ROBIN STEED, PHD, LOTRCHRIST INE WRIGHT, PHD, LOTR

(CO -CONSPIRATORS)

Evidence-Based Practice

What is EBP?

Best Practice

Clinical Reasoning

ResearchClient

Factors

Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence based medicine: How to practice and teach EBM (2nd ed.). London: Churchill Livingstone.

Why is EBP important?

Client education

Client trust

Do no harm!

Your own peace of mind

Our clients deserve the BEST!

Yes, you too can be an evidenced

based practitioner in just 5 easy

steps!

The Process of Evidence Based Practice

Identify the clinical problem

I want my clients to: be more functional have a higher quality of life have better outcomes faster transfer skills to home environment have maintained gains at follow-up have better adherence to treatment plan

1

Ask a PICO question

Patient or ProblemInterventionComparison InterventionOutcomes

2

PICO Examples

In children with autism, vigorous vs. mild exercise, on stereotyped behaviors

In clients with Schizophrenia, environmental supports on ability to transition to community

In children with ABI hemiplegia, constraint induced therapy on function

Systematic Review

P: serious or chronic mental illness, psychosis, schizophrenia, mood disorder, anxiety disorder

I: child care, meal preparation, home management, shopping, time management, safety, social participation, education exploration, retirement exploration, employment seeking

O: employment and education

Arbesman, M., & Logsdon, D. (2011). Occupational Therapy Interventions for Employment and Education for Adults With Serious Mental Illness: A Systematic Review. American Journal of Occupational Therapy, 65, 238-246.

3

Where do we find the evidence?

The Cochrane Collaboration Working together to provide the best evidence for health care

JOANNA BRIGGS INSTITUTE

Critically evaluate the evidence

Study Design randomization control for bias ethical control group

Sample size described

Assessment PropertiesIntervention

detailed/replicableStatistical AnalysisThreats to Validity

internal external

4Critical Review Forms at McMaster’s University

Make a decision

Given the quality of the evidence, what are the implications for clinical

practice?

Implement Evaluate

What is the risk?What is the cost?Do you need special

training?Getting client consentFacility support

Choose outcome measures

Keep records of outcomes and adverse events

Do a ROI assessment

Implement and evaluate5

LIKE I AM REALLY GOING TO HAVE TIME

FOR ALL THIS!

Get Real!

EBP in just 10 minutes a day!

Join AOTARead one or two journal articles a monthLook up the quick summaries on EBP web sitesSign up for evidence alerts at McMaster’sStart an EBP file at workJoin a journal club

EBP Books on Evidence

photos: amazon.com

EBP Books on Implementing EBP

PAIN

Creating Evidence: An Efficient Efficacy Study

Reasons to Create Evidence

ReferralsClient self-efficacyFunding for programThird party paymentResource allocationKeep your job !

www.robinsteed.pbworks.com

Resources at LSUHSC Shreveport