The method Evidence based only-sing

The method Evidence based only-sing covers a systematic procedure and can as a procedural instruction with six individual steps be represented. In addition belong:

• Order clarifying
• Question
• Literature search
• Critical evaluation
• Implementation and adaptation
• Evaluation

Originally in the literature only five steps were described (see Sackett et al., 2000, S.3) - to the achievement of results as in line with standard usage with the application of the smoothing method as possible these five steps were however such modified that as the first step the definition of setting of tasks added and that the step of the implementation was supplemented around the question of the adaptation.

Abb.3 of steps of the method Evidence based only-sing

1. Step: Order clarifying

The first step of the smoothing method covers an argument with the task of the care. Straight ones in occupations, which - like the care - work interdisciplinary, must be defined contents and responsibilities, in order to define the scopes of responsibility of the individual members of the therapeutic team from each other. A classical example for this is the blood withdrawal, with which it concerns an original task of the physicians, which is delegated however frequently to maintaining.

The considerations to the order clarifying require different efforts: Thus it will give cases, in which the order clarifying is clear and clear and only few considerations required; likewise the order clarifying can be complex and overlap with other occupations and their interests. In these cases the argument and accurate definition are particularly important.

2. Step: Question

The second step of the methodical procedure requires the formulation (beantwortbaren) of a question, which results from a certain care problem or from a certain interest; the relevance of this question is here justified by the before defined setting of tasks for the care.

For the achievement of precise a results as possible the formulation of a concrete question is on the one hand inevitable, on the other hand one it is to be noted that the obligation saves to put a clearly beantwortbare question to reason the danger to miss the actual interest of the investigation or the raised problem.

It is nevertheless crucial to define considering the concrete individual case a beantwortbare question which is so far limited that in need of care ones concerned in its environment, appropriate intervention as well as the comparison intervention and the result measure if necessary are certain which.

A suitable question could therefore read for example as follows: "Can the occurrence of a pneumonia be by a belly storage compared with a back storage with artificially respirated patients"

If one would like its member after feeling in need of care ones, or after certain situations, in which maintaining are stressed, ask, require this questions, which can be answered only by interpretive studies. Also here the person's group concerned and the concrete situation are to be specified exactly.

Questions can be seized far or closely - from it results, how extensively and/or how a search inquiry is specifically formulated and finally which search result is obtained.

3. Step: Literature search

The subject of the third step of the smoothing method, the literature search, is the search for research work, which is suitable to answer the question formulated before.

In order to obtain as productive and nevertheless sufficiently specific a search result as possible, it is necessary to extract from the appropriate question of search words as well as in and exclusion criteria. In the context of the literature search can be fallen back in principle to all sources of the literature and research - the final selection is made then by quality criteria.

Due to its topicality, its easy accesibility and its extent the search in on-line data bases of the search in libraries or hand search in magazines is to be preferred. Via Internet one keeps entrance to relevant data bases for the care, over on-line document delivery services fast can the desired articles directly following the search be ordered.

4. Step: Critical evaluation

The fourth step of the smoothing method argues with the quality of the available research work, because it would be to assume publications were by SE of good quality and could to the practice be unconditionally transferred.

The quality of a study can be estimated in different way; a possibility is it to evaluate orders of rank of different research Designs another possibility is, the reliability, to judge force of expression and applicability of a study on the basis pre-defined criteria. This evaluation requires methodical knowledge of qualitative as well as quantitative research Designs, because only so the studies can be judged critically and the danger of a systematic distortion bias be estimated.

Apart from the absolutely necessary methodical evaluation it is just as important to evaluate the applicability of the research results in care practice. According to the initially formulated question, as well as in the context of the pflegerischen task posed it is to be decided whether the study results will transfer to the own concrete care situation can and whether basic conditions as well as necessary resources an implementation to make possible.

5. Step: Implementation and adaptation

In a fifth step the scientific vouchers in care practice are converted. This can take place to the one via the implementation of the research realizations into the care everyday life via the change from care interventions, on the other hand one an adaptation of the institutional structures or processes can become necessary.

The range of the necessary changes results from the concrete question and in the context of the critical evaluation the won scientific realizations. The appropriate measures can be enough and require therefore of the conversion of individual care actions up to the reorganisation of the care system in a mechanism accordingly different concepts and different expenditure, which is to be decided in each case in the special individual case individually.

6. Step: Evaluation

In the sixth step of the smoothing method - the evaluation - it is to be examined whether the conversion of the won realizations in care practice led to success. For this suitable methods of the evaluation are like for example the structure suggested by Donabedian (see 1982, P. 9) using process and result evaluation.

Because individual care actions are not only changed, but also whole organisational structures if necessary to be concerned can be evaluated, should consistently after pflegerischen setting of tasks and the range of the made change and generally be attached to the evaluation an important place.

In practice the expiration of the individual steps does not take place always as linear as here described. Dependent on the concretely obtained results individual steps must again be considered; thus for example a unsuccessful literature search leads back to the question, equally qualitatively or quantitatively bad search result requires a modified question or a renewed search. If a change was implemented and if no improvements could be registered with their evaluation, if necessary a new question or new studies must be taken up for reasons be searched and.

Sources

• Behrens, J. & long one, G. (2004): Evidence based only-sing. Confidence-building disenchantment of the "science". "Qualitative ones" and "quantitative" methods with daily care decisions. Berne: Hans Huber
• Donabedian, A. (1982): Exploration in quality Assessment and monitoring. Ann Arbor, Michigan: Health administration press
• Sackett, D.L. ; Straus, His Excellency, Richardson, W.S., rose mountain, W. & Haynes, R.B. (2000): Evidence Based Medicine (Second OD.). London: Chirchill Livingstone
• G. (2000): Evicence based only-sing. Care, 13 (1), 47-53

See also

Was based medicine

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