Practice based in evidence (EBP) means that you must critique/synthesize evidence and then apply it to particular setting and populations using your best judgement. This means that you must discriminate about when (and when NOT) to apply the research. Be sure to use best professional judgment to particularize your actions to the situation!
Add to your repertoire of EBP tools, the Number Needed to Treat (NNT). This is not mumbo -jumbo. NNT explained here–short & sweet: http://www.thennt.com/thennt-explained/
CRITICAL THINKING: Check out this or other analyses at the site. How does the info on antihypertensives for mild hypertension answer the question of whether more is better? Are there patients in whom you SHOULD treat mild HTN? (“We report, you decide.”) http://www.thennt.com/nnt/anti-hypertensives-for-cardiovascular-prevention-in-mild-hypertension/
MORE INFO: Check out what the data say about other risk/benefit treatments at http://www.thennt.com/
In the last post we compared stronger direct measures of outcomes with weaker indirect
measures of project outcomes.
So…what direct measures are you “baking into your project cake”? What do you hope will be your project outcome & what measurement will show that you achieved it? –pain scores? weight? skin integrity? patient reports of a sound night’s sleep? Share your story. Help others learn.
Or if you just stuck with HCAHPS (or other) as outcome measure, explain why that was the best choice for your project. (Maybe in your case it was a direct measure!)
For More Info on direct vs. indirect measures & Critical thinking: Check out t Direct speaking about INdirect outcomes: HCAHPS as a measurement
Don’t Go Pokemon Go ….& if you must, watch out! New privacy and safety dangers are being recorded almost every day. The game is full of health and computer hazards, and has potential to distract workers from their life-saving care.
What is the evidence? At this point mostly anecdotal reports and the anticipated possibility that healthcare workers could be distracted from life-saving work. You need to translate this evidence into action. Why would you do this with such relatively weak research evidence? Because the risks are far higher to ignore it, & essentially NO risks if you use the evidence. The BBB lists these problems & makes some suggestions based on incoming reports:
- Privacy: In order to play the game, users must allow the app to access other applications, such as maps and camera. The iOS version for the iPhone can access all Google data.
- Malware: So far, the app is only available in the U.S., Australia and New Zealand, which has given cybercriminals an opportunity to capitalize on the demand…. Users should only download the app through official app stores, not third-party sites.
- Safety: Players should use the same safety precautions while playing the game that they would in any other outdoor setting, including caution in strange location.
- Infringement: PokeStops are supposed to all be on public property (or cooperative
private sites), but at least one health system, Dignity Health, is asking that its facilities be removed to avoid dangers to privacy and safety of patients, visitors, families & staff.
Translating this evidence into practice? Think before you Pokemon Go, if at all. Talk to your patients–when people don’t feel well they are even more likely to be distracted.
Critical thinking? 1) List specific actions that you will do to promote privacy, safety and fight malware and infringement. These can range from “never download;never play” to…..? When developing this list specifically address the challenges above. 2) What about patient players? staff players? visitor players? How should you help them to be safe?