Approaches to teach evidence-based practice among health professionals: an overview of the existing evidence

Athina E Patelarou,1,* Konstantinos G Kyriakoulis,2,3,* Aliki A Stamou,2,3 Aggelos Laliotis,4 Dimitra Sifaki-Pistolla,5 Michail Matalliotakis,6 Emmanuel Prokopakis,7 Evridiki Patelarou8 1Department of Anesthesiology, University Hospital of Heraklion, Crete, 2Society of Junior Doctors, 3Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 4Department of Oesophago-Gastric Surgery, Addenbrooke’s Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK; 5Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, 6Department of Obstetrics and Gynaecology, Venizeleio General Hospital, Heraklion, 7Department of Otorhinolaryngology, School of Medicine, University of Crete, Crete, Greece; 8Department of Family and Child Health, Florence Nightingale Faculty of Nursing and Midwifery, London, UK *These authors contributed equally to this work Abstract: Health care professionals’ adoption of evidence-based practice (EBP) remains limited, although most health care professionals are familiar with EBP and believe in its value. This systematic review aimed to bring together the best methods used to teach EBP to health professionals. The authors conducted a systematic search for the period 2005–2015 (an update of the search took place in October 2016) using PubMed interface (Medline). MeSH terms as well as free-text keywords were used. Studies were analyzed and evaluated by title and abstract. Those studies which fulfilled the inclusion criteria were assessed by full text. References of articles were also taken into consideration for identifying relevant studies not found through algorithm search. Twenty articles were found to be relevant. The majority of the studies were conducted among nurses (n=7) and physicians (n=6), and only a few among professionals from mixed disciplines (n=5). Two studies were conducted among chiropractors (n=1) and faculty members from a naturopathic and classical Chinese medicine institution (n=1). Researchers used a variety of different approaches, which varied with respect to duration and organization. We divided interventions into two categories. Single interventions included either a workshop, or a journal club, or a conference, or a lecture, or online learning tools, whereas multiple interventions included a combination of these approaches. An increase in EBP competencies and attitudes was reported in nine studies. Teaching methods for optimizing EBP among health professionals could become a robust standardized procedure of the medical educational curricula and lifelong learning of health care professionals. Keywords: advanced clinical practice, health personnel, teaching strategies, nurses, physicians, lifelong educatio

Association of placenta previa with a history of previous Cesarian deliveries and indications for a possible role of a genetic component

A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) (p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome

A prática baseada em evidência no contexto da Atenção Primária à Saúde

A prática baseada em evidência agrega o melhor conhecimento científico, com a experiência clínica do profissional e a escolha do paciente, resultando em uma maior resolutividade na assistência em saúde. O objetivo do estudo foi analisar a prática baseada em evidência dos profissionais das equipes com Estratégia Saúde da Família em um município de Santa Catarina. Trata-se de um estudo quantitativo, realizado por meio de questionários com 112 profissionais de saúde. Os resultados apontaram que eles consideram a prática baseada em evidência fundamental, contudo, em suas ações, ela está mais centrada na experiência clínica. Outrossim, não se sentem plenamente capacitados para realizar a busca de evidências científicas, destacando o pouco conhecimento e habilidades em pesquisa. Além disso, ressaltam a alta demanda de atendimentos, escasso domínio de língua estrangeira e falta de apoio da gestão como dificultadores. Conclui-se que os profissionais da atenção primária precisam se aprimorar para o desenvolvimento da prática baseada em evidência, sendo que isso ultrapassa a sua vontade individual, ficando também ao encargo das instituições formadoras e dos serviços de saúde.Evidence-based practice brings together the best scientific knowledge with the professional’s clinical experience and the patient’s choice, resulting in a higher resoluteness in health care. The research was carried out aiming at analyzing the evidence-based practice of professionals from Family Health Strategy teams, in a city in the state of Santa Catarina. It was a quantitative study, developed through questionnaires with 112 health professionals. The results showed that professionals consider evidence-based practice essential; however, such practice is more focused on clinical experience in their actions. Moreover, they do not feel completely qualified to search for scientific evidence, highlighting their little knowledge and abilities on research. In addition, they emphasized that applying evidence-based practice is even more difficult because of high demand for care, lack of foreign language skills and lack of management support. As a conclusion, primary care professionals need some improvement for the development of evidencebased practice, which doesn´t only depend on their individual willingness, but it is also a responsibility of educational institutions and health services.info:eu-repo/semantics/publishedVersio

Managerial attitudes and perceived barriers regarding evidence-based practice: An international survey

<div><p>Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived barriers related to EBP. In medicine and nursing, an abundance of research exists on this subject, although such studies are rare in management. To address this gap, we surveyed 2,789 management practitioners in Belgium, the Netherlands, the United States, the United Kingdom and Australia. Our findings indicate that most managers we studied have positive attitudes towards EBP. However, lack of time and a limited understanding of scientific research are perceived as major barriers to the uptake and implementation of EBP in management. Studies in other professions where EBP is far more established also report similar barriers. We discuss the implications of our findings for practice, education and research, providing suggestions to enhance use of EBP in management practice.</p></div

Allergen Avoidance Versus Tolerance Induction

Effective prevention, curative treatment, and accurate, rapid diagnosis of allergies are still major unmet needs according to the EAACI and EFA. As at least 60 million people are daily burdened by the consequences of their allergic disease(s), the need for more research is not only stressed by patient organizations, but also by health care professionals and the World Health Organization. Even though knowledge of the mechanisms underlying allergic responses is rapidly increasing, there are still a number of critical questions to be answered. In this chapter, a brief introduction on the use of biologicals, allergen-specific immunotherapy, and dietary compounds to actively reduce the allergic responses is provided with recommended literature for more detailed information about the individual topics. Furthermore, the current believes about the usefulness or risks of maternal allergen intake on the susceptibility of the infant are discussed. Finally, the debate on the suitability of partial or extensive hydrolyzates for specific target groups is summarized and is put into context with an opportunity to induce tolerance induction