How to Integrate Scientific Evidence into Best Clinical Practice
Medical teams today use evidence-based practice (EBP) to be more effective in changing their clinical practice. They need to have a comprehensive understanding and knowledge in their decision-making process of how to critically analyse and review peer-reviewed published research to obtain Best Research Evidence.
Why is Evidence-Based Practice (EBP) Important?
EBP is important because it aims to provide the most effective care that is available, with the aim of improving patient outcomes. Patients expect to receive the most effective care based on the best available evidence.
EBP promotes an attitude of inquiry in health professionals and starts us thinking about:
- Why am I doing this in this way?
- Is there evidence that can guide me to do this in a more effective way?
Is all Published Research of Good Quality?
Not all research is of sufficient quality to inform clinical decision making. Therefore, you need to critically appraise evidence before using it to inform your clinical decision making. The three major aspects of evidence that you need to critically appraise are:
- Validity – can you trust it?
- Impact – are the results clinically important?
- Applicability – can you apply it to your patient?
As health professionals, part of providing a professional service is ensuring that our practice is informed by the best available evidence. EBP also plays a role in ensuring that finite health resources are used wisely and that relevant evidence is considered when decisions are made about funding health services.
Has the correct Research Methodology been used?
For example the Munster Article – The study described in this article is clearly invalid from a scientific point of view. While all studies on disinfection systems, notably on ultrasound probes, are done with quantitative microbiological analysis methods, the discussed study used a qualitative method , which is often done in pharmaceutical research, but is invalid for the evaluation of semi-critical medical devices.
The discussed study finds more contamination after disinfection than before disinfection. This alone shows that the study design was inappropriate and did not have scientific value: “In some cases in our study, bacteria was found in the second swab taken after disinfection, which we had not found in the first swab taken before disinfection including 19 in the Antigermix group and 7 in the wipes group (12 % and 4.4 %).”
This study has no scientific value as it has proven to reintroduce very frequently contamination after disinfection. Other meaning flaws in the design are highlighted
Watch the Complete Webinar
Dr. David J. Weber, MD, MPH, FIDSA, FSHEA, FRSM