Evidence Based Health Care

Running Head: EVIDENCE BASED HEALTH CARE 1
Evidence Based Health Care
Name of Student
Institutional Affiliation

EVIDENCE BASED HEALTH CARE 2
Table of Contents
Part A...................................................................................................................................3
Evidence Based Practice......................................................................................................3
The use of research in clinical practice is faced with several barriers (Scurlo
References....................................................................................................................................6
Part B.................................................................................................................................10
Identification of Evidence..............................................................................................10
Clinical Question and Literature Search........................................................................10
PICO Question...........................................................................................................10
PICO Table................................................................................................................10
Conducting Search.....................................................................................................10
Literature Used; Google Scholar...................................................................................10
PICO Components From; Mortality after Distal Femur Fractures in Elderly
Patients. Clinical Orthopaedics and Related Research.........................................................16
References..........................................................................................................................17

EVIDENCE BASED HEALTH CARE 3
Part A
Evidence Based Practice
Evidence based practice (EBP) is a meticulous, unequivocal and shrewd use of the best
present evidence while performing important decision making for a patient (Khammarnia, Haj
Mohammadi, Amani, Rezaeian & Setoodehzadeh, 2015). Personal clinical expertise is
incorporated together with the finest outer medical evidence from methodical research (Budd,
Hough, Wegener & Stiers, 2017; Schaffer, Sandau & Diedrick, 2012). Patient values, personal
preferences, concerns as well as expectations form part of the decision making process when
identifying the best care for a patient (Joseph-Williams, Elwyn & Edwards, 2014). Quality life
and ideal clinical results come as a result of the integration of the above mentioned aspects
(Duke University Medical Center1, 2018).
The specific component, however, that triggers the whole practice of EBP is encounters
of the patient (Duke University Medical Center1, 2018). These patient experiences generate
questions concerning the effects of treatment, efficacy of diagnostic examinations, the prediction
of diseases and the causes of disorders. EBP has its requirements as the clinician’s new skills,
effective and ability to research competently, and even applying official rules in the evaluation of
clinical literature.
EBP follows some clear steps, strategies and processes. This, like all other practices is
bound to challenges that are barriers or challenges to implementing. This study is going to
expound on all these aspects to form a rational discussion.
There are two fundamental principles assumed by EBP. The first one is that scientific evidence
alone cannot inform competent decision making in clinical care (Rice, 2011). This means that

EVIDENCE BASED HEALTH CARE 4
scientific evidence is only a constituent of the decision making practice and cannot take the role
of the other steps. EBP involves integration of the finest scientific evidence together with best
relevant knowledge and judgment, values and principles held by the patient, and the
circumstances of the patient condition as at the time for clinical examination (Murphy,
MacCarthy, McAllister & Gilbert, 2014).
The second major principle of EBP is that there exist hierarchies that direct how
decisions are to be made within each formula of evidence. This means the processes of EBP are
guided by specific rules on how to interpret the evidence available. This principle particularly
addresses EBP as a wholesome process involving decision makers in healthcare settings
collecting and critically evaluating evidence in guiding decisions. This principle is against the
traditional model of decision making whereby healthcare relied on intuition and information
from superiors’ commands (Murphy, et al., 2014).
In order to put the aforementioned principles of evidence based practice a set of skills/
steps has to be followed. These skills are in components such as developing researchable
question, developing and implementing the best search strategy, critically assessing internal and
external evidence, integrating various evidently sources and finally evaluating outcomes
(Murphy, et al., 2014).
The identification of the problem question is enhanced by an accurate assessment and
competent specialized knowledge and practice (Duke University Medical Center2, 2018;
Murphy, et al., 2014). It is advisable to start with the patient because a clinical question starts or
arises from the care of a patient. The assessment here is patient-focused and it involves focusing
on self-motivated and static risk factors. Here the actuarial risks/ needs of a patient are assessed.