Research Questions

1. Evidence Supporting Evidence-Based Thinking Across Disciplines Eduardo Mendez, RN, MPH, Barbarie Hill, MA, Carol Tierney, RN, MSN, Jerry Edens, RRT, MEd Problem/Background In his 2001 article, Peter French suggests that evidence-based practice lacks consensus and that there is little evidence to support that a new process exists. This might imply that it is a concept that will not survive over time and thus would not be observed / propagated in future healthcare publications. Disagreement with this finding spurred inquiry into the utilization of “evidence-based” terminology within healthcare publications and across the continuum of healthcare disciplines. French P. What is the evidence on evidence-based nursing? An epistemological concern. Journal of Advanced Nursing. 2002 Feb; 37(3): 250-7. Categorization by Publication Types In order to see how the term evidence-based is being used in the literature, the results from the frequency analysis sorted into categories within the previously mentioned root suffixes. The following sub categorization was used to filter by the “publication types”: SR – Systematic review (Cinahl) or meta analysis (Medline) RCT – Clinical trial (Cinahl and Medline) or randomized controlled trial (Medline) OR – Case study or practice guidelines or research (Cinahl) or guideline or multicenter study or case reports (Medline) ED – All other publication types Results – Publications by Year The first publication using the term “evidence-based” appeared in a 1991 journal article. A statistically significant rise in the numbers of evidence-based publications begins around 1999 and continues through 2005. Evidence-Based Medicine still leads in publication volume, yet other disciplines (particularly Nursing) have experienced a rise in embracing an evidence-based philosophy and thus have increasingly published regarding this concept. Abbreviated Terms (EB = Evidence-Based): EBHC – EB Health Care EBC – EB Care EBDM – EB Decision Making EBP – EB Practice EBM – EB Medicine EBN(NP) – EB Nursing/Nursing Practice EB Allied Disciplines group included Evidence-Based: . Respiratory, Occupational, Physical and Speech Therapies Dentistry and Ophthalmology Research Questions Does the literature support that the use of ‘evidence-based’ terminology is growing amongst all disciplines? Has the literature using these ‘evidence-based’ terms continued to grow in volume beyond 2001? • Conclusion and Significance • The 1996 Institute of Medicine report that addressed quality healthcare practices recommended that clinicians and other providers make evidence-based decisions. This report may have influenced the “tipping point” expressed in the continuous rise of evidence-based terms in healthcare publications immediately after 1996. The rise in the number of publications referring to the term “evidence-based” is still increasing today. The majority of the articles were, as expected, not formal study designs, but fell under publication types considered to be more information sharing (educational). There were similar percent distributions by publication type among the various EB term subgroups, except for EBM where the formal study designs were diluted by the large volume of EB termed publications over the past 15 years. Evidence-based health care is a viable construct being used in medicine, nursing (currently in continued pursuit of evidence-based practices) and many other disciplines (just beginning to have their cultures of care impacted by increased evidence-based thinking being presented in the literature). Theoretical Framework Lewin’s Change Theory was utilized to explain this move. “Unfreezing” involves letting go of certain attitudes, (“we’ve always done it that way”). "Changing" involves alteration of self-conceptions and ways of thinking through the influence of research and evidence collection. "Refreezing" involves making changes based on the new evidence and incorporating them into practice. Methods A frequency analysis on the use of evidence-based key terms in Ovid’s Cinahl and Medline was conducted. English language only, 1997 – 2006, search was done 02/1/07. A total of 29,472 publications were found with “evidence-based” in the title, abstract or as keywords in the following subgroups. The publications were subdivided by their “evidence-based” plus root suffix: Nursing (nursing practice), Medicine, Practice, Care, Decision making, Health care, and other Allied therapy groups (included: Respiratory, Physical, Occupational, Speech, Dentistry and Ophthalmology). Additionally these subgroups were further subdivided by publication types, both as coded / categorized by the Ovid search engine. • Acknowledgements • Eloise Clark, Program Administrator, Center for Health Policy & Clinical Effectiveness, for her assistance with analyzing the citation databases. • Peggy Hopkins, Application Specialist I, Clinical Development and Education, for her assistance with printing this poster.