer, Martina; Chase, Tony; Department of Occupational Therapy, School of Health and Human Sciences
This rapid systematic review of the literature discusses the evidence of studies related to effective occupational therapy interventions in reducing phantom limb pain (PLP) due to amputations and brachial plexus avulsions (BPA). This review provides a comprehensive overview and analysis of 30 studies that addressed many of the interventions commonly used in phantom limb pain rehabilitation. Phantom limb pain is a painful sensation perceived in the absence of a limb or in a deafferented limb. Suffering from acute or chronic pain can decrease engagement and performance in meaningful occupations. Overall, we found moderate evidence to support the effectiveness of various therapy interventions for decreasing PLP in individuals with amputations and BPAs.
Dietetic Interns’ Perceptions and Use of Evidence-Based Practice: An Exploratory Study
(2018-01-01) Hinrichs, Rachel J.
Objective: To explore dietetic interns’ perceptions and knowledge of evidence-based practice (EBP), their use and observation of EBP principles during their clinical rotations, and their intentions to use EBP in their career. Methods: A mixed methods design combining a survey and focus group was employed. Dietetic interns (n=16) from a large Midwestern university were recruited in person and via email to participate in the survey, focus group, or both. Perceptions and experiences of EBP were analyzed through the focus group (qualitative), and EBP knowledge and clinical practice behaviors were analyzed through the survey (quantitative). The focus group discussion was recorded, transcribed, and analyzed using thematic analysis. Results: Four major themes emerged from the focus group data: 1) observations of EBP in clinical practice; 2) use of EBP during clinical rotations; 3) barriers to EBP; and 4) perceived use of EBP as future registered dietitians. Interns considered EBP as important for their profession and future career. They struggled, however, with the discrepancies between current research and practice and highlighted differences they observed and barriers experienced across different clinical settings. Conclusions: This exploratory study is the first to examine dietetic interns’ perceptions of and experiences with EBP in the clinical setting. Future research is needed to identify how dietetics educators, librarians, and preceptors can address the barriers interns perceive in applying EBP in their internship.
Effects of Virtual and Augmented Reality on Occupational Performance in Children with Cerebral Palsy: A Systematic Review
(2023-05-04) Shin, Christina; Brown, Katelyn; Ridgeway, Mariah; Ueki, Mio; Chase, Anthony; Sego, Daniel; Department of Occupational Therapy, School of Health and Human Sciences
Cerebral palsy (CP) is a non-progressive and permanent motor disability that affects the development of movement and posture due to abnormal brain development or damage to an immature brain. It often presents with motor, cognitive, sensory, and behavioral impairments that limit occupational performance and quality of life. CP affects about two to three children in every 1,000 live births, making it the most common motor disability in childhood (Metin et al., 2013). Virtual and augmented reality (V&AR) has emerged as an innovative therapeutic intervention that targets motor and cognitive rehabilitation in children with CP through its task-oriented, interactive, and intensive training system. However, there has been limited research on its effectiveness in the CP population due to its novelty and variety of interventions available. In this systematic review, a comprehensive literature review of 20 studies was conducted to evaluate the effects of V&AR on occupational performance in children with CP. The results of this review support the use of V&AR interventions in expanding and guiding rehabilitative practitioners who work with children with CP.
Evidence-based practice skill retention and use by dietetic interns: Did library instruction have an impact?
(2018-05) Hinrichs, Rachel J.
Objective: To determine if dietetic interns retain the evidence based practice(EBP)knowledge and skillsthat they weretaught in three libraryinstruction sessionsin the fallby the end of the 10-monthinternship, and whether there is a change in their EBP clinicalbehaviors.Methods: This non-randomized before and after study will use a validated survey to measure EBP knowledge,and EBP clinicalbehaviors. Dietetic interns(n=16)from a large, Midwestern university will be given the surveyafter EBP library instruction in the fall, and at the end of their internship in the spring.Library instruction sessions will cover PICO questions, database searching, filtered andunfiltered resources, and critical appraisal.A paired t-testwill be used to compare interns’ scores in the fall and spring. Results: Fourteen interns (n=14) completed both surveys. On the EBP knowledge assessment, interns scored an average of 18/24 (75%) in the fall after library instruction, and 13/24 (54%) in the spring, a difference that is considered statistically significant (t(13)=7.0, p<.0001). The decrease was primarily due to missing questions on statistics and advanced Boolean searching. Interns retained and even improved their scores on PICO, MeSH, and the evidence pyramid. A slightly statistically significant change in evidence-based practice behaviors was found between the fall and spring (t(26)=2.1, p=.046). Inparticular, interns reported that they searched PubMed(t(13)=2.8, p=.016),and criticallyappraised articles more frequently(p(13)=2.2, p=.045).Conclusion: Despite the three library sessions occurring early in the internship, these results suggest that interns retaininformation on PICO, MeSH, and the evidence pyramid, but not on statistics or complex Boolean searching. It is possible that these skills were not used frequently in the internship, so they did not retain the information. Interns did report, however, that they more frequently performed all evidence-based behaviors including searching PubMed, accessing systematic reviews, and critically appraising articles, while decreasing their use of textbooks. While the sample size is small and not necessarily generalizable to other populations, this study suggests that dietetic interns retain some information from library EBP instruction, and do make use of the EBP resources and skills demonstratedby the librarian during their internship.Future studies could examine different health professional students, and test whether spreading the library sessions out of the course of the yearwould increase retention and evidence-based behaviors further.
Exploring Evidence-Based Practice Norms Among Bedside Nurses in Magnet-Designated Hospitals: A Q Methodology Study
(2023-08) Ramsey, Rachel Anne; Wonder, Amy Hagedorn; Opsahl, Angela; Reising, Deanna; Gonzalez-Mulé, Erik
Evidence-based practice (EBP) is a recognized standard of professional nursing due to its positive impact on care quality and patient outcomes. Despite ongoing efforts to maximize EBP at the point of care, current estimates indicate that only 30% of healthcare decisions are evidence-based. Individual and organizational factors are commonly identified for their influences on EBP in nursing, but group factors have been largely unexplored. Group-level factors, such as norms, are essential to investigations of phenomena that occur within multilevel organizations (i.e., hospitals) where individuals work in groups. Understanding the EBP norms that emerge among groups of nurses in direct care roles may support the goal to increase evidence-based nursing care. The purpose of this dissertation study was to explore and describe the EBP norms that exist among groups of RNs who practice at bedside within Magnet-designated hospitals. Magnet-designated hospitals are recognized for their positive EBP cultures and infrastructures that support nurses’ EBP beliefs and goals, making them an ideal context to investigate shared viewpoints about EBP. Eligible Registered Nurses (RNs) were recruited from eight units within two Magnet-designated hospitals in the Midwestern United States. Using Q methodology, the participants’ individual perspectives about EBP were collected, then correlated and interpreted to uncover the shared viewpoints, or EBP norms, that existed within and across the study sites. Multiple EBP norms were discovered within each Magnet-designated hospital: four were found at Site A (Engaged, Overextended, Skeptical, and Reliable) and three were found at Site B (Amenable, Resistant, and Discerning). Two higher-order norms were also discovered (Invested and Marginalized). Differences were observed among these norms, especially regarding nurses’ viewpoints around time for EBP, input on EBP, and trust in EBP. The findings confirm that group-level factors should be considered in the study of evidence-based nursing. They also suggest that Magnet designation alone cannot ensure a unified EBP viewpoint. Consequently, standardized approaches for enhancing EBP should be reexamined, and more holistic interventions should be considered to address the variety of complex EBP viewpoints that exist among RNs who practice at bedside in Magnet-designated hospitals.
Implicit and explicit stigma of mental illness: attitudes in an evidence-based practice
(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2013-12) Stull, Laura G.; McGrew, John H.; Salyers, Michelle P.; Ashburn-Nardo, Leslie; Department of Psychology, School of Science
The extent to which explicit and implicit stigma are endorsed by mental health practitioners using evidence-based practices is unknown. The purposes of the current study were to a) examine implicit and explicit biases among Assertive Community Treatment (ACT) staff and b) explore the extent to which biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. Overall, the participants exhibited positive explicit and implicit attitudes toward people with mental illness. When modeled using latent factors, greater implicit, but not explicit, bias significantly predicted greater endorsement of restrictive or controlling clinical interventions. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, individual differences in provider stigma were related to clinical care. Mental health professionals, and specifically ACT clinicians, should be educated on types of bias and ways in which biases influence clinical interventions.
Implicit and Explicit Stigma of Mental Illness: Attitudes in an Evidence-Based Practice
(2013) Stull, Laura G.; McGrew, John H.; Salyers, Michelle P.; Ashburn-Nardo, Leslie
Integrating Information and Evidence-Based Oral Health Literacy Into An Expanded Dental Hygiene Curriculum: A Faculty-Librarian Collaboration
(2017-06-15) Stone, Sean M.; Lowe, M. Sara; Quirke, Michelle
Introduction: With the increased emphasis of evidence-based practice, early development of information literacy (IL) as well as other literacies (e.g., oral) is becoming widely accepted in medicine and allied fields. With long-standing programs, however, integration of IL instruction is often unplanned at the programmatic level leading to deficiencies in advanced students and frustrations for students and faculty. This project integrates lesson plans, assignments, and assessments that support dental hygiene and other health fields but also support general education and provide transferrable skills for any major. Aim: The school has expanded its Dental Hygiene curriculum from a two-year program to a four-year Bachelor of Science. We have used this opportunity to plan for ideal integration of information and oral health literacy instruction and evidence-based practice across the new curriculum. Advanced courses in dental hygiene emphasize evaluating specialized literature for both quality and currency with requirements for literature reviews in the third year and a capstone research project in the fourth. Information literacy integration, particularly at the introductory level, should give the required fundamental skills. Well planned scaffolding of basic IL skills in early courses removes the need for extensive IL skill remediation and lost time in advanced courses. Method: The curriculum has been mapped at all levels, from introductory courses to the capstone experience, with an eye to classes with research projects and learning outcomes that fit with the new Framework for Information Literacy (recently adopted by the Association for College & Research Libraries). Library and Dental Hygiene faculty have collaborated not only to adapt existing undergraduate and oral health pedagogies and assessments but also to create new ones which are appropriate for integration into the various courses. Courses have heavy librarian integration and embedding, both in the classroom and the course management software, as well as asynchronous learning tools, with opportunities for team teaching and robust student assessment (including authentic assessment). Results: This presentation reports on the planning of the new curriculum and the information pedagogy integration, the preliminary results of the first cohort to experience it, as well as the plans for the rollout of other integrated courses in the coming semesters. First year courses have evolved beyond their previous IL content with the inclusion of annotated bibliographies and research papers in discipline specific courses. This early introduction has elevated the level of student performance, and cultivated a culture of higher expectations of intermediate and advanced students. Conclusion: 2016 marks the official beginning of the new curriculum and the first opportunity to really integrate IL at the introductory level. The integration of oral health specific content has been particularly challenging at this level since students are not yet officially in the clinical program. In fact, the majority do not continue on in dental hygiene so a balance must be found that provides introductory students with IL skills general enough to be transferrable to disparate majors but specific enough to prepare students for the dental hygiene program or similar parallel planned careers in health science.

Browsing by Subject "Evidence-Based Practice"

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