Evidence-based practice implementation

The philosophy of evidence-based practice is widely accepted, although operational and implementation issues represent major barriers. One of the significant barriers is a shortage of evidence reports on topics of critical interest, and the lack of a national infrastructure to prepare such reports. In response to this need, AHRQ has funded 12 Evidence-based Practice Centers to conduct systematic, comprehensive analyses and syntheses of the scientific literature to develop evidence reports and technology assessments on clinical topics that are common, expensive, and present challenges to decision makers. Since December 1998, 11 evidence reports have been released on topics that include sleep apnea, traumatic brain injury, alcohol dependence, cervical cytology, urinary tract infection, depression, dysphasia, sinusitis, stable angina, testosterone suppression, and attention deficit hyperactivity disorder. 

Feldstein A, Elmer PJ, Orwoll E, et al. Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures A gap in evidence-based practice guideline implementation. Arch Intern Med 2003 163 2165-2172. 

Drake, R. E. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179-182. Equal opportunity pays. (1993, May 4). Wall Street Journal, p. 1. 

Mousavi, S.J., Akbari. M.E., Mehdian. H., Mobini. B., Montazeri. A., Akbarnia. B., and Parnianpour. M. 2011. Low back pain in Iran A growing need to adapt and implement evidence-based practice in... 

Research-to-practice (r2p) is an initiative first outlined by the US. National Institute for Occupational Safety and Health (NIOSH) as an approach to conducting pragmatic, goal-oriented research (http //www.cdc.gov/niosh/r2p/). Conceptually similar to evidence-based practice (e.g., Kitson et al., 1998), and rather than research for research s sake , the r2p paradigm is directed at translating research findings into implementable actions aimed at improving health and safety. Science-driven countermeasures are an end product of an r2p effort. 

Kitson, A., Harvey, G., and McCormack, B. 1998. Enabling the implementation of evidence based practice A conceptual framework. Quality in Health Care, 7, 149-158. 

For this chapter, we focus on the prescriptive portion of the model as it has been applied to school-based prevention and mental health-promotion programs. The model is presented in a format that facilitates its use as a guide to school-based mental health providers and educators in their efforts to provide their students with evidence-based practices. The prescriptive model has three components. The first refers to characteristics of the intervention, the second to training and technical support, and the third to the environment in which the program is to be implemented. For conceptual and evaluation purposes, the three components of the prescriptive model can be viewed as mediators or moderators of program outcomes. Descriptions of each component follow, and factors within each component are listed in Table 2. 

The evidence base then underpins the activities that ensure the maintenance of a high quality of service (1) provision of a knowledge resource that summarizes the evidence and its application, (2) use of this resource in education and training of health professionals, and (3) audit to ensure correct implementation and maintenance of good practice. 

The four steps in the process of applying evidence-based medicine (EBM) in practice are (a) formulate a clear question from a patient s problem, (b) identify relevant information, (c) critically appraise available evidence, and (d) implement the findings in clinical practice. 

H F Clarke, C Bradley, S Whytock, S Handfield, C Van Der Wal and S Gundry, Pressure ulcers Implementation of evidence-based nursing practice . Journal of Advanced Nursing, 2005 49Gss 6) 578-590. 

The aim of this chapter is to present and discuss examples of behavioural adaptation to road safety policy countermeasures, including those that relate to the vehicle ( safer vehicles ) and the road user ( safer road users ). Examples relating to safer roads are included in Chapter 7, and so are not repeated here. Based on these examples, an inventory of policy features that are predictive of behavioural adaptation is proposed. The chapter concludes with recommendations regarding best practices in policy implementation, which, along with evidence-based research, policymakers can use to not only guide policy planning efforts, but to limit the extent and impact of any associated behavioural adaptation. 

What is the definition of a displaced person In Alexander (1985), he discussed the difficulty of defining the dead and injured. What are the cutoff points of reporting An important agenda for the Integrated Research on Disaster Risk (IRDR) organization, whose goal is to develop trans-disciplinary, muIti-sectorial alliances for in-depth practical disaster risk reduction research studies, and the implementation of effective evidence based disaster risk policies and practice, ... 

We hope that by devoting greater attention to these issues in the future, the field can attain a high degree of confidence that evidence-based prevention and health-promotion practices can be implemented successfully in local schools and a thorough understanding of whether what is being done makes a difference and why. 

Both the BGY and LMBW equations are based on force balance considerations, as is evident from the fact that they involve derivatives of the potential of mean force between a particle and the surface (or source of the inhomogeneity). In the absence of approximations, the BGY and LMBW equations can yield the same (correct) result. However, if approximations are introduced (via the closure), these two equations will yield different results. There is no consensus as to which equation is to be preferred. In practice, the choice between the BGY and LMBW equation is based on which equation is easier to implement numerically in a given application. 

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