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Evidence Based Practice (EBP)

Evidence Based Practice (EBP). For Physical Therapists. Lecture-Topics. Clinical Practice Guidelines Evaluation of the CPGs Algorithms. Clinical Practice Guidelines.

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Evidence Based Practice (EBP)

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  1. Evidence Based Practice (EBP) For Physical Therapists

  2. Lecture-Topics • Clinical Practice Guidelines • Evaluation of the CPGs • Algorithms

  3. Clinical Practice Guidelines • The Institute of Medicine defines CPGs as “systematically developed statements that assist practitioner and patient decisions about appropriate health care for specific clinical circumstances". Field & Lohr,1992;Candian Medical Association,1994) • Guidelines may be based on expert opinion/Consensus and/or evidence based practice as identified by research and may be regional,facility-wide,program based, unit specific, or based on case types.

  4. Need for CPGs • CPGs offer recommendations for care and are prescriptive in nature, helping the practitioner determine the appropriateness of selected interventions. • Official statement or policies for proper care . • CPGs could be EBP based or none EBP based. • CPGs may be referred to as practice parameters, practice policies and appropriateness criteria.

  5. CPG for Radiography of the Ankle and Foot. (Ottawa Ankle Rule ) Ankle X-ray series is required only if there is pain in the malleolar Zone and any one of the following: • Bone tenderness along the distal 6cm of the posterior edge of the fibula or tip of the lateral malleolus. • Bone tenderness along the distal 6cm of the posterior edge of the tibia or tip of the medial malleolus. • Inability to bear weight for four steps, both immediately and in the emergency department.

  6. Evaluation of the CPGs • Step1;Conduct systematic search for practice guidelines. • Step 2;Select a validated guideline appraisal instrument. • Step 3 ;Assess quality of how guidelines were developed and quality of recommendations. • Steps 4;Assess clinical Content. • Step 5; Develop local protocol based on adaptation and adoption of existing guideline recommendations • Step 6;Return to step 1 for continual review and revision of guideline.

  7. Algorithms • Algorithms are “Written guidelines to stepwise evaluation and management strategies that require observations to be made, decisions to be considered, and actions to be taken”.(Hadorn,McCormick,&Diokno,1992) • Algorithms are simply CPGs arranged in a decision-tree format.

  8. Example

  9. Algorithms Algorithm= Logic + control

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