EBN - F AR EASTERN UNIVERSITY Institute of Nursing EVIDENCE...

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FAR EASTERN UNIVERSITY Institute of Nursing EVIDENCE BASED NURSING
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Submitted by: IGAT, RYDAL R. BSN034 I. Clinical Question How do primary care practitioners (general practitioners and practice nurse s ) use evidence in their day to day decisions about patient management? II. Citation “Primary Care Practitioners Based Everyday Practice on Internalized Tacit Guidelines Derived Through Social Interactions with Trusted Colleagues” Gabbay J, le May A. Evidence based guidelines or collectively constructed “mindlines?” III. Study Characteristics The participants on the study were 9 physicians, 3 nurses, a phlebotomist, and associated administrative staff from the Lawndale practice. Observations and interviews were either tape recorded or recorded in field notes. Thematic analysis led to derivation of a theoretical model of the ways in which evidence and information became built into clinical or policy decisions. The model’s transferability and credibility were assessed using data collected from observations and interviews held at the Urbchester practice. The study focuses on a significant problem in clinical practice to help them understand and be able to apply their chosen decisions on the client’s early improvement. The study is relevant to practice in clinical settings where nurses can empower their clients when setting mutually agreed upon goals towards patient management. IV. Methodology/Design In the Lawndale practice, data were collected on use of information in clinician-patient interactions in 10 GP surgeries, 4 nurse clinics, 9 practice meetings, and various other meetings using non-participant observation, semistructured formal and informal interviews, and documentary review of guidelines or practice protocols. Observations and interviews were either tape recorded or recorded in field notes. The design used in the study was Ethnographic study. The setting was a rural teaching practice (“Lawndale”) and a university based inner city practice (“Urbchester”) in the UK. A theoretical model was derived to illustrate the ways in which evidence and information became built into clinical or policy decisions. The authors observed that individual clinicians did not go
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through the steps usually associated with a “linear-rational” model of evidence-based health care (EBHC). None of the GPS were observed to use easily accessible expert systems or the internet to solve clinical problems in real time. V. Results of the Study Use of guidelines . The authors observed that individual clinicians did not go through the steps usually associated with a “linear-rational” model of evidence-based health care (EBHC). Nurses used guidelines when they encountered unfamiliar problems; however, once familiar with
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This note was uploaded on 07/27/2011 for the course NURSING N219.6 taught by Professor Dr.tuazon during the Spring '09 term at University of the Philippines Los Baños.

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EBN - F AR EASTERN UNIVERSITY Institute of Nursing EVIDENCE...

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