Från evidens till bättre praxis : tillämpning av evidens

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Från evidens till bättre praxis : tillämpning av evidens

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Publication Article, peer reviewed scientific
Title Från evidens till bättre praxis : tillämpning av evidens
Author(s) Rohlin, Madeleine ; Knutsson, Kerstin ; Levi, Ragnar
Date 2005
English abstract
Is it reasonable to disregard effective methods or to use methods that result in more harm than benefits for the patients and their health? The answer is of course no! However, effective methods do not auto¬matically win out over alternatives, which might be ineffective or unproven. Surveys of practice show gaps between the evidence of what clinicians should be doing, and what is actually being done. How should these gaps be dealt with? To date, no single strategy is available. Diffe¬rent approaches to changing clinical practice are used and most are more based on belief rather than scientific evidence. Evidence relating to the implementation of changes in health care demonstrates that changing practice seldom entails a single action. Good plan¬ning is usually demanded, which requires a multi-fa¬ceted approach with different interventions at differ¬rent organisational levels. Evidence also emphasises the importance of developing good understanding of the barriers to change. Thus, approaches to changing to best practice should be evidence-based. To illustrate the complexity of achieving changes in health care, the case of hand hygiene is cited from a review article [7]. Despite well-established evidence on the benefits of hand washing, compli¬ance by health-care workers is known to be poor. From the literature on changing clinical practice, we present some obstacles and strategies on how to improve hand hygiene in patient care. An example on notation of periodontal status in the patient record is also presented.
Swedish abstract
Om vården ska göra största möjliga nytta måste bästa tillgängliga vetenskapliga kunskap – evidens – tillämpas systematiskt. Ineffektiva kliniska rutiner måste förändras och bevisat effektiva behandlingar spridas. Men forskningen ger inget enkelt svar på hur sådana förändringar ska åstadkommas. Studier av praxispåverkan visar dels att åtgärder som syftar till att förändra praxis bör skräddarsys efter budskap, målgrupp och nuläge, dels att enskilda insatser oftast endast har liten eller måttlig effekt. En effektiv praxispåverkan kräver ofta ett paket av samordnade åtgärder som är anpassade till sammanhanget. Dessutom krävs en strategi för att hantera tänkbara hinder för en evidensbaserad tandvård.
Link http://www.tandlakartidningen.se/media/1620/Rohlin2_6_2005.pdf (external link to publication)
Host/Issue Tandläkartidningen;6
Volume 97
ISSN 0039-6982
Pages 58-63
Language swe (iso)
Subject(s) Medicine
Research Subject Categories::MEDICINE
Handle http://hdl.handle.net/2043/3691 (link to this page)

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