PRINCIPLES AND PRACTICE OF CARE

Principles and Practice of Care

Abstract

Objective

In this research, we will explore dieticians', occupational therapists' and physical therapists' attitudes, beliefs, knowledge and behaviour concerning the evidence-based practice within a university hospital setting. I also focus on the Understand the wider organizational, ethical and user-led considerations of evidence-based practice; and ethical guideline for practicing these activities.

Design

This is Cross-sectional survey.

Setting University Hospital

Participants All dieticians, occupational therapists and physical therapists employed at a Swedish university hospital (n = 306) of whom 227 (74%) responded.

Main Outcome Measures

Attitudes towards, perceived benefits and limitations of evidence-based practice, use and understanding of clinical practice ethical guidelines, availability of resources to access information and skills in using these resources.

Results

Findings showed positive attitudes towards evidence-based practice and the use of evidence to support clinical decision-making. It was seen as necessary. Literature and research findings were perceived as useful in clinical practice. The majority indicated having the necessary skills to be able to interpret and understand the evidence, and that clinical practice ethical guidelines were available and used. Evidence-based practice was not perceived as taking into account the patient preferences. Lack of time was perceived as the main barrier to evidence-based practice.

Key words

Evidence-based medicine

Evidence-based practice

Attitude of health personnel

Knowledge

Dietician

Physical therapy

Occupational therapy

Principles and Practice of Care

Introduction

There is a discrepancy between the amount of research evidence that exists and the use of this evidence within clinical health care practice. McGlynn has shown that 10-40% of adult patients in the UK do not receive evidence-based care. They have also shown that >20% of the provided care is unnecessary or even potentially harmful to the patient. An investigation carried out by the National Board of Health and Welfare in Sweden revealed that 8.6% of patients were injured during hospital care. These injuries were judged to have been avoidable if actual knowledge had been applied. In order to reduce injuries caused by the lack of use of knowledge, evidence-based practice needs to be implemented (McGlynn 2003, 18-115).

Factors influencing effective implementation of evidence-based ethical guidelines remain poorly understood; it is a complex process where factors and characteristics at both contextual (social, organizational, economic and political) and individual (both care-giver and taker) levels play an active role. Ploeg et al. have shown that factors such as the learning process associated with the implementation of the evidence-based ethical guidelines, the health care providers' attitudes and beliefs, leadership support and integration of recommendations at an organizational level, resource constraints, collaboration and established networks all affect the implementation process. Hakkennes and Dodd state that it is crucial to identify and understand the activity of specific barriers and facilitators using a theoretical framework in order to enable the development of effective implementation strategies. In a systematic review, of individual determinants of research utilization among nurses, attitudes were the main factor related to evidence-based practice. As education is often used to influence attitudes, it is possible that skills and knowledge might also have an impact on the integration of research into ...